NURSING AT McLEAN
An interdisciplinary approach to program planning
By Sheila Evans APRN, RN
I recently attended a conference presented by SB2, the Geriatric Neuropsychiatry Unit, entitled, "Breaking Away from Parallel Play: an Interdisciplinary Approach to Program Planning." The panel defined parallel play as, "attending to discipline-specific tasks without team collaboration." In contrast, presenters focused on a collaborative approach to program planning and care-delivery.
The concepts shared throughout the conference came about as a result of an interdisciplinary care-planning session. While working with a patient, an occupational therapist, mental health specialist, registered nurse, and physical therapist realized they each brought to the table very different skills, strengths, and information about the patient. They also brought different perspectives due to their individual personalities, education, and life experiences. The value of this approach quickly became evident as staff started integrating ideas for both the milieu and program planning.
One example of an integrated-care approach shared at the conference involved Deb Arsenault, occupational therapist, assessing a patient's ability to eat. She conferred with the mental health specialist and nurses and spoke with the neuropsychologist about the patient's level of cognitive functioning prior to conducting her evaluation. She then worked with the patient and made certain recommendations for adaptive equipment and special utensils. In so doing, she helped staff to help the patient function more effectively.
The Interdisciplinary Caregiver Group has come a long way since the days of parallel play. A collaborative approach involving all disciplines ensures better patient outcomes. One result of this new approach has been a concerted effort to focus on the strengths of both patients and staff. All staff members have a voice that reflects their unique experiences, interests, and strengths. Participating in decision-making gives staff a sense of accountability. Instead of hearing, ‘my' patient or ‘your' patient, more and more we're hearing ‘our' patients and ‘our' milieu.
The panel performed a number of skits that vividly demonstrated the advantages of a collaborative approach. Working in isolation was clearly limiting; when all team members brought their knowledge and ideas to the table, positive outcomes were much more likely.
As the unit moved toward interdisciplinary planning, they employed Maslow's Hierarchy of Needs and adapted it to fit their practice model. In the diagram below, Maslow's levels of development begin with the physiological, move through safety, love/belonging, esteem, and self-actualization. The corresponding pyramid for program planning is comprised of: safety, a level where core staffing needs are met; competence, where staff members know their roles and work independently (parallel play); interdependence; recognition; and the potential for excellence. In this last phase, staff routinely step outside their comfort zone and cross interdisciplinary barriers to meet their goals.
It was exciting to learn about the program on SB2 and hear how enthusiastic staff are about their progress.
