Rajiv Singh, Ayşe A. Küçükdeveci, Klemen Grabljevec, Alan Gray
School of Health and Related Research, University of Sheffield, S1 4DA Sheffield, United Kingdom. E-mail: rajiv.singh@sth.nhs.uk
DOI: 10.2340/16501977-2364

The increasing complexity of healthcare provision and medical interventions requires collaboration between large numbers of health professionals. The nature of the interactions between team members determines whether the pattern of working is described as multi-, inter- or trans-disciplinary. Such team-working is an important part of the specialty of Physical and Rehabilitation Medicine. Grounded in group behaviour theory, team-working demonstrates that joint aims, trust and willingness to share knowledge, can improve patient outcomes, including mortality. The synthesis of individual skills and knowledge and working to common patient goals, has shown benefit in many conditions. This evidence base is perhaps best in stroke, but has been demonstrated in many other conditions, including acquired brain injury, back pain, mental health, cardiopulmonary conditions, chronic pain and hip fracture. There are also considerable benefits to staff and health organizations in terms of outcome and staff morale. This review paper examines the evidence for the benefit of such team-working and for the recommendations of team-working in rehabilitation services.

Groups are more likely to perform well when individuals work together effectively as a team. This harnesses the individual skills, knowledge and talents of each member. It has been shown in many areas of medicine that good teamwork can produce an effect greater than the sum of individual efforts. This is particularly true in Physical and Rehabilitation Medicine, where the work of separate specialists and professions combines to direct treatments toward patient-oriented goals. It is important that a team has common goals, structured meetings and agreed processes for decision-making and accountability. The literature on evidence and guidance for such teamwork in rehabilitation is discussed.