PHYSIOTHERAPIST&

HOSPITAL STAFFRELATIONSHIP

Dr. Shrikant S. Sant.(PT)

Asst. Professor

Community Physiotherapy

Padm. Dr. D. Y. Patil College of Physiotherapy, Pimpri, Pune-18.

IntroductionIPE When students from two or more professions

learn about, from and with each other to enable effective collaboration and improve health outcomes (WHO, 2010)

IPC When multiple health workers from different professional backgrounds work together with patients, families, careers, and communities to deliver the highest quality of care (WHO, 2010)

Core Competencies: Four Domains

Work in IP Teams

Core Competencies

TeamworkProcesses

Roles/Responsibilities

Values/Ethics

Communication

VALUES/ETHICSOverall Competency

Work with individuals of other professions

to maintain a climate of mutual respect

and shared values

VALUES/ETHICS Example competencies

• Place the interests of patients and populations at the center of IP health care delivery

• Respect the unique cultures, values, roles/responsibilities and expertise of other health professions

ROLES & RESPONSIBILITIESOverall Competency

Use the knowledge of one’s own role

and those of other professions

to appropriately assess and address

the health care needs of the patients

and populations served

ROLES & RESPONSIBILITIESExample Competencies

• Recognize one’s limitations in skills, knowledge and abilities

• Engage diverse health care professionals who complement one’s own professional expertise, as well as associated resources, to develop strategies to meet specific patient care needs

INTERPROFESSIONAL COMMUNICATION

Overall Competency

Communicate with patients, families, communities and other health

professionals

in a responsive and responsible manner

that supports a team approach

to the maintenance of health

and treatment of disease

INTERPROFESSIONAL COMMUNICATION

Example Competencies

• Organize and communicate information with patients, families and health care team members in a form that is understandable, avoiding discipline-specific terminology when possible

• Give timely, sensitive, instructive feedback to others about their performance on the team, and respond respectfully as a team member to feedback from others

INTERPROFESSIONAL TEAMWORK &

TEAM-BASED CARE Overall Competency

Apply relationship-building values

and the principles of team dynamics

to perform effectively in different team roles

to plan and deliver patient/population-centered care that is safe, timely,

efficient, effective, and equitable

INTERPROFESSIONAL TEAMWORK & TEAM-BASED CARE

Example Competencies

• Integrate the knowledge and experience of other professions-appropriate to the specific care situation-to inform care decisions, while respecting patient and community values and priorities/preferences for care

• Use process improvement strategies to increase effectiveness of Interprofessional teamwork and team-based care

Why bother?• “Good communication is the

glue holding society together. It is the beacon that guides our life journey. It is the mirror that gives us a quick glimpse of who we are in the eyes of others. It is the vehicle we use to achieve outcomes…”

(Koerner, J. & Huber, D.L., 2006, p 427)

BASIC BARRIERES

Not knowing how things work/not having the

knowledge/skill Get the job done

Inability to prioritise, conflicting priorities

Too much to do Communication

Newness

Gaining confidence

Fear of appearing incompetent

Inter/intra professional support

Personal, Interprofessional & professional identities

Knowledge

+

Barriers to teamwork: Though we practice together until recently we

trained apart (from Cleary & Howell, 2003)

Staff-Physician Flashpoints

• Recurring staff-physician frustrations• Inhibits proactive problem solving and relationship

improvement efforts. • Collaboration is impossible.

Events that signal tension in the staff-physician relationship

Resolving Flashpoints

Putting Our House in Order“The physicians will never see us as good practitioners if we can’t manage our own practice… Our responsibility is to get

our act together, and then we’ll expect the physicians to respond.”

Donna Davidson, RN, MSN

Boswell Hospital

Flashpoints: Events that signal tension in the staff-physician relationship.

Physio complains that she can’t find MD notes in

chart.

Physician complains when case cancelled

due to equipment unavailability.

Physio irritated when receives

conflicting orders from 2 physicians

Physician aggravated when delayed by

pending Rx results

Physio upset when physician unresponsive to

page

Physician frustrated with staff’s inability

to operate new equipment

Good Reads…

“Finding out what you are doing wrong, what you don’t see, what you haven’t figured out yet is the first step toward innovation and improvement. Mined properly, conflict is a source of creativity. Without conflict there is no need to innovate or to develop. “

Annette Simmons

“A Safe Place for Dangerous Truths”

We’re in this Together!

Interprofessional collaboration: Definitions

”The term ´interprofessional collaboration´ is the key term that refers to interaction between the

professionals involved, albeit from different backrounds, but who have the same joint goals in

working together.” (Leathard, 2003)

”The term collaboration conveys the idea of sharing and implies collective action oriented toward a

common goal, in a spirit of harmony and trust.” (D´Amour et al. 2005)

Different facets of sharing• Shared responsibilities

• Shared decision-making• Shared healt care philosophy• Shared data• Shared planning and intervention• Shared professional perspectives

History of Teamwork in Health Care Dynamic Multi-Professional Team

from a cadre of professionals

Physician

Nutrition

Psychology

Physio

Nurse Social Work

SLP

OT

Pharmacy

Dentist Recreation

Interprofessional collaboration:remember your own color and mix it with

other

But in worsiest case, it looks odd

But in best way it gives possibilities for clients and professionals

Collaborative Skills for Teamwork

• Cooperation• Assertiveness• Responsibility• Communication• Autonomy• Coordination

Aspects of Communication

• Spoken words = 7% of communication interpretation• Non-verbal = 93%

vocal quality, facial expressions, body language

• Listening for understanding and connectionFind common goals (mutual purpose) to help

understand where physician is coming from

Leadership Skills for staff to bring to Interactions

• Self awareness• How my mood affects interactions

• Self management• Keep from transferring my negative mood to others

• Social Awareness• Be sensitive to the emotions and moods of others

• Relationship Management• Disarm conflict and develop emotional maturity as team

leaders (crucial conversations training to come)

Human Relation Skills (“People Skills”)

Remember names Refer to people by name when

interacting Remember information about people Be positive Be complimentary

Interpersonal ConflictsMinimizing and Resolving Conflicts

The right time and placeAllow adequate response time Do not dismiss or discount others Time out or cease fire Make points assertively Focus on specific behavior (use “I” messages)Focus on problem solving, not winning End discussions on a constructive note Express appreciation Refer to a higher authority

PHYSIOTHERAPIST• As we are aware WHO has already classified Physiotherapy

as a separate , independent profession and not as paramedic. • International Standard Classification of Occupations Code

(ISCO) for Physiotherapy is 2264.• Physiotherapists are considered associate professionals to

treat disorders of bone, muscles and part of the circulatory or nervous system by manipulative methods, ultrasound, heating, laser or similar techniques, or apply physiotherapy and related therapies as a part of the treatment for the physically disabled, mentally ill or unbalanced. (www.ilo.org/public/english/bureau/stat/isco/iscco88/3226.html)

THANK YOU