A substantial proportion of potentially preventable adverse events are underpinned by failures in communication and teamwork (between members of a single healthcare service or across multiple healthcare services).
Multidisciplinary collaboration, where healthcare providers involved in a patient’s care communicate and work as a team, is an important element of comprehensive care. It includes referral to other healthcare providers, sending reports to a referring healthcare provider and discussions regarding a patient’s care to ensure that a coordinated approach to care is provided.
Referral process
The healthcare service should provide accessible guidance about referral processes to different services. This should outline the:
- Clinical or other criteria for referral
- Consent from patient to refer, and the information the patient consents to sharing
- Necessary patient information (for example, co-morbidities, medical history and medications)
- Process for making the referral (for example, referring to the service or to a particular healthcare provider, by phone or email)
- Processes for expediting urgent referrals
- Availability of different services (for example, after-hours)
- Expected response time
- Follow-up and escalation process for delayed response to a referral (if relevant).
Collaboration with other healthcare providers
While healthcare providers deliver comprehensive care within their scope of clinical practice, no single healthcare provider can deliver all aspects of the care that a patient might need. Individual healthcare provider groups bring specific expertise. Effective collaboration relies on establishing and communicating clear and shared goals.
Collaboration with other healthcare providers can be supported by developing processes for effective communication, communicating critical information and documenting information.
- Interventions to improve multidisciplinary collaboration vary, but broadly include:
- Training and education of individuals and the team (where present)
- Identifying opportunities for better multidisciplinary communication
- Detailing what information and decision need to be documented
- Communication of information and decisions to other healthcare providers, patients, carers and families
- Using structured communication processes and communication tools such as Introduction, Situation, Background, Assessment and Recommendation (ISBAR) to increase the reliability of communication
- Clear understanding of the roles, responsibilities and accountabilities of different healthcare providers in the delivery of safe and good quality care.
Links to Actions 3.27 Communication to support patient referral and multidisciplinary collaboration; and 3.29 Communication of critical information
Rural and Remote Multidisciplinary Health Teams
Multidisciplinary teamwork is particularly relevant to the rural and remote healthcare context of service provision. Working in these teams strengthens the support for and connections between individual healthcare practitioners and communities.[i]
The Office of the National Rural Health Commissioner has developed the Ngayubah Gadan Consensus Statement to define Rural and Remote Multidisciplinary Health Teams. The statement recognises the contribution of the healthcare workforce in meeting the unique health needs in rural and remote communities. The Rural and Remote Multidisciplinary Health Team model provides the foundation to achieve appropriate, acceptable and locally determined healthcare services.[ii]
