Exploring multidisciplinary teamwork in community elderly healthcare in Hong Kong

Abstract

Hong Kong’s ageing population, due to a decreasing fertility rate and increasing life expectancy, creates challenges for society such as sustained pressure on healthcare, social welfare and public finance. The elderly often experience complex health problems, and multidisciplinary teams in community healthcare have emerged to address their specialized needs. However, little research in Hong Kong has sought to understand how members in such teams work together in their goal of supporting the elderly.

This study aimed to examine the experiences and perceptions of members in multidisciplinary teams, to explore the factors associated with effective teamwork and to understand the underlying process and mechanism of the interaction among teamwork contributors. Seventeen members from two teams in a community elderly healthcare unit were included in the study. Non-participant observation and semi-structured individual face-to-face in-depth interviews were used to collect team members’ experiences and perceptions of teamwork.

Four themes emerged after analyzing the transcripts from the interviews: communication, team structure, leadership, and team member quality. Communication was the core behaviour in teamwork. Formal communication facilitated the transmission of routine and structured information, while informal communication delivered information in a flexible manner for urgent and complex issues. Team structure was the organizational foundation of an effective team. The common goal unified team members to play interdependent roles under a well-designed teamwork procedure. Team stability maintained the sustainability of effective teamwork. Leadership coordinated the teamwork in decision-making and problem-solving processes. An effective leader fostered a supportive climate through the establishment of trust and non-hierarchical relationships in the team. Team members were the basic elements of a team. Members with excellent professionalism, harmonious interpersonal relationships and effective interpersonal skills were indispensable parts of an effective team.

Among the four themes, an underlying process and mechanism existed. Effective communication was supported by a well-designed team structure and excellent team members, with these two elements being mutually supported and leadership facilitating the process. Findings in the study showed that multidisciplinary teams in community elderly healthcare were interprofession-based problem-solving teams. The broad objectives of the team were to provide appropriate clinical support to elderly patients post discharge and when residing in the community. The team’s work procedures emphasized healthcare expertise, focused tasks, clear roles, standard operation procedures and interdependent collaboration.

The findings in the study provide an in-depth understanding of teamwork in healthcare and recommendations are given to help enhance the future work of multidisciplinary healthcare teams.