Professional differences in interprofessional working.

UK government policy is encouraging healthcare staff to blur traditional roles, in the drive to increase joint working between practitioners. However, there is currently a lack of clarity regarding the impact that changes to traditional working practice might have on staff delivering the services, or on patient care. In this article, we report findings from three qualitative case studies examining interprofessional practice in stroke care, in which the influence of professional differences emerged as a significant theme. We draw on findings from individual semi-structured interviews, as well as fieldwork observations, to describe the influence of professional knowledge and skills, role and identity, and power and status considerations in interprofessional working. The insights that were gained contribute to the understanding of how professional differences impact on healthcare staff joint working, and suggest that the elements identified need to be fully considered in drives towards changed working practice.

Once a week is not enough: evaluating current measures of teamworking in stroke.

RATIONALE, AIMS AND OBJECTIVES: Stroke care has been at the forefront of the drive to deliver health care by teamworking in the UK. Teamworking is the subject of ongoing audit of stroke provision with measures such as a weekly team meeting being used to evaluate services. A qualitative study was recently undertaken to explore these evaluations and to gain further understanding of the processes underlying teamworking practice. METHODS: Three case study sites across the stroke care pathway were investigated using data collection methods of fieldwork observation, interviews and visual imagery. The data were coded and analysed in an inductive process in parallel to the data gathering. RESULTS: It was found that teamworking practice was affected by organizational conditions, such as location of staff, time constraints, management structures and team contact. Other important aspects of teamworking related to the formation of subteams, decision-making processes, leadership, identification of goals, and training in teamworking. CONCLUSIONS: It is suggested that additional measures of team functioning are required. This paper highlights the importance of the organizational background with the need to consider team size, accountability and changing group membership. It discusses the decision-making systems and the need to more fully consider the role and purpose of team meetings.

The role of music therapy in an interdisciplinary approach to address functional communication in complex neuro-communication disorders: a case report.

PURPOSE: This paper presents a case report of collaborative work between speech and language therapy (SLT) and music therapy (MT) in the case of an individual presenting with complex communication difficulties and lability caused by pseudo-Parkinsonian vascular disease. DESIGN: MT intervention was used to investigate whether participation could be enabled in a client presenting with complex problems as well as facilitate change in communication parameters which remained unresponsive to conventional SLT intervention. A single case design measured communication and well-being parameters using pre-, during and post-intervention measures. In addition, analysis of the client's musical responses was undertaken to examine changes in vocal functioning which are involved in communication. RESULTS: Analysis of the client's performance during MT intervention revealed improvements in prosody and phonation, with positive reports of participation, reduced incidence of lability and improvements in measures of well-being. CONCLUSIONS: The results indicate the value of such collaborative working in addition to making recommendations for the modification of existing treatment protocols. The findings highlight that fatigue is a major consideration when working with people with severe and complex clinical presentations.