Cook G, Gerrish K, Clarke C
University of Northumbria at Newcastle, Tyne and Wear, UK.
J Interprof Care. 2001 May;15(2):141-51. doi: 10.1080/13561820120039874.
Interagency and interprofessional working has often been operationalised through the development of integrated, multiprofessional teams in the UK. However, there is considerable ambivalence reported about the success of such teams. This paper reports on two evaluations of different types of inter-agency/intra-agency, interdisciplinary/unidisciplinary teams. One study used a soft systems methodology to evaluate a health and social care team for people with enduring mental health needs and the other used a pluralistic framework to examine integrated nursing teams in primary care. In both studies, the team-working arrangements influenced the decisions made by the team members such that client care became increasingly responsive and proactive. These changes were made possible by two processes. First, information transaction was augmented and was instrumental in supporting effective client-related decision-making. Second, there was enhanced support for decision-making, especially in respect of problem solving. However, the increased autonomy of the team members had the potential to marginalise those outside the team from decision-making. It is suggested that working within a team can impact on the decisions made by team members, which exceeds a collection of individual decisions. The strengths of complex multiprofessional teams for service users may be realised if the processes of decision-making are respected.
在英国，跨部门和跨专业合作通常是通过组建综合多专业团队来实现的。然而，关于此类团队的成功存在相当大的矛盾观点。本文报告了对不同类型的跨部门/部门内、跨学科/单学科团队的两项评估。一项研究采用软系统方法评估了一个为有长期心理健康需求的人群提供健康和社会护理的团队，另一项研究则使用多元框架来考察初级保健中的综合护理团队。在这两项研究中，团队协作安排影响了团队成员的决策，从而使客户护理变得越来越积极主动且反应迅速。这些变化通过两个过程得以实现。首先，信息交流得到加强，这有助于支持与客户相关的有效决策。其次，对决策的支持得到增强，尤其是在解决问题方面。然而，团队成员自主权的增加有可能将团队之外的人排除在决策之外。研究表明，在团队中工作会影响团队成员的决策，这超过了个人决策的总和。如果决策过程得到尊重，复杂多专业团队对服务使用者的优势可能会得以实现。
