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Multidisciplinary teams: The importance of getting it right

By Karen Warren, ILS Case Management



In my role as a case manager navigating the complex landscape of client care, managing collaboration among professionals from diverse backgrounds is fundamental to addressing the intricate needs of our clients.

Over the years, I’ve learned to appreciate the challenges, dynamics, and surprises of forming and managing multidisciplinary teams (MDTs).

In these teams, the diverse set of skills is a key strength in helping our clients reach their goals.

It is frequently necessary to have any number of professionals form part of a client’s team, including occupational therapists, nurses, physiotherapists, social workers, psychologists, and dieticians—each contributing their unique perspectives and skills to deliver a comprehensive and holistic system of care.

Understanding our clients’ needs is paramount.

Building rapport and listening carefully to their personal narratives can reveal aspirations, interests, and milestones crucial for formulating personalised goals.

The philosophy of ILS revolves around client-centred care, where we empower clients to pursue their passions while addressing their clinical needs.

Integrating clinical and rehabilitative goals is where innovation thrives. Where we can, we blend functional objectives with clients’ passions, making therapy sessions meaningful and relevant.

                                    Karen Warren

Occupational therapists can devise creative strategies like adaptive sports to bridge the gap between clinical exercises and real-world pursuits, fostering progress and empowerment.

However, assembling the ideal MDT is not without its challenges.

Recruiting suitable professionals can pose logistical hurdles, worsened by geographical constraints and the scarcity of specialised expertise.

Navigating family dynamics adds complexity, as differing expectations and communication styles among family members require delicate navigation and mediation.

Case Study: Anna’s Story

The power of strong multidisciplinary collaboration is evidenced in clients’ successes, my client Anna’s, story illustrates this perfectly.

Working with Anna has been both challenging and rewarding.

She’s a remarkable 20-year-old with significant physical limitations – she’s got a lot of contractures and scoliosis and is a full-time wheelchair user as a result; she is also non-verbal.

She requires constant attention, mainly from her mother who is her primary caregiver. 

Despite the physical challenges, she is, nonetheless, a content and smiley young lady.

She loves to visit the theatre, smiling as she watches the shows and responding to the colours and music that she sees and hears there.

 Anna loves anything that is pretty, sparkly or bright and this gives her a lot of pleasure.  She also likes to have her nails and toes painted and to look her best when she goes out. 

Anna has a cheeky sense of humour too.

Anna has recently purchased an adapted motor home which has enabled her to visit festivals.

The motor home has provided an opportunity for her to have a rest throughout the day or to have her personal care needs met when she is enjoying the festival.

Previously she would have needed to leave early as it was so hard to meet her needs in such a challenging environment. She can now enjoy the whole experience like her peers.

Anna has a dedicated team of professionals working with her, who are all genuinely committed to her wellbeing.

This includes a physiotherapist, an occupational therapist who had already conducted a postural and wheelchair assessment and provided a comfort chair and a new wheelchair as a result, and a massage therapist who would work on stretches and some lymphatic (drainage) of the upper limbs as well as some nice relaxation techniques.

I also brought a music therapist into the team to provide a stimulating activity that Anna could participate in and feel immersed in.

Each member of the team contributes to bringing about positive outcomes in a truly holistic sense.

The teamwork truly came to the fore when the OT observed significant swelling in Anna’s feet. We wasted no time in convening to discuss the issue, bringing in a lymphatic nurse to guide our intervention.

Together, we developed a comprehensive action plan, ensuring that each team member understood their role in order to address this new presenting need and avoiding any potential harm.

The physio and massage therapist worked together in hydrotherapy sessions – the water was ideal for releasing the pressure on Anna’s body so they could get right into the joints.

The lymphatic nurse was also able to join them to advise where they should place their hands to avoid exacerbating the issue and maintain the integrity of her skin. It was fantastic.

The team recognised the importance of managing this issue in every aspect of Anna’s day and facilitate her engagement in activities that were important to her.

For example, the OT and physio worked together looking at every postural detail right down to the foot positioning to ensure that Anna could still attend a session with her music therapist safely whilst being extremely mindful of her posture as we didn’t want to compromise her lower limbs. 

The whole episode was the most wonderful joined-up approach, true teamwork.

Everyone wanted to do the best for the client to avoid any kind of surgery, or potentially skin splitting which would have been devastating.

Despite the complexities involved with Anna’s case, every member approached their work with a can-do attitude and a commitment to empowering the client.

It’s this collective effort and shared vision that drive us forward, knowing that we’re making a tangible difference in her life. 

Beyond the Clinical

As well as addressing Anna’s physical health, as a team, we also recognise the importance of sensory stimulation and engagement.

Previously, I hadn’t seen Anna engage or interact much when you said ‘hello’ to her for example, she would just look and then go back to sleep.

I have seen videos of her sessions with the music therapist though, which are lovely. She’ll smile and turn to where the music is, demonstrating rarely seen upper limb function which is wonderful.

When we introduced the art therapist, she brought along kinetic sand for her initial meet and greet session. She gently poured the kinetic sand over Anna’s arm.

It was obviously cold because she pulled both arms up and kind of grimaced as if to say, “Oh, get that off of me.”

We all laughed as it was such a brilliant reaction, and then after a while, she settled, and you could see her look at it intrigued as if to say, “What is this?”

And then as the sand warmed up, the art therapist continued to apply it to her arm, and it seemed to soothe and relax until she fell asleep. It was beautiful to watch.

We’ve also discussed the notion that art therapy activities need not solely consist of messy play.

We’re considering alternative approaches with the art therapist such as incorporating storytelling sessions or using items from the outdoors.

Anna responds really positively to farmyard and zoo scents, which, although unconventional to some, hold great appeal for her.

So we’ve discussed the possibility of sourcing outdoor items such as pinecones or moss, or seeing what can be collected from local farms – sheep wool for example.

Furthermore, we’re currently exploring the idea of themed sessions that look at seasons or places such as beach or forest themes, to enrich Anna’s artistic experiences.

It’s essential to recognise that art therapy extends beyond traditional notions of painting, emphasising sensory exploration and environmental engagement.

By fostering such experiences, we aim to provide Anna with opportunities for independent exploration within her surroundings.

Ultimately, our goal is to empower Anna to reach her full potential, not just physically but also emotionally and spiritually.

And with such a dedicated team by her side, I’m confident that we’ll continue to achieve that.

Final Thoughts

As case managers, we play a vital role in facilitating communication and collaboration among team members, clients and their wider support networks ensuring that clients like Anna receive the support, care, and attention they need to thrive.

By working together as a cohesive team, we can make a meaningful difference in the lives of our clients, empowering them to overcome challenges, achieve their goals, and live life to the fullest.

Witnessing the dedication and positive attitude of the MDTs that I coordinate is one of the most fulfilling aspects of my role as a case manager.