5: The Interprofessional Team

Introduction

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 of different health professionals, ideally working together. A series of landmark Institute of Medicine reports recommended interprofessional teams and training of all health care workers 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; new models of team care that demonstrate efficiency, lower cost, and improved outcomes; and national policy changes that incentivize the creation of these models.

Older adults, with their high prevalence of 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 and supported 2 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, 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.

Key Definitions and Concepts

The teamwork literature consists of a wide array of terms, used interchangeably, to describe this phenomenon—from interdisciplinary, to multidisciplinary, to interprofessional. In addition to this terminologic uncertainty, different authors describing “interdisciplinary teamwork” often employ very differing conceptualizations related to team composition, function, and outcome. It is possible, however, to distinguish the different types of teamwork as follows: “interprofessional teamwork” involves different health care professionals who share a team identity, have clarity of roles, work in an interdependent and integrated fashion, and have a shared responsibility to solve problems and deliver services. This contrasts to “interdisciplinary teamwork,” which is seen as a collaborative activity undertaken by individuals from different disciplines, such as psychology, anthropology, economics, medicine, political science, and computer science. This, in turn, contrasts with “multidisciplinary teamwork,” which is regarded as an approach like interprofessional teamwork, but different in that the team members come from different academic disciplines (psychology, sociology, mathematics) rather than from different professions, such as medicine, nursing and social work. ...