Interprofessional teamwork in medical rehabilitation: a comparison of multidisciplinary and interdisciplinary team approach.

摘要

OBJECTIVE: To compare multi- and interdisciplinary team approaches concerning team process (teamwork) and team effectiveness (team performance and staff satisfaction) in German medical rehabilitation clinics. DESIGN: A cross-sectional study with a descriptive-explorative design. Setting: Eighteen medical rehabilitation clinics divided into two groups (somatic and psychosomatic indication fields). SUBJECTS: The 18 head physicians or psychotherapists in the clinics and their complete rehabilitation teams (n = 824). MAIN MEASURES: An interview guide was designed to determine the team approach in a telephone interview. A staff questionnaire for team members measured teamwork and team effectiveness with psychometrically validated questionnaires and self-administered items. RESULTS: All 18 head physicians took part in the telephone interview. The response rate of the employee attitude survey averaged 46% (n = 378). Eight teams were categorized as multidisciplinary and seven teams as interdisciplinary. In three cases the results were ambiguous. These teams were not considered in the further study. As expected, the interdisciplinary team approach showed significantly better results for nearly all aspects of teamwork and team effectiveness in comparison with the multidisciplinary team approach. The differences between multi- and interdisciplinary approach concerning teamwork and team effectiveness were higher in the somatic (8 teams, n = 183) than in the psychosomatic indication fields (7 teams, n = 195). CONCLUSIONS: Teamwork and team effectiveness are higher in teams working with the interdisciplinary team approach. Therefore the interdisciplinary approach can be recommended, particularly for clinics in the somatic indication field. Team development can help to move from the multidisciplinary to the interdisciplinary approach.