According to Stille and Antonelli (2004), coordination of care is a critical function of pediatric primary care that may be best delivered using a team approach. Coordination of care is a holistic health care approach that is often delivered by a team of practitioners such as a physician, advanced practice nurse, school nurse, social worker, pharmacist, nutritionist, respiratory therapist, and others. Coordination is defined as “the state of being harmonized in a common action or effort” (Stille & Antonelli, 2004). The cases of Dewey Jones, Martha Ames, and Spike Smith are examples of interdisciplinary coordinated care.
According to Cole (2008), your goal as a team member is to help your team achieve results, regardless of team member title. Each member of the health care team has a title or a role within the team such as: team leader, manager, or facilitator. Each member of the team brings valuable professional experience and perspective regarding patient care to the team. This makes each team member valuable, and when each team member’s experience and perspective is brought together, patient care is improved, and delivered in a more complete and holistic manner. Each team member also has a unique personality. Different personality styles often have strengths and weaknesses, so it is important that a team member is acting within a team role that best suits the needs and goals of them team. Team roles varied within the three cases of Dewey Jones, Martha Ames, and Spike Smith.
According to Cole (2008), not only are there individual team member styles, but there are also team interactive styles. These styles are described in a team interaction model created by Russell (1986) and consist of the following styles: driver, enthusiast, analyzer, and affiliator. Assessments of these team styles will allow the team to understand variances in personalities as well as strengths and weakness of the team members. Team style also varied within the three cases of Dewey Jones, Martha Ames, and Spike Smith, and I believe this is to be the result of the different personality styles present within the teams. Each team member is unique and has a role and a purpose. Each team member brings their expertise which is shared and discussed to meet the best interests of the child in a holistic manner.
In the Dewey Jones Case, the team members involved were: Dr Green, pulmologist, Becki, APRN; Rhonda, respiratory therapist (in patient); Candace, respiratory therapist (home care); and Craig, social worker. Although the team members of the Dewey case (and other cases) did not have “official” titles, I believe that they each functioned as a leader, manager, or facilitator. The team interaction style functioned in a driver style, in my opinion.
A team conflict occurs in the Dewey Jones case between the pulmologist and the other members of the team. Some members of the team feel that they must advocate for the client and family and their needs at home. The RTs, APRN, and SW feel that it is in the best interest of the child to prescribe the chest physiology vest, because Dewey’s mom may not be performing the physiotherapy due to her carpal tunnel pain. There are several complex family dynamics that are taken into consideration in this case. In this case, the physician is "calling the shots" refusing to make compromises with the other team members by refusing to prescribe the chest physiology vest.
It is apparent that the power of this team is not being shared equally and that the physician has more power than the other team members. The physician stated "I've got my heels dug in" as far as refusing to write a prescription for the chest physiology vest, and then stating that in addition to refusing to write the prescription, that he also will be uncomfortable following the care of the child if another provider prescribed the vest. It puts the team integrity in...