Physiotherapy Team Leader, Bay of Plenty DHB, Tauranga, NZ
Griffin, H., Tauranga Hospital, Tauranga, NZ
Hay-Smith, E.J.C., Otago University, Dunedin, NZ
Introduction: Interdisciplinary teams (multidisciplinary team collaborating in assessment and treatment) were recently distinguished from multidisciplinary teams (treatment provided by practitioners from different disciplines) by the International Association for the Study of Pain (IASP). A systematic summary of studies of chronic pain teams provides a starting point for understanding what contributes to effective interdisciplinary teamwork.
Aims: To investigate the features supporting development and maintenance of a well-functioning chronic pain team.
Methods: A mixed-method systematic review of empirical research of clinician-reported experience of teams providing treatment for chronic, non-cancer related, pain in adults. After searching five electronic databases, two reviewers independently completed all study procedures with any disagreements resolved through discussion. Included studies were rated for study quality (the Mixed Method Appraisal Tool) and transferability to the New Zealand chronic pain setting. Data from included studies was tabulated using the systems model as a framework (inputs, throughputs, outputs), and thematically analysed. Themes had contributions from multiple papers; ‘key’ papers had good quality and good transferability.
Results: Seven studies were included after full-text screening. Seven features of a well-functioning team were identified – philosophy, roles, culture, co-location, stable workforce, role boundaries and blurring, and communication. Four themes were strongest, containing data from one or more key papers, and demonstrated the benefits of: an explicit and collective understanding of the team values and goals; sharing office and treatment space; limited staff turnover for team maturity; formal and informal opportunities for team communication including ‘venting’ difficult feelings.
Conclusions: Identified features are congruent with the broader literature on effective teamwork and the IASP definition of interdisciplinary treatment. Four features stood out, suggesting these might be particularly important for development and maintenance of effective chronic pain teams in the New Zealand context.