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CAPC Palliative Care Discussion Forum
Leadership and Team Dynamics

Next Reply: Re:Interdisciplinary team rounding
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Post Interdisciplinary team rounding
Author: sbryant111
Date: May 18, 2010 3:42 pm
I am the chaplain for a hospital based palliative care team that includes a physician and a licensed mental health counselor. We are all full time.
Our goal is to make initial assessment visits as a team to present a unified approach. With this initial visit the physician dictates an H&P if needed and records in the medical record the goals and plan of care for the palliative care consult. The chaplain and LMHC write a separate note in the chart identifying the discipline specific goals and interventions. Due to the varying discipline specific notes that need to be documented there are times when the chaplain and LMHC are idle waiting on the physician.
We are open to exploring other ways to round on initial consults and I would appreciate any ideas.
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Re:Interdisciplinary team rounding (by SharolHerr on 05/18/2010)
There are lots of different strategies for managing consults. Some programs take all team members on initial consult and some have a physician or NP do the initial consult and then engage other team members to discuss the case and identify/create the appropriate plan of care. Our team has the physician/NP see the patient and initiate the palliative plan of care and then the case is discussed with the IDT at the next IDT conference which may be the same day or the next day. The down time could be used for you to see individual cases in follow-up with specific needs related to your individual discipline or education and/or networking initiatives to engage in with the hospital staff. It may not be sustainable to attempt to always round as a group. That could dramatically impact productivity and may also be overwhelming to patients and families. For the patients on our acute palliative care unit there is a pre-rounding clinical conference with all disciplines on the team (usually under 30 minutes) and then room to room rounds. The time spent in the room is usually about 5 minutes. During these times the current plan is reviewed and then modified as appropriate. Sharol Herr, RN, BSN, MSEd, CHPN; Nurse Clinician/Education Coordinator; Mount Carmel Health Palliative Care Leadership Center; Columbus, Ohio.

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