Why the Interdisciplinary Team Approach Works: Insights from Complexity Science.

Background: Although an interdisciplinary approach is considered best practice for caring for patients at the end of life, or in need of palliative care (PC) services, there is growing tension between healthcare organizations' need to contain costs and the provision of this beneficial, yet resource-intensive service.

Objective: To support the interdisciplinary team (IDT) approach by recognizing organizations, teams, patients, and families as complex adaptive systems, illustrated by a qualitative study of the experiences, roles, and attributes of healthcare professionals (HCPs) who work with patients in need of PC services.

Design: In-depth, semi-structured interviews of PC health professionals were conducted, transcribed, and independently reviewed using grounded theory methodology and preliminary interpretations. A combined deductive and inductive iterative qualitative approach was used to identify recurring themes.

Setting/subjects: The study was conducted in a physician-led, not-for-profit, multispecialty integrated health system serving three large, Western, rural states. A purposive sample of 10 HCPs who regularly provide PC services were interviewed.

Results: A positive team/patient experience was related to individual attributes, including self-awareness, spirit of inquiry, humility, and comfort with dying. IDT attributes included shared purpose, relational coordination, holistic thinking, trust, and respect for patient autonomy. Professional and personal motivations also contributed to a positive team/patient experience.

Conclusions: Interdisciplinary PC teams have the potential to significantly impact patient and team experiences when caring for seriously ill patients. Findings from this study support interventions that focus on relationship building and application of a complex systems theory approach to team development.