BraceLab Clinical Clues

April 2022 No. 26

Collaboration…Expanding Your Professional Relationships

By Jerry Ditz, DPT, Dip. Osteopractic, Cert. SMT, Cert. DN and Karol S. Young OTD, OTR/L, CHT

Collaboration is defined as “the act of working together in order to create or to produce something.” (1) We develop collaborative relationships with other clinicians to learn new treatment techniques, to obtain assurance we are making good clinical decisions, or to gain a new perspective on a patient problem. Our end goal is to achieve maximum positive patient outcomes. By working with other medical professionals we learn new skills and perspectives and they gain the same from us.

Insights from a PT

I worked with an OT/CHT who was a clinical instructor at our practice. She consistently received feedback that students did not feel confident completing a cervical screen because they were concerned how their findings would be used by other medical professionals.

Although the OT/CHT instructor accurately taught the essential cervical screening elements and the students practiced on her patients, the fact that the OT/CHT only saw patients who had already received three screenings prior to referral, meant she rarely saw patients with cervical pathology. This also meant the students only saw negative results when they practiced a cervical screen on her patients. Because they never experienced a positive result during screening, confidence in their screening ability was greatly diminished.

Luckily, as a PT, I frequently saw patients with cervical symptoms who had not received prior screening. Allowing these students to shadow me during cervical exams, helped them see what elicited positive findings and taught them how to better identify causes of concern before proceeding with therapy when certain positive responses were identified. Following this change in their clinical rotation, the students stated they were better prepared when leaving their clinical rotation.

Another time I experienced valuable clinician collaboration was when I worked in a large outpatient practice located near a military base. The practice experienced frequent staff turnover because most military therapists move every three to five years.

A simple exercise was used to share varied treatment approaches. The clinic director would present a diagnosis and a stage of rehabilitation to each therapist; for example: shoulder pain in an overhead athlete at end stage of rehabilitation close to discharge.

Each therapist would then describe one treatment approach, the rationale for its use, and any important insights or suggestions. One response to the example above is:

  • Treatment: Crawling forwards and backwards in the quadruped position.
  • Rationale: To combine demands on the patient’s core strength while placing a heavy load on the involved shoulder in a safe position.
  • Insights/Suggestion: Encourage patients to maintain a horizontal spine position. If this is challenging, rest an object (chart, book, foam roll) on their lumbar spine and ask them to keep it from falling off.

Insights from an OT/CHT

Therapists often work alone or in a small clinic with limited resources. In such circumstances, effort is required to collaborate with other health care professionals. When in that situation, I reached out to therapists in surrounding communities to initiate informal lunch meetings to discuss current topics and/or share clinical expertise. This resulted in a network of clinicians to whom we could refer patients for specific needs such as athletes with throwing injuries, women’s health issues, and individuals with lymphedema.

I also attended a journal club comprised of physicians, residents in training, and hand therapists. Multiple disciplines discussing journal articles allowed me to develop a greater appreciation of varying perspectives, as well as learn current treatment interventions. The physician’s perspective gave me insight into the technical aspects of surgery, including details not found in an operative note.

Additionally, through these discussions, residents learned the important role therapists play in the postoperative care of patients. Involvement in the journal club also led to volunteer teaching opportunities within a community college and an Orthopedic Sports Residency program.

In another clinic we met weekly to review the treatment approaches of our longer-term patients. Each therapist asked questions about treatment rationale and/or made suggestions for fresh rehabilitation approaches. It is often easy to lose perspective when treating a long-term patient who is making slow progress. The clinical insight of other skilled therapists is a great way to maintain a relevant and effective treatment approach, or perhaps conclude that treatment needs to come to an end.

The clinicians at Bracelab work together to share ideas and solutions. We encourage you to find others in your medical community with whom you can collaborate. Collaboration provides supportive learning opportunities that assist in positive outcomes for your patients and professional growth for you. (2)

 

1. https://www.merriam-webster.com/

2. Hand Therapy Certification Commission. The hand therapist peer mentoring manual. Ed. 2. HTCC; 2021. https://htcc.org/mentoring/mentoring-handbook

 

Download Clinical Clues No.26, Collaboration…Expanding Your Professional Relationships; April 2022

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Disclaimer: BraceLab Clinical Clues are intended to be an informal sharing of practical clinical ideas; not formal evidence-based conclusions of fact.

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