Multidisciplinary teamworking in the care of elderly patients with hip fracture

Abstract

In spite of the increasing diversification of ward-based teams, there has been little empirical research into the evolution and functioning of multidisciplinary teams in the acute hospital setting. The importance of ‘good teamwork’ and ‘multidisciplinary collaboration’ has been highlighted recently in recommendations for ‘best practice’ in the care of elderly patients with hip fracture. Where any elaboration is offered, however, it concentrates narrowly on the specific component of ‘ortho-geriatric collaboration’. This has also been the focus of research in the field. It is argued in this article that further research into the effectiveness of multidisciplinary teamworking in hip fracture care cannot proceed without first understanding the ways in which teams actually operate in current practice, whether in specialised rehabilitation units or in ordinary orthopaedic wards. An empirical dimension to this discussion is provided by drawing on a recent four-centre study of hip fracture care in Scotland which shows that, although the basic membership of orthopaedic teams is fairly standard, there are considerable variations in staffing levels and composition and in the extent of geriatrician involvement and styles of teamworking. Although this paper is concerned with reshaping a specific research agenda, it should stimulate practitioners who work in orthopaedic wards, and indeed other types of hospital ward, to reflect on their teamworking arrangements.

Key Words:

• Hip fracture
• elderly
• rehabilitation
• multidisciplinary teams
• orthopaedics
• cost-effectiveness