Multidisciplinary team care is a key feature of the HealthOne NSW
service model of care. Care is provided by general practitioners and community health and other health and community care professionals.
The following definition outlines the objectives as well as some of the challenges involved in the provision of multidisciplinary team care:
Multidisciplinary care - when professionals from a range of disciplines work together to deliver comprehensive care that addresses as many of the patient's needs as possible. This can be delivered by a range of professionals functioning as a team under one organisational umbrella or by professionals from a range of organisations, including private practice, brought together as a unique team. As a patient's condition changes over time, the composition of the team may change to reflect the changing clinical and psychosocial needs of the patient.
Mitchell G.K., Tieman, J.J., and Shelby-James T.M. (2008), Multidisciplinary care planning and teamwork in primary care, Medical Journal of Australia, Vol. 188, No. 8, p.S63.
A HealthOne NSW multidisciplinary team
A multidisciplinary team involves a range of health professionals, from one or more organisations, working together to deliver comprehensive patient care. The ideal multidisciplinary team for the delivery of the HealthOne NSW model of care includes:
community health nurses;
allied health professionals (may be a mix of government and non-government community health professionals) such as physiotherapists, occupational therapists, dieticians, psychologists, social workers, podiatrists and Aboriginal Health Workers;
health educators - such as diabetes educators - providing promotion and prevention clinics and other activities.
Multidisciplinary teams convey many benefits to both the patients and the health professionals working on the team. These include improved health outcomes and enhanced satisfaction for clients, and the more efficient use of resources and enhanced job satisfaction for team members.
To ensure optimum functioning of the team and effective patient outcomes, the roles of the multidisciplinary team members in care planning and delivery must be clearly negotiated and defined.
respect and trust between team members;
the best use of the skill mix within the team;
agreed clinical governance structures;
agreed systems and protocols for communication and interaction between team members.
These issues are complex and achievement of them can involve significant change to work practices and organisational arrangements, as well as multifaceted implementation strategies.