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Dynamics of the Interprofessional Team in Acute Care

The Med-Surg team is a microcosm of the entire hospital, requiring constant, coordinated effort from multiple disciplines to manage the patient's acute illness, prepare for discharge, and manage the health system's flow.

Key Roles and Their Contributions

Challenges and Barriers to Effective Teamwork

The dynamics on a Med-Surg floor often involve several structural challenges:

Hierarchy and Power Dynamics: Traditionally, the physician holds the highest authority, which can lead to nurses and other allied health professionals feeling hesitant to speak up if they disagree with a plan or notice an issue. This can create a significant barrier to psychological safety and critical information sharing.

Information Silos and Timing: The various professionals are not all present at the same time. The physician may round in the morning, the PT mid-day, and the SW afternoon. If the RN doesn't successfully and completely pass on the PT's recommendation for discharge equipment to the CM, the discharge can be delayed, creating a bed flow issue for the administrator.

Jargon and Perspective: Each discipline has its own professional language. A physical therapist's assessment of "modified independent" is precise to them, but a physician or social worker must understand the practical implications of that phrase for the patient's life outside the hospital. The physician focuses on the disease, while the SW/CM focuses on the social context of the patient's life.

Effective teamwork in this setting relies heavily on the use of standardized communication tools (like SBAR) and the daily Multidisciplinary Rounds to force all critical members to align their individual plans toward the singular goal of a safe, timely, and effective patient discharge.