Table of Contents
Introduction
James is a 49-year old African man with several chronic conditions. He suffers from chronic kidney disease, type 2 diabetes, and moderate depression. He lives 3 hours from Prince Albert. In a week, he has to make a trip twice to Prince Albert where he receives the hemodialysis services. James lives alone and does not own a car. On occasional basis, he manages to get ride with a relative or friend, but when it does not happen he has to hitchhike.
The paper focuses on the analysis of the ailment of James and how the illness affects him biologically, sociologically, psychologically, and his life course. This is followed by an examination of the work of multidisciplinary team (MDT) in responding to his ailment. Such includes examining what was done well and what could be improved in the future when MDT handles such a situation.
Biological
The chronic disease of James subjects him to the stressor associated with the body reacting to different challenges from the environment. Thus, James is undergoing a pain from the stimuli in the environment, which results into his body responding in different ways. Such responses could aggravate the problem and delay the healing process (Dingel, Karkazis & Koenig, 2011, 1364). In the body of a human being, hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous systems are the ones that assist in responding to stressing situations.
James should have the homeostasis, which the biochemical process of maintaining equilibrium. However, his lack of a common means of attending the hospital on weekly basis induces a significant problem, which indicates that he will not have a good state of conducting and running his activities. The external or internal stimuli in the environment tend to disrupt this homeostasis, which affects the condition of the living organism.
The patient is vulnerable to the development of chronic stress. Such a stress could cause allostatic shift in the function of the body (Irwin, Johnson, Henderson, Dahinten & Hertzman, 2007, 354). The prolonged stress indicates that James will have a slower healing process. Acute stressors may also hinder the immune system of the patient from responding immediately on emergent issues in the body of the patient.
Sociological
Culture and socialeconomic status of James affects how quickly he will recover from the chronic problems. He does not have a car to go to the hospital, which makes him result into hitchhiking. Such a condition will trigger him to develop depression, stress, and more illness, as well as physical health problems (Hall & Jurow, 2015, 174). At the end of the day, James may suffer from anorexia nervosa, which is a condition associated with purposeful and excessive loss of the weight.
James is in a state of social isolation. He lives alone and does not have social relationships. Hence, his medical condition may trigger him to be vulnerable to the strained aspects of relationship, which include stress and conflict. Social ties are paramount in the healing process, but for individuals who have no social relationships like James, the ailments will take long to cure (Dingel, Karkazis & Koenig, 2011, 1365).
James may think that he understands his medical condition while in the real sense he is suffering. A health care service provider should not link the causes to events in the life of James. Rather, focus should be to take James through a journey of forgetting the social events, which could make him develop stress and negative attitude towards the environment body (Irwin, Johnson, Henderson, Dahinten & Hertzman, 2007, 354). Historically, he has been living alone. Therefore, caution has to be extended to his health care service provision to ensure that he does not start recalling what happened previously in his life. His pre-conceived notions, beliefs, and values could make him vulnerable to different sociological problems, which exist in the environment that slow down the entire process of healing.
Psychological
Psychologically, James has developed an array of symptoms, which include overwhelming sadness, irritability, and impulsivity. These include the development of negative thinking, which makes him vulnerable to depression. Hence, using psychological perspectives would assist in understanding the feelings, behavior, thoughts, and actions of James. Such an activity would assist in changing his behavior and improving the quality of life.
James could develop attitudes and behavior, which instead of enhancing his healing process; they could be inducing a challenge on his health condition. Further, James could suffer from psychological distress, which includes depression and anxiety. The situation occurs since the prolonged pain adds stress to the cognitive and brain issues, which include low mood and challenges of concentration or memory abilities (Short, Claire Yang & Jenkins, 2013, 94). Consequently, the quality of life is reduced significantly. Further, psychological effects pain becomes excess as compared to the chronic pain, which presents an additional health disorder to James.
We can do it today.
Life course
The past experiences in chronic suffering of James give him the hope and courage to carry on in life in spite of the challenges he is facing. As such, his past experiences have made him to adapt to the medical condition, which improves on his balance between vulnerability and resilience. Further, the socioeconomic status of James is not good, which indicates why he finds it complex to visit the health care facility in order to receive the medication. Therefore, the provision of health services for his chronic condition should focus on addressing this issue to ensure that he does not develop the negative feelings of being isolated in the entire society.
However, the lifestyle of James makes him vulnerable to other risk factors that include diabetes, dyslipidemia, hypertension, and obesity that act synergistically and independently. These are risk factors, which could not be diagnosed immediately in the health care facilities (Short, Claire Yang & Jenkins, 2013, 95). The cultural, social, and structural environment where James lives does not help him to improve on his health condition. Instead, it makes him worse because there are no people to support his emotional well-being well at home.
Working together of the lenses
Biological, psychological, sociological, and life course lenses work together in helping to comprehend the healing process of a patient. As such, the lenses are vital to a practicing physician because they give room for detailed and further investigation on what could be causing the problem to the patient. Moreover, these lenses assist in understanding what should be done in solving the problem that a given patient could be suffering from based on the immediate of surrounding environments. The behavioral and social status of James affects his healing process of chronic disorder. Therefore, efforts by the health care practitioners to provide him with medication for him to recover are constrained by these limitations, which indicate that he could fail to recover to the fullest because of his medical, social, and behavioral problems. Moreover, the biological and life course experiences of James induce psychological challenges, which could negatively impact his healing process.
Multidisciplinary team responses
Team makeup
The team is composed of nurses and physicians from Prince Albert. These focus on assessing the medical condition and situation of James as he visits the health care facility. The physicians and nurses also play a pivotal role in providing the management strategy, which can be used in calming the health problem, which James is facing. Such includes offering the referrals to clinical pharmacists and the behavioral medicine interns. The behavioral medicine interns engage in screening the patient to identify any medical conditions and ascertain on the healing process (Coppack, Bilzon, Wills, McCurdie, Partridge, Nicol & Bennett, 2016, 6). They use techniques that include shared decision-making and motivational interviewing as a way of assisting the patient in self-management and establishment of the goal to improve on health behavior.
The pharmacist engages in scheduled or same-day sessions for education, which focus on the key needs of James. Such includes an investigation of his barriers to care, lifestyle issues, exercise, complications because of the use of the medication, and exercises. A social worker is availed, who helps in the process of ensuring that James accesses the medication, he has subsidies on the living cost, solves transportation problems, and he gets good food referrals, which do not complicate his health status (Roncaglia, 2016, 18). Finally, there is an IT support specialist who engages in ensuring that the entire team has a good coordination on service delivery to James. Therefore, there are no team members who do not play their role as expected. The IT specialist also ensures that the team members have a chance of sharing data, information, and knowledge regarding the health of James without major challenges.
Team processes
James is one patient who enjoys an effective multidisciplinary team process. As such, all the team is actively involved in making decisions, which are related to the health and well-being of James. On the first diagnosis of the medical situation of James, the team had a meeting, which focused on deliberating on the protocols to administer health care, as well as monitor the recovery process of James while visiting the facility. The meeting was chaired by the medical officer in charge of patients under chronic conditions.
From the meetings, the team was in agreement on the information, which will be shared regarding the health of the patient. Such includes who will be collecting the information and how it will be presented to other team members (Coppack, Bilzon, Wills, McCurdie, Partridge, Nicol & Bennett, 2016, 8). There was also an indication on the role that each team member was to play in terms of the action to take in relation to the health status of the patient. The team members then engaged in exercising their duties at the highest level of expertise, skills, and knowledge in the provision of health care to patients with chronic conditions.
The nurses worked in unison with the physicians at Prince Albert health care facility. These in turn shared the information on the well-being of James with the social worker who had the role of ensuring that he followed his medication schedule and attended all the clinical appointments (Roncaglia, 2016, 18). Further, the physicians shared information with the pharmacists who advised on the correct medication and how James should take it in order to recover. The pharmacist also collaborated with the social worker to ensure that the patient was able to follow all the instructions, which are related to medication. Moreover, the social worker had the task of reporting to the other team members of the health and eating habits of James.
Team outcome
The team worked together to provide comprehensive health care services to James. These services were very integral into the recovery and healing process of James who is now in good health and able to participate in several community based tasks and projects. The physicians had an opportunity of having efficiency in delivery of quality care services to the patient. Such occurred while ensuring that it was possible to meet the standards for health on chronic conditions.
James had an opportunity of getting consistent care from the team, which was reliable, safe, and of high quality. Thus, his chronic condition was disappearing enabling him to gain good health (Sharma, Mahesh, Richard, & Mauro, 2017, 73). The staff members exercised their duties and roles at the highest levels of ability and expertise, which ensured that members had a chance of becoming successful in service delivery. Moreover, the team members had a chance of utilizing their time in an effective manner, which ensured that they were able to offer services to other patients in the hospital successfully.
Prince Albert health care facility also benefits from the efficiency of the team in addressing the chronic condition of James. The institution gets a chance of effective service delivery and it continued to build its brand name as a reputable health care facility, which ensures that patients have a chance of recovering from their medical conditions. The situation occurs since James will always talk of how effective the hospital is in delivering services to patients. Thus, a direct marketing for the institution will be obtained from this patient.
Evaluation and recommendations
Evaluation criteria
In order to judge the success of the team, the focus will be on the outcomes. As such, a question would be posed, which is; was the multidisciplinary response team engaged in an activity, which did not have positive outcomes or did it have any outcome on the patient? Answering this question will help in knowing whether there was success in the team (Sharma, Mahesh, Richard, & Mauro, 2017, 73). For this case, the team was successful because it had an opportunity to have the positive outcomes of giving James another chance for good health and life. The adopted team approach was also efficient in administration of the medication and giving quality care to the patient.
The involved team members did not engage in any form of conflict, which could have delayed or affected the treatment, which was being provided to James. These individuals worked in unison and mutual respect for one another, which depicts that there was success in offering health care to the patient. The medication and personal advice provided to the patient was also beneficial and contributing to the recovery process. Hence, the patient was always happy when attending the appointments since he knew that he will get the best of the best in terms of health care service delivery from the institution.
Moreover, the team adopted evidence-based practice as a way of addressing the chronic condition, which the patient was facing. Therefore, there were positive outcomes in the administration of medication and ensuring that the patient regained his health (Subramaniyan, Mital, Rao & Chandra, 2017, 13). Furthermore, there were no negative outcomes, which were reported as a result of the administration of the health care services to the patient. In addition, the administration was not subjected to legal suits for failure to administer medication or offering bad services to the patients.
Evaluation process
The process of the team could be evaluated by determining whether the leader had a clear vision and direction while providing and listening to the supervision and support of all the members of the team. Further, the team should have values that indicate the direction of how the members engage in service provision. The values should be portrayed and visible to all individuals. Furthermore, the team should have interdisciplinary atmosphere and culture where there is fostering of consensus and value among all the members. Such includes ensuring that there is appropriate infrastructure and processes to enhance the service have a vision.
The services should be quality patient-focused with outcomes that are documented where the feedback is utilized in the process of improving quality care. Further, communication strategies should be adopted that enhance collaborative decision-making, intra-team communication, and effective team processes (Subramaniyan, Mital, Rao & Chandra, 2017, 13). The staffing of the team should have the right of mix of personalities, competencies, and skills for effective functioning and meeting the needs of the patients. Moreover, autonomy should exist in relation to the functionality of the roles of each member of the team.
As such, the team make up, processes, and outcomes were effective in service delivery to James. The implication is that health care practice should continue using evidence-based practice where there is good leadership of a team to provide quality health care services to patients (Kabrhel, 2017, 17). In the future, the team should focus on incorporating the next of kin or the family members of the patient to whom they are providing the medical services. Such an approach will ensure that there is effective service delivery, which can be appreciated by all individuals in society.
Recommendations
The evaluation efforts should be focused on how the team creates a link with the family members of the patient. Such offers a great opportunity for the multidisciplinary approach to focus on delivery quality health care services in society (Babur, Mumtaz & Shafqat, 2017, 43). Further, the MDT should have the ability to develop strong trust and respect among the members. Such is vital since the team utilizes a mixture of skills and agrees on specific clinical governance structures. These include protocols and systems for interaction and communication among the team members.
MDT meetings should always be conducted under clear leadership to offer a chance for them to deliver in improving the quality of health of patients. These meetings act as the key determining factors of how the team members will proceed in providing health care services to the patients (Kabrhel, 2017, 17). Thus, the leadership should focus on the effectiveness and productivity of the meeting, as well as decision-making so that quality health services are offered to the patients. These helps in increasing the value of health care while using the available resources in an effective manner.
Teamwork is an integral thing in ensuring that patients attain the recovery or the healing that they desire. Leaders of MDT have to ensure that the team does not contribute to errors (Babur, Mumtaz & Shafqat, 2017, 43). Instead, the team should focus on offering the best services, which assist in improving the efficiency level and outcome of health care services, which are provided to the patient. Working in a team should also be a great step towards ensuring that the health care service providers have a habit of working together in delivering services to patients. Such a harmonious work aids in securing good health and well-being of patients.
Conclusion
In conclusion, the chronic disease, which James faces, could not be addressed effectively without successful functionality of the MDT. Such a disease tends to add stressors to his body and social well-being. These stressors emerge from psychological, sociological, biological, and life course of the patient. His social environment subjects him to psychological problems because he lives alone and his economic background does not warrant him good transport to the hospital. Hence, his life course is characterized of a myriad of challenges. However, the MDT was effective and successful in responding to his medical condition. The team adopted a process, which ensured that James does not suffer, but recover from his suffering situation to be a normal person in society who is able to enjoy life like other members. Such a response gives James hope of being healthy. Evidence-based practice, trust, respect, and a mixture of skills, expertise, and experience should be used by MDT when responding to challenges like the one described in the medical condition of James.
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