Communication and collaboration

Question 1NHS England (2015) described multi-agency working as aptly using knowledge, expertise and best practices from across various disciplines, bodies or service providers to reclassify and modify the nature of service delivery in health and social care, and to achieve results based on improved aggregate understanding of the intricate needs of patients. Lloyd et al(2001) also defined multi-agency working as more than one body collaborating in an organised and formal manner, as opposed to just through ordinary informal systems (despite the fact that latter may bolster and build up the former). This can be at a vital or operational level, which may be triggered by joint planning or easily be a form of duplication, as a consequence of an absence of effective interagency organization (Harley, et al 2003). Lewis and Reeves (2011) stated that multi agency working is where the challenges that might impact on the well being and achievements of vulnerable persons can be prevented through early intervention by sharing of information, duties and responsibilities by more than one agency collaborating together. Multi-agency workings can therefore be regarded as a team of professionals from various backgrounds in mental health, primary, community and social care services who work hand in hand to establish a patient’s care (Salmon et al 2006). According to NHS England (2015) the degree of integration can extend from just one professional tasked with a duty of care drawing on other services or staff for contribution, through to various professionals handling shared duty regarding the service delivered to the patient, possibly drawing from a more extensive pool of available agencies and services. Working towards a shared objective raises exceptionally difficult challenge for professionals from various backgrounds and agencies, far beyond those issues emerging from collaboration within a single discipline or profession (Burn, 2011). Such challenges stem somewhat from the contrasting belief system, work practices, cultures and needs that are experienced when teachers, social service administrators and healthcare professional plan to work collaboratively to promote the interest of children and other vulnerable adults they work with (Burn, 2011).The benefits of multi agency working on vulnerable adults with severe learning difficulty and mental health cannot be overstated as an example of the Winterbourne care home abuse case that might have been prevented (Department of Health, 2012). The report highlighted that there was sufficient information necessary to prevent such abuse available to various agencies that covered the shared responsibility of the victims if only they had been put together and shared in a timely manner (Department of Health, 2012). There is easy access to specified support when required, as challenges can be addressed in a quicker and more robust way by various agencies working together and applying their expertise to achieve the best outcomes (Watson, 2006). For example the care pathway of a vulnerable adult with severe learning disabilities will include a number of skilled professionals like doctors, nurses, teacher and so on providing the necessary care and support thereby making the patient secure and rest assured (Bickerton, 2011) . Multi-agency working this limits the probability for errors or mistakes that may put adults with severe learning disability at risk, because activities are checked by various individuals (Dowling et, al 2004). By upholding a level of proficient monitoring, adults with vulnerabilities may not likely require a broad and specific service for an extensive period of time. This is on the grounds that any occurrence or fall in care practices will be seen and properly handled before it deteriorates (Watson 2006). As multi agency working allows for collective decisions to be made by several agencies and professionals, in the same vein this leads a smoother and uniform implementation of policies and strategies, as all practitioners are already in agreement (Milbourne, 2005). It also helps eliminate boundaries and close-minded attitudes amongst other professionals, while echoing the voice of the organisation and building agreement. It encourages staff to share not only ideas, working knowledge, good practice and resources, but also to elevate the level of mutual support thereby prompting efficient work load management (Dowling et, al 2004). Helps to lift staff spirit realizing that they don’t work seclusion or isolation and that challenges and obstacles can be resolved with cooperation (Milbourne, 2005). Multi agency working also provides dedicated and resourceful staff with a certain level of increased belief of themselves as well as other people. There is an increased degree of trust present between service providers/bodies in connection to everyone acknowledging that each can and will deliver. QUESTION 2According to Curry et, al (2010) collaboration in health is regarded as health care professionals accepting similar or familiar duties and jointly working together, proffering solutions through shared responsibility and taking actions to create and carry out patient care plans. The World Health Organisation, (2010) identifies this as a significant policy strategy for tackling patient safety and health care workers issues, and changing health care systems. While Flin et, al (2003) mentions this under the five degrees of multi agency working which includes cooperation, co-existence, coordination and co-ownership. Collaboration herein was described as long-term responsibilities between members, with systematic changes that bring shared guidance, direction, assets and risk-taking. Members from various bodies agreed to work jointly on plans or strategies, each adding to accomplishing shared objectives (Flin et al 2003). Thistlethwaite (2012) also argued that collaboration can be different from coordination, cooperation in the sense that working together results to achieving something new when you have a shared vision. The support of healthcare providers, patients and families can be improved through effective collaboration during the process of treatment this also results in improved quality results, general patient experience, wellbeing and efficient use of resources. Patient care is one of the hallmarks of collaboration, as all healthcare professionals must establish good communication across team members (Thistlethwaite 2012). For example it is easier to uncover any loophole in the care system that might lead to vulnerable adults with mental health or severe learning disabilities being abused (Harris 2003).Collaboration, trust and respect are some of the general characteristics of an effective team. Teamwork is Key to the functionality of any healthcare system, whereby everyone involved is working towards a common goal. According to Dowling (2004) interdisciplinary method works better than the multidisciplinary approach when taking into account teamwork model in health care. For example the medical care team for a pregnant woman who develops a blood clot along with pre-existing diabetes includes: respiratory physician, an endocrinologist and an obstetrician. In addition, the teams of health care professionals in charge of managing her care will consist of different staffs doing both day and nightshift. It will also require the coordinated care of a team of doctors from each professional field (Schyve, 2005). Under multidisciplinary method each team member is accountable for only the services associated with his/her own profession and creates separate objectives for the patient, whereas interdisciplinary workings ensures a combined effort on the patients behalf with a shared goal from every profession or body concerned with the care plan. To achieve successful teamwork certain components should be present such as clear direction, shared accountability for team success, respectful environment, defined goal and objectives for all members of the team, decision making procedures must be clear .and defined. Information sharing and communication must be constantly available and resources should be readily available in an enabling environment (Cameron et al, 2003). Working as an effective team member and in collaboration can be associated to certain benefits for the healthcare professional and the service user for example it creates an environment where healthcare professionals from different backgrounds and skills can perform their roles effectively (Dowling 2004). The work environment is more supportive and staff isolation is reduced. There is improved satisfaction and patient outcomes as the risk of missed or delayed care is reduced significantly (WHO, 2014). With effective team work and collaboration also attracts a shared workload thereby reducing the stress levels amongst healthcare professional. This would in turn improve job morale and satisfaction. Patient safety is increased through valuable insight from healthcare professionals as they adhere to the Care act 2014 or Mental Capacity Act 2005 policies of safeguarding vulnerable patients (MacIntyre, et al 2018). Catlett et al (2004) highlighted the difficulties encountered in promoting a team collaborative environment such as clash of ideas, lack of trust in decisions made by others, increased timing, territorialism and loss of autonomy between members. The latter can be regarded as the storming stage of successful team building, which was one of the four stages postulated under Bruce Tuckman’s model of team stages in 1965. This stage is characterised by conflicts between team members, clash of ideas and lack of cohesion REF Nevertheless, all these challenges can be overcome by imbibing a positive feeling and open attitude with trust and mutual respect REF Question 3Communication is of utmost importance to health practitioners in all areas of interaction and interventions for instance in process of treatment, recuperation, healing and wellbeing promotion (Colombo et al 2011). Bernard Shaw quoted that “The greatest problem with communication is the illusion that it has been accomplished”. Michael Argyle (1972) associated interpersonal communication with learning to drive a car “when you drive a car you have to change your behaviour depending on what is happening on the road” .He was of the opinion that communication was on a one to one basis and there is a cycle, which consist of six stages known as; the idea occurs, message coded, message sent, message received, message decoded and message understood REF. This is beneficial in a hospital setting where there is often more one on one interaction, as health practitioners ensure accurate judgements are made with the assistance of the patient having room to relay their questions and apprehension to the healthcare professionals REF. However, patients with severe learning disabilities and those who lack the mental capacity to relay fully their opinion would not be able to provide sufficient information during communication. In addition, this cycle may be difficult to complete based on the manner and feelings of the service user at the time of receiving and decoding the information REF. For example if they are upset or emotionally unstable at the point of communicating. On the other hand Bruce Tuckman (1965) focused on the interaction between two or more people in a group and how they addressed challenges, particularly as a team. Consisting of four stages namely forming, storming, norming and performing. They concentrate on the primary objective and the connections and are more relaxed, the management is less confrontational and the team performs more efficiently REF. Information is utilized with the assistance of the multiagency group in order to determine the type of treatment needed for example adults with severe learning difficulties or those with other conditions (McCarthy et.al 2013). Moreover, in this situation the health practitioner is entrusted to convey the exact information regarding the treatment, side effect, and determine timely forward care plan and also dealing with psychological challenges (Kollark and Ingrid, 2006).Through effective communication the healthcare professional can establish a certain level of trust and also show empathy by putting forward the right questions in humility and kindness without unnerving the patient or end users (Lee et.al, 2002).Effective communication requires being understanding of a patient and the conditions they have experienced. Kollark and Ingrid (2006) mentioned that being able to differentiate workplace difficulties from that of your private life might require excellent training in communication. A significant part of communicating is listening therefore healthcare practitioners collaborating through teamwork must be able to recognize certain instances that might put vulnerable patients in their care at risk. Listening provides reassurance to the patient that they are been cared for. Effective communication establishes a cohesion amongst multiagency groups, which eventually creates an opportunity for the team integrate the patients care plan at all stages in accordance with the diagnosis (Edwards, 2008). Lee et.al,(2002) Asserted that effective communication requires the presence of a therapeutic relationship between members of the multi-agency team and patients collaborating together to share not only ideas and information, but also to address the mental and psychological difficulties that may come as a result. For example the self esteem of vulnerable adults can be greatly affected by their conditions. Health care practitioners and members of the multiagency team can match the experience of vulnerable adults during their periods of highs and low without being condescending by embracing effective communication. Effective communication can also assist in identifying patients who are struggling emotionally (Sutcliffe et,al 2004). Rosenstein et,al (2006) conducted an extensive research on the impact of communication failure and patient safety and it was discovered that collaboration, teamwork and communication most times are not present in hospital setting due to poor communication. There is an understanding that the quality of care which also includes the safety of a patient can be compromised through communication and collaboration because certain members of the team prefer to still execute their duties autonomously, though they remain part of the team (Edwards, 2008).There are common limitations to the nature of collaboration and communication experienced within the health care setting in order to promote the wellbeing and safety of the patient such as individual qualities and desires, culture and ethnicity, language barriers, contrast in guidelines, requirements and professional knowledge, gender, concerns with respect to clinical obligation, fears of weakened professional identity. Individuals from various cultural backgrounds may worsen communications barriers (Edwards, 2008). For example in certain traditions or culture individuals are not openly self-confident in making their opinion known. This can also reduce the level of nonverbal communication such as in cultures where certain forms of reaction carries a different meaning, from head nodding to common eye contact and other forms of expression. According to Sutcliff et, al (2004) smooth communication can still be hindered based on the contrast in hierarchies as there is often a greater chance of individual power struggle when executing shared decision making or in scenarios when a team member is not competent (making several errors on the job) but cannot be called out because of his/her level, the presence of intimidation and reprisal. Sutcliff et, al (2004) echoed the need for a uniform communication technique where various views can be freely expressed and acted upon for the benefit of the patient. (Karlsson et al, 2013). Alzheimer’s society (2015) mentioned that person-centred care entails fitting an individual’s care to their capabilities, interest, character and history. Through effective communication person centred cared can be promoted via training and education provided by the health care professional which is tailored to fit the circumstances of the patient. It creates an opportunity for vulnerable adults and patients with severe learning disabilities to engage in the activities they enjoy.QUESTION 4Feng et, al (2017) stated that regardless of ones age and the condition of their body including physical appearance and state of mind they have a basic right to individuality and self determination. All health care professionals are encouraged to promote the total wellbeing of the patient. This can best be accomplished by compassionate acceptance and supporting of that potential in every person and by an understanding that their condition may improve in time (Bickerton, 2011). Healthcare professionals must work to safeguard the dignity and privacy of patients under their care for example adults with severe learning difficulties and mental health conditions should be shown privacy and respect ranging from what want to eat ,drink and so on. Healthcare professional must refrain from being overly cautious and patronising with their approach towards these patients. When effectively practiced, these are good practices that would impact on the wellbeing of service users positively.Health professionals should encourage self esteem. This is a key aspect of a patient care plan, as those who rely on others for support like vulnerable adults should be made to feel valued as this helps to improve to relieve emotional stress, feeling of social isolation and lonelinessREF. Health professionals and members of the multidisciplinary team often witness new signs of improvement and better communication when the patient becomes expressive in their attitude and emotions (Braverman, 2013). Health professionals should encouraging independence. It is important to create an enabling environment for the patient to handle his/ her own personal care as they may want to carry out certain task themselves However, health professionals and members of the team should avoid being negligent of their primary role which is to provide quality service. Partnership is one of the core principles of the care act 2014 therefore, they must be able to collate and share incisive information about the condition of the patient in order to prevent abuse. Health professional should be able to provide sufficient information to patients in order to guide them in making the right choice about the kind of treatment they are willing to embark upon based on their existing conditions (Bickerton, 2011). Individuals with severe learning disability and mental health conditions this decision can be made in partnership with their relatives and family members that would be involved in the recovery process or after care plan. In addition, members of the multi-agency working should be ready to provide accurate and reliable information so as to enable the patient informed decision (Focus, 2015). Recognition of diversity and individuality patients should be made to feel free when expressing their opinions or perspective concerning religion, ethnicity, social and cultural issues REF. Healthcare professional should be sensitive to their needs as patients or vulnerable adults in their care rather than imposing their own rules. At every possible opportunity, fears and tensions ought to be recognized but in the same vein being overly protective and undue worry for safety may prompt a violation of individual rights (Focus, 2

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