Geriatric interdisciplinary team care has been shown to be essential to manage the complex syndromes experienced by frail older adults. Providing comprehensive care to geriatric patients with multiple illnesses, disabilities, increased social problems, and fragmented care requires skills that no one individual possesses. Older adults are, therefore, best cared for by a team of health professionals. Outcomes associated with effective geriatric interdisciplinary team care include the improvement of functional status, perceived well-being, mental status, and depression. Geriatric interdisciplinary team care has also been shown to be cost effective by reducing patient readmission rates and numbers of physician office visits. Specialized interdisciplinary teams focusing on specific diseases such as congestive heart failure, stroke, or myocardial infarction have also demonstrated improved patient outcomes. The purpose of this chapter is to outline the benefits of interdisciplinary geriatric team care. The current and projected health care workforce shortage, coupled with the aging of the population dictate that care models be as efficient and effective as possible. Managing the complex syndromes experienced by frail older adults requires skills beyond the training of one discipline and multiple clinicians to communicate with each other regularly in order to coordinate services. These needs have resulted in the growth of geriatric interdisciplinary teams.
In 1993, the Pew Health Professions Commission predicted that health professionals would need 17 competencies to practice health care in 2005. Anticipating a shift toward population-based medicine, increasing use of technology, and managed care, the competencies included an emphasis on primary care, participation in coordinated care, involvement of patients and families in decision making, and ensuring cost effectiveness. While regulators and policy makers, almost a decade later, seem less enthralled with managed care, the forces driving managed care-increasing costs, concerns about cost effectiveness, and a focus on prevention have not slowed.
The Joint Commission on Accreditation of Healthcare Organizations stated that shared decision making and an interdisciplinary health care team approach are essential to reduce medical errors and to provide improved patient safety in all health care organizations in America. The Institute of Medicine of the National Academies made a similar plea in the Quality Chasm report, strongly urging that all health professionals receive interdisciplinary team training to ensure the delivery of patient-centered care. More recently, additional reports from the Institute of Medicine of the National Academies specifically point to the need for interdisciplinary care for geriatric patients.
In 1995, The American Geriatrics Society developed a position statement on interdisciplinary care for older adults, which supports the interdisciplinary care model for the following reasons:
Interdisciplinary care meets the complex needs of older adults with multiple, interacting comorbidities.
Interdisciplinary care improves health care processes and outcomes for geriatric syndromes.
Interdisciplinary care benefits the health care system as well as caregivers of older adults.
Interdisciplinary training and education effectively prepares providers to care for older adults.
Studies of the clinical effectiveness and cost effectiveness of teams generally demonstrate that patients ...