The Palliative Care Team

The palliative care team is an interdisciplinary team that can include a physician, physician assistant, nurse practitioner, registered nurse, social worker, and chaplain as well as other disciplines depending on the population served. The interdisciplinary team works closely to both develop and provide one patient-centered plan of care.

There are many different ways one may find team work described in the healthcare literature. The most frequently found terms are interdisciplinary , multidisciplinary, and transdisciplinary. More recently interprofessional can be found. Traditionally, palliative care teams are referred to as interdisciplinary, however it is often used interchangeably with multidisciplinary teams in other settings such as the hospital. Why all the different terms and do they actually mean different things? In a word, yes.

• Multidisciplinary teams are hierarchical headed by the highest-ranking individual managing the care of the patient, usually a physician. Individuals from different disciplines work independently and parallel to each other creating separate plans of care that may or may not have an integrated impact on the patient. Communication between team members is often lacking in this type of care.
• Interdisciplinary teams work interdependently providing care that is characterized by having a common goal or plan of care. Interdisciplinary care is not hierarchical; the leader of the team is that individual with the discipline most needed by the patient at any given time. For instance, if the greatest need of the patient is psychosocial, the social worker will direct care. Communication in a well functioning interdisciplinary team is frequent and strong.
• Transdisciplinary teams are interdisciplinary teams that also share a common goal or plan of care across disciplines. The difference however, is that individuals within the team are sufficiently familiar with the approaches of other disciplines that they may provide education and support for the patient that is beyond the more traditional boundaries of their own discipline.
• Interprofessional education and practice focuses on understanding and respecting the different scope and standards of the different healthcare professions in order to develop a more cohesive practice. The process of interprofessional care begins with the joint education and training of different disciplines such as medicine and nursing in order to develop a common ground from which to build strong interprofessional practice.

Additional Resources

References

• Alberto, J. and Herth, K. “Interprofessional Collaboration within Faculty Roles: Teaching, Service, and Research.” OJIN: The Online Journal of Issues in Nursing 14 no. 2 (2009): doi 10.3912/OJIN.Vol14No02PPT02.
• D’Amour, D. & Oandasan, I. (2005). Interprofessionality as the field of interprofessional practice and interprofessional education: An emerging concept. Journal of Interprofessional Care. Supplement: 1: 8-20.
• McDonald, C., and McCallin, A. “Interprofessional Collaboration in Palliative Nursing: What is the Patient-Family Role?”
• Youngwerth, J., and Twaddle, M. “Cultures of Interdisciplinary Teams: How to Foster Good Dynamics.”