Collaboration in healthcare is essential to provide our patients with the best possible care. While it might seem obvious even to an outsider that healthcare professionals need to collaborate regarding plans of care, it doesn’t always happen. As clinicians, we should ask ourselves if we are doing all we can to collaborate and provide a truly thorough, well-rounded approach to the treatment of each patient.
Why Should OTs, PTs, and SLPs Collaborate?
As clinicians, we are called upon to assess and treat patients with a variety of complex needs. We have the luxury of spending long periods of time with our patients and end up learning valuable information about them beyond what is written in a medical chart or on a prescription pad.
In order to maximize interdisciplinary collaboration, this must occur at the beginning, middle, and end of your treatment plan. In this way, our patients receive the necessary care at the optimal time. This will result in improved outcomes for your individual plan of care and, most importantly, lead to a more positive and lasting change for your patient. So where does the collaboration begin? It begins with you! No matter when you entered the case or your number of years on the job, set the tone for a consistent, collaborative effort. It might sound like a lot of extra time to talk to a variety of other health professionals for each patient, but in today’s high-tech world, communication can be a cinch. Maintain HIPAA compliance and send a secure message on Teams to get the ball rolling or check-in during care. Encourage caregivers to talk about all the professionals involved in their loved one’s treatment. Initiate a therapy log or diary that is kept with the patient. Always feel free to share successes with your counterparts, as this will not only be positive feedback for your patient, but for the clinician who facilitated that success as well!
As treatment progresses, you want to continue to keep in touch closely with your therapy counterparts. PTs and OTs need to stay on the same page regarding ambulation recommendations, for example. You wouldn’t want to recommend a walker when your counterpart advises a cane. Maybe the OT in the case identified a great modification due to a patient’s vision impairment and this, in turn, allowed the SLP to create successful memory cue cards in the home setting. When your therapy counterpart knows all of the patient’s rehabilitation goals, he or she can provide feedback regarding the carryover of skills and techniques in daily activities. All of this collaboration builds a more complete picture of what’s happening with your patient and allows you to direct your care accordingly.
How to Collaborate With Other Clinicians and Healthcare Professionals
In most cases, a primary care physician or specialist has referred your patient to you for therapy services. This is the first touchpoint of collaboration. It is important to follow up with the referring physician to provide updates, positive feedback, express concerns, and advocate for your patient as needed. Many of our older adult patients have a longstanding history with their primary care physicians and these physicians are pleased to see that patients they have known over decades are in good hands for therapy services. Alternatively, a patient might be seeing a new physician and your feedback from therapy sessions provides valuable insight into the life of this patient.
You will also find excellent collaboration opportunities with your clinical counterparts. Physical and occupational therapists along with speech-language pathologists collaborate constantly. While clinicians might not be working within the same physical space, there are easy, HIPAA-compliant ways to communicate and collaborate:
- Findings of initial evaluation
- Scheduling needs for you and your shared patient
- Abnormal findings or red flags noted in a session
- Goals for each therapy discipline (especially to avoid duplication of services)
- Home exercise programs
Weekly communication is a great target interval for collaboration with your clinical counterparts. In this way, you are able to discuss therapy progress, results of trialing new equipment, responses to changes in therapeutic techniques, barriers to progress and possible solutions, and discharge plans.
Here’s a great example of early collaboration among a therapy team:
PT services are prescribed for a patient with Parkinson’s disease after having a fall. After the initial evaluation, the PT refers to OT services due to functional changes noted in the patient’s ability to bathe and toilet. A few sessions and a phone conversation later, the PT and OT determine SLP services are warranted as this patient has a new onset of coughing when drinking water. The PT contacts the referring physician and orders are written for an evaluation with the SLP.
In addition to referring to your clinical counterparts, there are many other healthcare professionals who potentially comprise the team supporting your patient. Whether you are referring to a new professional service or collaborating with a professional the patient already knows, communication between you and other team members is the best practice. These might include, but are not limited to:
- Respiratory Therapist
- Registered Dietician
- Nursing (CNA, LPN, RN)
- Music Therapist
- Social Worker
- Physician’s Assistant or Nurse Practitioner
- Powers of Attorney
- Physician Specialists (cardiology, neurology, psychiatry, etc.)
Every patient’s needs are unique and the plan of care should be tailored appropriately, including the collaborative effort. Having the right group of professionals involved will ensure a more holistic approach to care.
Does Interdisciplinary Collaboration Between Healthcare Professionals Work?
Interdisciplinary collaboration is not only helpful, it is evidence-based. Moyers and Metzler indicate collaboration prevents medication errors and hospitalizations as well as increases the likelihood that patients utilize community resources that are available to them. Older adults may or may not know what services are available to them or how to access the services that would best suit their needs. When more professionals are involved in a case, the door is opened to many more opportunities beyond a one-time visit. Szanton et al. note that collaborative modifications in the home setting led to improved ADL function. Occupational and physical therapists have, for example, established great relationships with general contractors who correctly install items such as grab bars. Coogle et al. highlight fall prevention as a proven result of interdisciplinary collaboration.
According to the Centers for Disease Control & Prevention (CDC), more than one out of four older people fall each year, but less than half tell their doctors. When there are more professionals collaborating about one patient, that individual has more opportunity to communicate occurrences such as falls and will perhaps feel more comfortable talking to medical professionals in general. Knapp and Iemmi easily prove the reduction in costs to the healthcare system through the use of collaborative care.
As is obvious by this brief summary of research, interdisciplinary collaboration vastly improves the treatment and outcomes for patients in all healthcare settings.
Take the First Steps to Collaborate With Other Healthcare Professionals
We want our patients to be stronger and to live better longer. We ask them to make major changes to their daily routines in order to achieve their goals. We can’t impose such life-altering plans without a holistic approach. For example, a patient supported by well-trained caregivers, a physician who is aware of subtle functional changes, a psychologist who regularly provides strategies to manage depression, and a clinical team to improve strength and function will enjoy a much greater quality of life as a result.
If you’re reading this, you are likely a rehabilitation professional looking to continually improve the quality of care you provide. Challenge yourself in the coming weeks to up your interdisciplinary collaboration game. Call that physician about a blood pressure trend, make that referral to psychiatry services when you suspect worsening anxiety, and reach out to your clinical counterpart(s) when you discover a compensatory strategy that works great for your patient.
Living well over the years can be a puzzle at times, but we can all find some pieces and, when assembled correctly, create a beautiful picture together.