Interdisciplinary care plans: Teamwork makes the dream work

As provider attitudes and patient expectations have shifted toward more patient-centric care models, many healthcare organizations have adopted an interdisciplinary approach to planning and assessing care. In facilities across the country, interdisciplinary care plans are created using input from multiple disciplines, including physicians, nurses, pharmacists, case managers, and others.  In many cases, care plans are created and updated during rounds, either at the bedside or in a centralized location like the nurse’s station.

Research shows that interdisciplinary care plans are beneficial not only for each patient, but also for healthcare team members included in planning care. But this practice isn’t without its challenges. Overcoming these difficulties takes commitment and focus on improving the patient care experience as much as possible.

Interdisciplinary care plans provide measurable benefits

At their core, interdisciplinary care plans are detailed plans of care created by representatives from several medical disciplines or specialties, each focused on a specific patient’s condition, treatment goals, and methods for improving outcomes. As part of the care planning process, input from each provider must be taken into consideration and weighed against the benefits and risks to the patient.

In many healthcare facilities, interdisciplinary rounds are an essential part of patient care planning. This highly structured, multidisciplinary process occurs either at the patient bedside or in a location that can accommodate representatives from the entire care team. This type of care planning increases communication effectiveness among healthcare staff, building a sense of collaboration and teamwork and crystalizing the overall picture of care that each patient needs.

Beyond benefits to hospital staff, the advantages an interdisciplinary care plan provides to patients are significant.  Increased collaboration among healthcare providers, especially between physicians and nurses, helps patients who have interdisciplinary care plans by:

• Decreasing the overall length of stay, regardless of diagnosis
• Lowering rates of hospital-acquired conditions unrelated to the original diagnosis
• Reducing healthcare-related expenditures

Additionally, these types of care plans have been shown to decrease overall mortality, lessen the amount of time Foley catheters are in place, and promote faster discontinuation of central lines.

Challenges to creating effective interdisciplinary care plans

Even though the benefits of interdisciplinary care plans are clear and measurable, certain obstacles can still prevent this type of care planning from being as effective as possible.

Time management

Unstructured team meetings, either at the bedside or not, can severely hamper a team’s ability to create a care plan that maximizes patient outcomes. To be successful, interdisciplinary care plans must be created during meetings that occur at the same time and in the same place every day. Representatives from each discipline must be present in order to offer opinions and provide advice to other caregivers.

Communication skills

It’s important to keep in mind that each team member has their own unique set of skills and treatment goals for each patient based on varying degrees of education and experience. Interpersonal differences or variations in level of expertise can make it easy for one member of the group to try to override other members. If necessary, formal training in effective communication techniques that enhance interdisciplinary collaboration should be provided to all team members, regardless of their position within your organization.

Clear responsibilities

Successful implementation of interdisciplinary care plans requires clear definition of each provider’s responsibilities, respect among the group, and transparency among providers sharing information about a specific patient. It can be helpful to select a leader, like a clinical team facilitator, to help make multidisciplinary discussions productive.

Leaders help bring more structure to care planning meetings by identifying goals for the discussion, encouraging participation from each team member, and probing for more information about the patient when necessary. Defining the objectives of interdisciplinary meetings, along with specific patient goals and intended outcomes, is essential for creating a plan of care that meets the needs of the patient while incorporating feedback from the entire multidisciplinary team.