Nationally and worldwide, interprofessional teamwork is increasingly recognized as a means to address the challenges of the current health care system. Patients with complex problems and diverse needs require the expertise and collaboration of different health professionals. In the United States, a series of landmark Institute of Medicine reports recommended interprofessional collaboration and training of all health care professionals in teamwork as a key mechanism to increase health care safety and quality. Additional factors driving the need for effective teamwork include patient expectations; a primary care workforce shortage; a renewed focus on creating health care systems that demonstrate efficiency, lower cost, and improved outcomes; and national policy changes that incentivize the creation of interprofessional collaborative models. For example, the passage of the Patient Protection and Affordable Care Act (ACA) has led to the development of accountable care organizations with a focus on improving population health through interprofessional teamwork.
Older adults, with their increased prevalence of multiple chronic conditions, functional decline, geriatric syndromes, and terminal illness, are high utilizers of the health care system and its teams. The American Geriatrics Society has developed two position statements that underscore the benefits of interprofessional team care for older adults, and endorses interprofessional team training for all professions. This chapter defines the multiple types of interprofessional work in health care, describes practice-based interprofessional geriatrics innovations in the United States, reviews the evidence for interprofessional collaboration in the care of older adults, provides resources for building interprofessional skills and teams, and discusses barriers and future steps to improve interprofessional teamwork in geriatrics.
et al. Interdisciplinary care for older adults with complex needs: American Geriatrics Society position statement. J Am Geriatr Soc
Partnership for Health in Aging Workgroup on Interdisciplinary Team Training. Position Statement on interdisciplinary team training in geriatrics: an essential component of quality healthcare for older adults. J Am Geriatr Soc
KEY DEFINITIONS AND CONCEPTS
The teamwork literature consists of a wide array of terms, often used interchangeably, to describe this phenomenon, including interdisciplinary, multidisciplinary, and interprofessional. In addition to this terminology uncertainty, different authors describing “teams” and “teamwork” often employ very different conceptualizations related to team composition, function, and outcome. A first distinction to clarify is discipline versus profession. “Discipline” refers to various fields of study, such as economics, anthropology, and medicine, whereas a “profession” typically refers to fields with licensing and/or regulatory requirements. Although the terms interdisciplinary and multidisciplinary have been prevalent for at least the past 40 years in US health care, including in geriatrics, scholars increasingly contend that applying these terms in a health care setting is conceptually incorrect, as the notion of “interprofessional” collaboration more accurately describes the various health care professionals who work together to deliver services. A second distinction to clarify is interprofessional versus intraprofessional. ...