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Dr.

Saini Jeffery
Consultant Rehabilitation Physician
KPJ KL Rehabilitation Centre

Origin of Quote?
In Metaphysica

What Does it Mean?

Interpretations

Max Wertheimer - founder of Gestalt Theory


Team Dynamics in learning skills - synergy activity

Team models in Rehabilitation Medicine

Rehabilitation

Process of helping a person to

reach the fullest physical, psychological, social,


vocational, avocational and educational
potential
consistent with his or her physiologic or
anatomical impairment, environmental
limitations, and desires and life plans

Rehabilitation
Comprehensive
Patient-centred
Maximising outcomes with from limitations
Prevention and early recognition
Outpatient, inpatient and extended care programmes
Anticipated outcomes: increased independence, shortened
LOS, improved QOL

Goal Oriented

Treatment plans are


generated from goals that
arise from problems list
developed during evaluation
Treatment plan is dynamic

Rehabilitation Process

Multiple Health-Care Providers

Potential for Chaos and Confusion?

Team Communication

Comprehensive medical rehabilitation requires


interaction of various caregivers
Primary goal of interactions is communication of
patients needs and coordination of their efforts in a
synergistic manner
4 models of interactions will be discussed

Medical Model

Physician attends to patient's


needs
If services of another
professional needed, general
or specific requests for
assistance are made
The caregiver would usually
discuss with referring doctor
regarding any additional
treatment identified before
proceeding

Advantages & Disadvantages


Advantage:
clear chain of responsibility well- respected medicolegally
Disadvantages:
Multiple professionals performing multiple tasks which
may be similar

Difficult for attending physician to coordinate resulting


in less efficient patient care

Multi-disciplinary Team Model

Multi-disciplinary Team Model

Provide a means for multiple professionals to meet


and coordinate efforts on a consistent basis
Remains an attending physician controlled team
Evolution of medical model

Advantages & Disadvantages

Efficient team conference with clear line of


authority and control
Still directed by attending physician
Obstacle to optimum use of other professionals'
expertise, negating group synergism
Not patient-centred

Interdisciplinary Team Model


Group decision making and
group responsibility
Patient considered part of
planning group and has a
central role in team'
considerations
May be led by any team
member
Allow a freer exchange of
ideas benefitting a group
synergy concept

Disadvantages

Less time efficient

Considerable training needed


Physician may be uncomfortable as he is the one
that must assume medico-legal responsibility
Difficulty in having physician complete the
appropriate prescription if the plan differs from what
the physician recalled or desired

Transdisciplinary Team Model

Transdiciplinary Team Model


More recent development
Encourages cross-treatment between disciplines
Justified on basis of economic market forces and inadequate
number of therapists
Consistency of information exchange with patient intrinsic to
cotreatment
? Future rehabilitation generalists
? Competency of therapists

Most effective team model?

Lack of research
evidence
May be dependent on
practice environment
Combination of
models

Conclusion
Comprehensive rehabilitation can be a complex task

Desired goals are not disease specific


Patient is expected to make transition from passive
observer to an active participatory role
Planning and facilitating all desired interventions can
be achieved best by multiple disciplines and then
sharing of knowledge must take place to ensure a
cohesive treatment plan is formulated

Thank You

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