Take home messages

Rehabilitation and return to work progress more smoothly when stakeholders collaborate. Relevant collaboration may involve a group of professionals who work together regularly, who interact on only one occasion, or who are in contact for the duration of only one case.

Whilst policy makers are encouraging collaboration and teamwork, to date there has not been a focus on how effective teams are developed. There is also a tension between policy demands for healthcare professionals to become more collaborative, and the time it takes to develop such a team work approach. Systems, such as time allocation and funding, are needed to support the development of a team approach.

On the ground, teamwork is enhanced by:

• A positive focus on nurturing and developing the team;
• Making decisions via consensus;
• Expressing interest in and respecting for other’s professional input;
• Embracing shared responsibilities;
• A learning culture; and
• Actively seeking knowledge from others in the team.

Why the research matters  

In healthcare in general there is a push towards creating a comprehensive network of services. Increasingly, teamwork, collaboration and inter-professional care are recognised as important aspects of rehabilitation and return to work.

Given the importance of teamwork, we need to know what practices encourage and improve it across disciplines, however to date this has not been a focus of research. This study evaluates various approaches.

What the research involved  

Team members at an outpatient work rehabilitation clinic employing health professionals were interviewed over a series of sessions and the information was collated by the researchers. The researchers also attended team meetings to observe interactions.

Summary of research findings 

The authors noted there were three elements essential for good teamwork:

1. Nurturing consensus. This requires team members to be consciously engaged in efforts to seek and value the input of others in the team, focused on reaching an agreement through collaboration and discussion, and willing to compromise.
2.  Nurturing professional synergy. Working as a team member can be a humbling experience that requires a high level of self awareness and openness to feedback. Successful teamwork involves the ability to respond as a member of the team, rather than a person who knows all the answers. It involves simple accommodations, such as answering the telephone for one another, to more complex issues such as reframing opinions based on input from other team members. Flexibility contributes to successful teamwork and respecting other’s professional input is also important.
3.  Nurturing a learning culture. In order to operate authentically and equitably, teams need to foster a learning culture. Professionals should be open to learning from co-workers, managers and clients.

Learning culture is best achieved through fostering an environment in which:

• People are interested in learning; and
• The regular exchange of information makes learning possible.

Involving clients as a part of the team, and ensuring that clients have ownership of goals is also useful. Encouraging clients to take responsibility and ownership of their own situation is an important aspect of management.

The study authors believe that their findings have implications for both health professionals and policy makers. There is an assumption that health professionals intuitively know how to work as a team, however, the findings from the study indicates that team functioning can be improved by focus on the issues that support teamwork.

There is a tension between policy demands for healthcare professionals to become more collaborative, and the time it takes to develop such a team work approach. Systems, such as time allocation and funding, are needed to support the development of team approach.