Question
How can we increase the shared caseload?
Problem description
In our team we deal there are about 135 ongoing cases. The team consists of 11 collaborators (1 fulltime, 2 x 0.75, 7 x 0.50, 1 x 0.25 and 6 hours psychiatrist). The cases are distributed among 10 collaborators. Quite a lot of cases were transferred from the already existing psychiatric home care, at the time the mobile team was started up. Most of the time these are long enduring accompaniments. The team members handle these cases almost alone. The weekly team meetings is the only moment that information is exchanged on the ongoing accompaniments. There are no other moments when the team comes together for briefing or consultation. Recently, there is a biweekly intervision moment in which we discuss some relevant themes
Impact - effect
For the client. Several clients have for years same professional coming at home. There is a certain familiarity and relationship between these people. For some clients a certain attachment develops, which can make some possible difficulties in holiday periods, in periods of bridging a long absence or completion of the accompaniment.
For the professional. Because of the exclusive relationship with the client, he feels very responsible in supporting the client, for his wellbeing, but also for the treatment process, although the individual responsibility is built in into the team functioning and supervised by the doctor. Another risk in long term accompaniments is losing attention for the recovery and rehabilitation goals.
Also in complex cases (e.g. serious personality problems, care avoiders who are cause of concern) there’s one person to maintain the contact and to think about appropriate interventions. Especially for severe cases with destructive behaviour (aggression, self-injury, suicidality…) this is an arduous task for one person
To do
1) It could be considered to divide tasks, linked to discipline or expertise, which can mean that different team members could meet the same client to do different things (e.g. social administrative issues, practical problems, psychological issues…). Different views can possibly lead to a more complete view and treatment, and a broader support for the case.
2) New cases could be started up with pairs: always two persons to follow the case. Which means automatically more case discussions and more perspectives, shared concerned, a broader base for support, less exclusivity in the relationship and possibly more focus on goals
Hyperlink
Theme
Starting up and further development/deployment of mobile teams
Topic
multidisciplinary team functioning
Reference - contact
Ilse Colen
Mobile team
2b
Project
Noolim
Intership abroad - place
Birmingham (AOT Matthews Centre)
Date
October 2014