Table 1 Students’ suggestions for improved interprofessional working
Relationship building | • Healthcare professionals taking time to introduce themselves to colleagues when visiting wards would help to avoid misunderstandings • Weekly multi-disciplinary team lunch could facilitate relationship building, practitioner wellbeing, and mitigate shifting teams • Active support for good relationships between different members of the MDT would help facilitate a multidisciplinary approach to problems |
Patient dignity | • Interprofessional and interpersonal issues should be dealt with away from patients • Holding MDT meetings behind doors and not in the open ward would help to preserve patient confidentiality and dignity |
Support for novices and juniors | • Actively inviting junior nurses, doctors and midwives to speak up and ask for help could help to overcome hierarchy • Written guides would help to support new doctors and locums to work more effectively in unfamiliar contexts • Keeping a list of patients consented for medical students to see on a ward would mean that students would not have to keep asking senior nursing staff |
Interfaces between services | • Give paramedics direct access to patient records to support diagnosis, improve care and reduce admissions • Give hospitals access to primary care patient records to improve A&E efficiency and safety • Primary care doctors would benefit from direct telephone access to specialists, to consult on the effective care of complex conditions, improving patient confidence in their care • Centralising patient records would avoid duplication of scans, tests and investigations, and facilitate sharing of expertise |
Collaborative practices | • Doctors and nurses could come together to explain results to patients, draw on each other’s skills, to ensure is information is both correct and communicated well • Nursing staff could proactively share the workload of surgeons during surgical admission, giving surgeons more time to respond to patient questions and concerns during the consent process • Include surgeons in MDT meetings to give them opportunities to meet new staff and to discuss the care of their patients • Enable pharmacists to join the main ward round rather than conduct their own, to help to avoid fragmentation of care and disruption to patients • Involve junior staff (as witnessed on a labour ward) to give more patients a voice through their closest carer • Institute multidisciplinary ward rounds to give junior midwives more of a voice • Multidisciplinary primary care meetings, to discuss regular or complex patients, would help to share expertise and understanding • A mid-day huddle would help ensure that developments and issues were communicated verbally across the team, reducing errors • Team huddles, rather than relying on others to find and read notes, would allow questions, improve care and facilitate the discharge process • Greater use of traffic light systems on ward whiteboards would help to communicate task prioritisation and coordinate patient discharge • ‘Parking’ questions until a handover presentation had been completed would help to ensure that there was an organised flow of information |