Vocational Rehabilitation Teams Does the concept match the reality? - PowerPoint PPT Presentation

Vocational Rehabilitation Teams Does the concept match the reality?

Background • Presenter: Lisa McAulay Regional Manager and Occupational Therapist for Fit For Work • Masters Degree at AUT • My research is focused on how New Zealand teams compare to the international literature • Limited research in New Zealand based on Vocational Rehabilitation teams • Supervisors: Dr Joanna Fadyl Dr Gareth Terry • Acknowledgements: Fit For Work

How do you describe your team? • Interdisciplinary • Multidisciplinary • Uni-disciplinary • Transdisciplinary

Other things about your team? • Where does the client sit in your team? • Who is in your team? • All together in the same building, spread across different sites • Involved with different organisations • Who is the decision maker? • Does the team have shared goals? • Do professionals have defined roles?

Team Descriptions • Uni-disciplinary – a single professional or group of professionals of the same discipline working towards a healthcare goal. • Multidisciplinary – work to address the same barriers/problems but maintain their own profession specific roles and independent decision making for intervention • Interdisciplinary – profession specific roles remain but intervention goals are shared and created by the team. Team roles are often delegated and there can be role mergence across disciplines • Transdisciplinary – a group of professionals working towards a client centred goal, with evolving and changing roles and responsibilities dependent on client need. Sharing of skills and knowledge is common place to reduce role boundaries. (Cartmill, Soklaridis, & Cassidy, 2011; Brunarski, Shaw, & Doupe, 2008; Molineux, 2017).

Considering all of Considering all of Considering all of Considering all of these factors, is your these factors, is your these factors, is your these factors, is your team how you first team how you first team how you first team how you first described it? described it? described it? described it?

Interdisciplinary team Client Employer Health Professional Case Manager Insurance rep GP Specialist

The reality? Client Employer Case Manager Case Manager Referrer Health/VR Client Professional Health/VR GP Professional s Specialist Employer Referrer

Why does the concept Why does the concept Why does the concept Why does the concept not match reality? not match reality? not match reality? not match reality?

There are lots of barriers and enablers to effective team work Client factors Organisational factors Shared views Client involvement and ownership of RTW Team factors Shared ideas Models of practice Environmental factors Training Case management Scope of practice Leadership Compensation/Funding systems Expectations Communication Technology Timing

Organisational Factors: Barriers: 1. Top down approach 2. Working within regulations and policies and influence on practice 3. Funding 4. Inability to afford vocational rehabilitation (Désiron, Donceel, Godderis, Van Hoof, & Rijk, 2015; Hart et al., 2006; Shaw, Walker, & Hogue, 2008; Stubbs & Deaner, 2005; Ståhl, Svensson, Petersson, & Ekberg, 2009)

Organisational Factors Enablers: 1. Team feel supported by the organisation they work for 2. Team members are part of the same organisation 3. Even though different organisations involved team members are equal participants 4. Funding (Aust et al., 2015; Cartmill, Soklaridis, & Cassidy, 2011;Hart et al., 2006; Lytsy, Carlsson, & Anderzén, 2017)

Team Factors Barriers: 1. Hierarchical perceptions 2. Difficult to gain cooperation within RTW teams/Unwillingness to change viewpoint 3. Role conflict/unclear roles 4. High turnover of staff/difficulty in recruitment (contracted providers) (Aust et al., 2015;Brendbekken et al., 2017; Brunarski, Shaw, & Doupe, 2008; Cartmill, Soklaridis, & Cassidy, 2011; Loisel, Durand, Baril, Gervais, & Falardeau, 2005)

Team Factors: Enablers : 1. No one professional viewed as the ultimate expert 2. Commitment, trust, respect, support, non-competitive environment 3. Knowing scope of own practice 4. Unity and credibility 5. Shared and clearly outlined values (Braathen, Veiersted, & Heggenes, 2007; Cartmill, Soklaridis, & Cassidy, 2011; Loisel et al., 2005; Shaw, Walker, & Hogue, 2008; Ståhl, Svensson, Petersson, & Ekberg, 2009)

Communication Barriers: There are several barriers to communication as already noted under team and organisation factors. There is limited information on communication barriers alone. • Different approaches to co-operation • Different professionals saying different things • Locations of professionals • No regular or planned meetings (Brunarski, Shaw, & Doupe, 2008; Loisel, Durand, Baril, Gervais, & Falardeau, 2005; Ståhl, Svensson, Petersson, & Ekberg, 2009)

Communication Enablers: 1. Open debate and challenging of thought processes 2. Compromise 3. Same language, same approach 4. Creative communication strategies 5. Continuous feedback to all stakeholders 6. Regular meetings with client and the “team” (Brunarski, Shaw, & Doupe, 2008;Cartmill, Soklaridis, & Cassidy, 2011; Faucett & McCarthy, 2003; Kärrholm et al., 2006; Shaw, Walker, & Hogue, 2008)

“working as a team member is sometimes a humbling experience that requires a high level of self awareness and openness to feedback and response in the midst of practice” (Shaw, Walker, & Hogue pg. 302)

Vocational Rehabilitation Vocational Rehabilitation Vocational Rehabilitation Vocational Rehabilitation teams: Does the concept teams: Does the concept teams: Does the concept teams: Does the concept match the reality? match the reality? match the reality? match the reality?

Contact details: Lisa McAulay Lisa.mcaulay@fitforwork.co.nz 021595807

References: Aust, B., Helverskov, T., Nielsen, M. B. D., Bjorner, J. B., Rugulies, R., Nielsen, K., . . . Ørbaek, P. (2012). The Danish national return-to-work program - aims, content, and design of the process and effect evaluation. Scandinavian Journal of Work, Environment and Health, 38 (2), 120-133. Aust, B., Nielsen, M. B. D., Grundtvig, G., Buchardt, H. L., Ferm, L., Andersen, I., . . . Poulsen, O. M. (2015). Implementation of the Danish return-to-work program: process evaluation of a trial in 21 Danish municipalities (Vol. 41, pp. 529-541). Braathen, T. N., Veiersted, K. B., & Heggenes, J. (2007). Improved work ability and return to work following vocational multidisciplinary rehabilitation of subjects on long-term sick leave. Journal of Rehabilitation Medicine (Stiftelsen Rehabiliteringsinformation), 39 (6), 493-499. Brendbekken, R., Eriksen, H., Grasdal, A., Harris, A., Hagen, E., & Tangen, T. (2017). Return to Work in Patients with Chronic Musculoskeletal Pain: Multidisciplinary Intervention Versus Brief Intervention: A Randomized Clinical Trial. Journal of Occupational Rehabilitation, 27 (1), 82-91. doi:10.1007/s10926-016-9634-5 Brunarski, D., Shaw, L., & Doupe, L. (2008). Moving toward virtual interdisciplinary teams and a multi- stakeholder approach in community-based return-to-work care. Work, 30 (3), 329-336. Cartmill, C., Soklaridis, S., & Cassidy, J. D. (2011). Transdisciplinary Teamwork: The Experience of Clinicians at a Functional Restoration Program. Journal of Occupational Rehabilitation, 21 (1), 1-8. Désiron, H. A. M., Donceel, P., Godderis, L., Van Hoof, E., & Rijk, A. (2015). What is the value of occupational therapy in return to work for breast cancer patients? A qualitative inquiry among experts. European Journal of Cancer Care, 24 (2), 267-280. doi:10.1111/ecc.12209 Faucett, J., & McCarthy, D. (2003). Chronic pain in the workplace. Nursing Clinics of North America, 38 (3), 509- 523. .