Social workers' perceptions of multi-disciplinary team work: A case study of health social workers at a major regional hospital in New Zealand

INTRODUCTION: International research has highlighted the importance of effective multi-disciplinary team (MDT) functioning in health care settings: when collaboration between disciplines is effective, higher quality patient care results; whereas poor MDT functioning is associated with deleterious health outcomes. This study explores the findings of a small-scale case study into social workers' views of MDT functioning at a major, regional public hospital in New Zealand. METHODS: Data was collected using in-depth interviews with eight health social workers and one focus group with three additional health social workers. Thematic analysis was used to identify key themes, and a discourse analysis undertaken to identify predominant discourses evident in the data. FINDINGS: Study participants considered that when MDTs were well-facilitated important non-medical aspects of patient care were addressed: patient care and discharge plans were communicated clearly and consistently to patients and families, and coordination between MDT members was effective. However, participants also identified occasions when the facilitation of MDTs was poor, where meetings were unstructured and unfocussed, and where social work and patient concerns with wider non-medical issues was devalued. Participants considered that such situations could lead to confusion and distress for patients and a failure to coordinate effective plans for discharge. CONCLUSION: The findings from this case-study suggest that, from the perspective of health social workers, ineffective facilitation of MDTs, an undue emphasis on the discourse of the patient as a 'site of disease', and a preoccupation with the management of risk can demote and devalue more holistic patient-centred perspectives, and the effectiveness of important, non-medical aspects of patient care.