I write a lot about SJSU, probably because I've taught there since 1990 and it's the organization I know best. Plus it provides so many great examples it's difficult to resist talking about when I'm teaching organizational communication.
But today I thought I'd write about hospice interdisciplinary care teams in the context of differentiation and integration discussed in Chapter 2. My dissertation research focused on hospice teams and I following that line of research for several years. I found hospice teams fascinating because I'd studied interdisciplinary teams in two other contexts, one in a large mental health institution and the other a diagnostic team for severely developmentally disabled children. The teams that functioned (dysfunctioned is the better term) in the mental hospital were not a happy group. They spent a great deal of time battling over turf and not much time focusing on patient needs. There was a high degree of differentiation, but little integration. The intensely bureaucratic nature of the organization made team functioning a challenge.
The diagnostic team also functioned within a highly bureaucratic organization--the university where I did my doctoral work. But the team was fairly independent. In addition, the team did not implement its recommendations, so there was a greater incentive to work together to determine the best treatment plan for the clients.
Hospice interdisciplinary teams develop treatment plans and implement them. What I found in my research is that while far from perfect, these teams did a pretty good job carving out their individual tasks while still coming together as a group. Hospice organizations do have some level of bureaucracy, in part because they have to interact with highly bureaucratic structures such as hospitals and insurance companies. But for the most part they strive to be team-based in every aspect of the organization, not just the interdisciplinary teams. Thus, hospices are generally fairly adept at balancing specialization/differentiation and integration.
Managers as Friends?
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I believe title already sounds pretty weird but I would still like to
provoke this idea. Have you ever become friends with your manager? Does it
really w...
15 years ago
2 comments:
Introduction
Interdisciplinary action teams provide triage and support at a local level for people who want help with a wide range of problems, enabling;
• police to more easily connect any person, whether that person be a victim, offender or other person who need help with appropriate services;
• further integrate the health and welfare professional response across sectors;
• further progress a change in the culture and practise of police and community services at the health/justice interface.
Background
The police/healthcare interface has developed in an ad-hoc, issue by issue, sector by sector basis. Crisis referral pathways are now well established , however, early intervention referral pathways continue to be developed to an increasing number of specialist health and welfare services. Individual sectors have recognised the need for healthcare to take a more integrated approach . Interdisciplinary Action Teams offers the next step in this evolution.
Significantly rationalising the number of early intervention referral pathways is achieved by;
• healthcare services contributing to the formation of local interdisciplinary teams (including existing service providers funded to receive referrals from police). The team includes, Alcohol & Other Drugs, Family Violence, Child & Family services and Mental Health counsellors at a municipal/police service area level.
• responds to victims and offenders or any person in need of assistance by contacting them within 24 hours.
Benefits
This approach re-engineers the response in line with developments within healthcare and applies it at the justice/healthcare interface. Importantly, this approach also has positive occupational health and safety outcomes for operational police, reducing re-attendance by police to incidents of often escalating levels of violence and reducing levels of frustration and stress in attempting to navigate an increasingly complex labyrinth of referral pathways.
Northern Assessment Referral & Treatment Team
The Northern Assessment Referral and Treatment Team (NARTT) has been operating from Plenty Valley Community Health, Epping since April 2003, receiving referrals from 3 x 24 police stations, Reservoir, Epping and Mill Park. Over 2,300 referrals from 320 individual police. During 2007 over 900 referrals were made.
REFERRALS BY TYPE
Offender 313
Victim 381
Family Member 114
Other/Unknown 96
TOTALS Primary Issues Secondary Issues (where noted)
Family Violence 591 31
D&A 90 138
Anger 70 56
Other 51 12
Mental Health 27 53
Assault 26 44
$ 5 46
Housing 5 5
Gambling 4 14
Sex Offences 3 1
Unemployment 1 28
An independent evaluation recommended the concept be implemented statewide . Evaluation of the program is ongoing. An evaluation of 234 people referred,
1/7/2005 - 31/12/2005 showed those referred as offenders (53) who did not take up a referral had more than double the re-involvement rate with police within six months, 73% to 33%. This was consistent with an earlier evaluation.
Recognition NARTT was awarded the 2006 Victorian Healthcare Ministers Award for Outstanding Team Achievement and received a Certificate of Merit and prize of $7,000.00 in the 2007 Australian Crime and Violence Prevention Awards, placing it in the top 8 projects across Australia. Despite this recognition an impediment to roll out is a lack of recurrent funding available as the concept crosses funding silos, e.g. mental health, drug and alcohol, family violence.
Replication across settings Interdisciplinary Action Teams now operate in metropolitan, regional centre and rural settings with the Shepparton Moira Assessment and Referral Team (SMART) operating from Goulburn Valley Community Health since July 2007 and the Border Integrated Referral Team (BIRT) operating from Echuca Regional Health since March 2007. All programs are very well supported by local police and community services. SMART and BIRT have been implemented utilising existing resources.
Summary
Interdisciplinary Action Teams is a whole of government, cross sectoral approach, that empowers local people to solve local problems. It currently demonstrates that an integrated response and improved outcomes can be achieved across a range of sectors and healthcare disciplines. It complements the crisis response and other existing referral pathways. It enables police to refer a wide range of issues to a single team of health and welfare professionals and requires no additional Victoria Police personnel or equipment and minimal police training.
Thank you for your informative comment on a type of interdisciplinary team I didn't know about. When team members work together in integrative ways, interdisciplinary teams are crucial for addressing complex problems such as the ones you describe. When they don't work well, they can actually perform more poorly than individuals working on their own.
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