In this section you will learn to:
- Develop and maintain effective interrelationships and communication with colleagues and multi-disciplinary teams
- Industry terminology relevant for effective communication with colleagues
- Share information within multi-disciplinary teams
- Funding environment
Supplementary materials relevant to this section:
- Reading E - Communicating for Safety: Improving clinical communication, collaboration and teamwork in Australian health services
Effective communication skills and techniques that apply to clients are also applicable to workplace collaboration. Working within health and/or community services is mainly collaborative in nature – this means the individual worker works with others including, but not limited to, clients, client’s family and carers, co-workers, supervisors, and other professionals. For Health workers, specifically, “there may be a team of people you work with on a daily basis depending on the size of the Practice. You may interact with the following people in your role: Practice Managers, Doctors/General Practitioners, Nurses, Patients, Supervisors, and work colleagues.” (MAT, n.d.).
Collaboration with colleagues can be beneficial for several reasons:
- Professional development: collaboration provides opportunities for personal and professional growth through the exchange of ideas and experiences.
- Increased effectiveness: working with colleagues can lead to improved treatment outcomes for clients, as it allows for diverse perspectives and problem-solving approaches.
- Enhanced expertise: collaboration can provide access to a wider range of expertise, leading to better informed and effective treatments.
- Improved continuity of care: when working as part of a team, counsellors can ensure a continuity of care for clients and ensure that the necessary support is in place.
- Support and well-being: collaboration can provide a supportive network for the counsellor, reducing the risk of burnout and promoting well-being.
There are several lines, or ‘channels’ of communication relevant for collaborative teamwork, such as face-to-face communication, communication via phone, through written notes or other documentation, and through electronic formats (e.g., electronic health records and mobile applications). Clear lines of communication are important for team collaboration. This can include establishing a clear chain of command, setting expectations for communication, and creating opportunities for team members to provide feedback to one another.
As stated in the Australian Commission on Safety and Quality in Health Care (2020), teamwork is “everyone on the same page working towards a shared goal.” In this instance, the shared goal is safe, high-quality care for clients. This teamwork involves collaboration between colleagues, between agencies (which will be covered in more detail below), and with patients and their families, carers, and any support people. There are different roles and responsibilities for each team member, with shared problem solving and decision making often taking place. This collaborative effort is based on respect and trust; skills, experience, and knowledge; adherence to clear roles and responsibilities; and a dedication to person-centred care. Within this, the standard legislations and communication protocols that apply to clients, also apply when communicating with colleagues. Any person you interact with deserves to be treated with respect, dignity, and without discrimination. (These legislations are touched on below). In addition, it is important to act within your scope of practice and to respect the roles and responsibilities of others and to follow lines of authority for reporting any issues or confusion.
The techniques for effective communication that were discussed in Section 1, apply within teamwork settings as well. Active listening and confirming and clarifying instructions and information are integral for team collaboration and communication. Another important factor to consider here, is timelines. Many studies suggest that, among other variables, time pressure can impact group outcomes. This highlights the importance of ensuring timeframes are established and agreed upon for successful teamwork, from prioritising more urgent tasks to availability of collaboration/meeting times with other team members. Delegation of tasks, an understanding of each team-members roles and responsibilities and setting and adhering to deadlines ensure that each team member can carry out their respective duties efficiently for optimal client care. Throughout the project or task, workers should keep their colleagues updated on their progress and communicate any potential delays or issues that may impact on agreed timeframes.
Reflect
If you were assigned to a number of tasks by your supervisor – which one should you do first? Which one next? Which one last? In situations such as these, it is best that you clarify and agree on timeframes for each of these tasks. How would you go about agreeing these timeframes with your team leader or manager?
Read
Reading E - Communicating for Safety: Improving clinical communication, collaboration and teamwork in Australian health services
This reading provides an in-depth analysis of findings relating to best practices in improving clinical communication skills as well as collaboration and teamwork skills in a health services context.
Sharing information with other agencies/services
There will be times when it is necessary to share information about your client with other agencies. This could be to access support services, to obtain information, to share patient files or results with colleagues or other health care professionals.
The information that is shared between agencies may include:
- information to enable referrals
- incident reports
- individual plans and goals
- information about individual needs
An individual must give consent before any information is shared with or accessed from another agency. Most community organisations gather this consent using a specific form (which will be discussed further in Section 5. Consent is provided for a particular purpose; often the specific workers within the agency receiving the information are also named.
When collaborating with colleagues, it is important that you understand a range of industry terminology relevant to allied health and the specific organisations in which you end up working.
Below is a non-exhaustive list of terms, services, and legislations that are vital to allied health.
| Referrals | Depending on the range of services your workplace provides, your role may involve processing referrals. Referrals are letters or notes to a specialist or consultant physician to ask them to further investigate or provide an opinion about a patient’s condition or to perform specific examinations or procedures. While referrals are generally accepted by many specialists, the referral needs to be valid to receive the Medicare benefits. |
|---|---|
| Bulk Billing | Bulk billing is when the practice bills Medicare directly for the services and/or treatment provided to the patients without incurring any out-of-pocket costs on the patient. There are a few different avenues to submit bulk bill claims, with the two commonly used ones being Medicare Online claiming and Medicare Easyclaim. Other claiming options include ECLIPSE and Medicare Bulk Bill Webclaim. You need to check with your supervisor which system your workplace uses, as different systems have different billing document requirements. You also need to familiarise yourself with the procedure set out by your workplace, to ensure that you prepare the medical account accurately to not hold up the claims process. |
| Veterans’ Affairs Accounts | Your workplace may provide services and/or treatments to patients who hold a Department of Veterans’ Affairs (DVA) Health Card. DVA offers a range of health services for veterans, war widows/widowers, and dependents to treatment or services that are clinically required. Services Australia, on behalf of DVA, makes payments for services provided by health professionals to DVA Health Card holders. |
| Medicare | Medicare is Australia’s universal health insurance scheme established under the Health Insurance Act 1973, where Australians are entitled to access various healthcare and hospital services without having to pay a large sum of fees. Clients must enroll in Medicare and obtain a Medicare card to access the full benefits. They must also meet other eligibility requirements. |
| Informed Consent | Informed consent refers to a client voluntary decision to begin or continue with a healthcare treatment, intervention, or procedure. It is a legal and ethical requirement and will be covered in more detail in Section 4. |
| Confidentiality | Confidentiality is another legal and ethical requirement that involves limiting access to a client’s private information. This is typically acquired through obtaining written confidentiality agreements. This will be covered in more detail in Section 4. |
There will be many opportunities within an allied health workers career, for collaboration. This collaboration may include referring a client to external specialists or engaging other complimentary providers in a multidisciplinary team approach. A multidisciplinary team consists of professionals from a range of different professions working as a group to deliver comprehensive care for clients. As is the case with client care and teamwork, collaboration is the key to effective allied health service delivery. Many clients with complex needs benefit from a multidisciplinary team with a diverse range of knowledge and skillsets. Ability Action Australia (2023) reported that their NDIS participants with complex needs had better outcomes with support from a multidisciplinary team. In addition to this, there are many benefits for the allied health professionals working in the team, such as:
- Shared expertise: being able to share information, liaise in person, and conduct team consultations improves service delivery and outcomes for clients
- Multiple perspectives: the diversity of perspectives – unique skills and experience – involved in a multidisciplinary team of allied health professionals fosters innovation
- Continuity of care: sharing of clinical information means the client avoids having to repeat/retell their story, and it also may reduce wait times
- A holistic approach: A multi-disciplinary team can offer a more holistic approach to client care, addressing all aspects of the client's needs, including medical, emotional, and social needs. This can lead to more comprehensive and effective care for the client
According to Ability Action Australia (2023), allied health professionals "discuss a participant’s needs, set goals, report on assessment results and intervention outcomes, solve problems, and work out the best way to treat each participant. The participant, their family and support workers are actively involved in all discussions about their treatment.” As a health worker, you will be one of many involved in client care and will need to ensure your communication is kept professional and appropriate to enhance client outcomes.
Below are two case studies from Ability Action Australia (2023) that show how multidisciplinary teams can work together towards positive outcomes for clients:
Case Study
“One of our participants is a 14-year-old boy living with autism spectrum disorder, attention deficit hyperactivity disorder, and oppositional defiance disorder. He is working with one of our registered clinical Exercise Physiologists who is also working closely with one of our Occupational Therapists (and his school teachers) to come up with classroom strategies for preventing concerning behaviours such as aggression when he becomes frustrated. Since conducting exercise sessions at the school, this participant has been able to improve his focus in the classroom and the teacher has reported fewer negative behaviours after exercise sessions.”
“Another participant is a 51-year-old male living with spina bifida, schizophrenia and chronic pain. After an initial assessment with our Exercise Physiologist, this participant was found to have fear avoidance (where a person develops and maintains chronic musculoskeletal pain as a result of avoidant behaviour based on pain-related fear). This was particularly the case when performing basic movements such as getting up from a chair, walking around the home, bending down and other daily tasks. All of these tasks caused him significant pain. Our Exercise Physiologist brought in and has worked closely with our Occupational Therapist who has provided specialised education around pain and mindfulness. At the same time, the Exercise Physiologist was able to supplement this by gradually re-introducing basic movements and ensuring that positive reinforcement was used to change this participant’s mindset around ‘this movement is going to cause me too much pain’. Upon re-assessment, our participant has now reduced his pain reporting and effectively doubled his walking assessments, which means his mobility has increased. This has vastly improved his enjoyment of daily life and his community integration.”
(Ability Action Australia, 2023)
When working with people in different services, though beneficial for client outcomes, there are issues that may arise that should be considered and addressed if necessary. These issues may include:
- Communication breakdowns: This may occur due to different professionals using different terminologies or having different levels of understanding of a client's situation, leading to misinterpretations, misunderstandings, or assumptions. In order to address this, a communication protocol could be agreed upon for non-urgent versus urgent communication, for example, emails versus face-to-face or online meetings.
- Role conflicts: Different professionals may have different views on what their roles should entail, which may lead to misunderstandings and disagreements. For example, one professional may feel that they should have more authority over a particular client, while another may feel that they should have more say in the treatment plan or care plan. In this instance, team members should review the roles and responsibilities of others either through team meetings or individual discussions. Efforts should also be made to understand or explain relevant industry specific terminology.
- Power differentials: Power differentials may also occur in multi-disciplinary work relationships. For example, a medical doctor may be perceived to have more power and authority than a social worker, which may lead to unequal decision-making and power imbalances within the team. This can impact the effectiveness of the team's collaboration and the quality of care provided to the client.
- Time constraints: There will be occasions where it is hard to schedule time for meetings or discussions due to conflicting schedules. Multi-disciplinary meetings should be scheduled at a time that is convenient for all team members. Setting up an online platform where team members can communicate and share information when they are unable to attend team meetings could assist with addressing this issue.
A last point to discuss in this section is the funding environment. Funding directly affects the resources available to providers. Adequate funding can improve the quality of care and increase access to services, while insufficient funding can lead to a reduction in the quality of care and limit access to services. When providers have access to sufficient funding, they can invest in staff training, equipment, and facilities to provide better care. This can include hiring more staff to reduce workload and ensure adequate attention is given to each client. Insufficient funding can lead to a reduction in the quality of care provided, as providers may have limited resources to invest in new equipment or staff. This can lead to longer wait times for services, reduced access to care, and increased stress for both clients and providers.
Health and community services in Australia may be funded:
- Publicly – that is, by governments at different levels, through taxation
- Privately – that is, by service-users, on a pay-per-use basis
This section of the module provided an exploration on how to effectively work with colleagues and multi-disciplinary teams to ensure good outcomes for client delivery and service, as well as having a good understanding of your role and other roles within the workplace. This section identified sharing information, and what this entails according to confidentiality and client-centred care. This section also discussed techniques on how to resolve conflict when it arises in the workplace and how to diffuse conversations to negotiate agreements.
- Ability Action Australia. (2023). A Multidisciplinary allied health service. https://abilityactionaustralia.com.au/multidisciplinary-allied-health-service/
- Australian Commission on Safety and Quality in Health Care. (2020). Improving clinical communication, collaboration and teamwork in Australian health services. https://www.safetyandquality.gov.au/publications-and-resources/resource-library/improving-clinical-communication-collaboration-and-teamwork-australian-health-services
- Chan, B. C., Perkins, D., Wan, Q., Zwar, N., Daniel, C., Crookes, P., & Harris, M. F. (2010). Finding common ground? Evaluating an intervention to improve teamwork among primary health-care professionals. International Journal of Quality in Health Care, 22(6), pp. 519-524. https://doi.org/10.1093/intqhc/mzq057
- Mitchell, G. K., Tieman, J.J., & Shelby-James, T.M. (2008). Multidisciplinary care planning and teamwork in primary care. Med J Aust. 188(S8):61–64.
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- Reeves, S. (2010). Interpersonal teamwork for health and social care. UK: John Wiley and Sons Ltd.
- Ringer, J. (2022). We Have to Talk: A Step-by-Step Checklist for Difficult Conversations. https://www.judyringer.com/resources/articles/we-have-to-talk-a-stepbystep-checklist-for-difficult-conversations.php
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- Wocintechchat. (2019). [Photograph of two people sitting at a table having a conversation]. Unsplash. https://unsplash.com/photos/eF7HN40WbAQ
- Zajac, S., Woods, A., Tannenbaum, S., Salas, E., & Holladay, C. L. (2021). Overcoming Challenges to Teamwork in Healthcare: A Team Effectiveness Framework and Evidence-Based Guidance. Frontiers in Communication, 6. https://www.frontiersin.org/articles/10.3389/fcomm.2021.606445
