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CAPC Palliative Care Discussion Forum
Leadership and Team Dynamics
roundingAuthor: maryg
Date: Mar 17, 2011 12:49 pm
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Generally, as a consult service, there are no clear requirements. The frequency for each member of the team can hinge on many factors.
(1) the clinical need, first and foremost
(2) the need for the team to "divide and conquer." As teams get busy, most find that they need to increase "efficiency" by not necessarily having all members of the team see all patients every day. Teams can thoughtfully triage patients that require various members of the team at various times
(3)Some teams set up structures to have a member of the team (often the NP) see and assess the patient's need and then direct various members of the team to see the patient based on need.
(4)Expectation is key. What is the culture at your institution for consult services. Are patients seen every day until the consult signs off the case?
(5) Non-abandonment is key but this can often be achieved within the team as a whole.
Generally, when the whole team is not seeing the patient, the team does need some mechanism (eg team meetings and charting) to keep everyone up-to-date and to gather the wisdom of the group.
I welcome others' thoughts.
best,
Mike Rabow, MD
UCSF Palliative Care Leadership Center