Implementing Team Approaches in Primary and Tertiary Care Settings: Applications from the Rehabilitation Context

The need for collaboration and use of team approaches in primary and tertiary care settings has been the Zeitgeist of healthcare in recent years. Fueled by the managed care crisis, increasing efforts have been made to implement team models of care as innovative cost- and time-effective modalities of treatment. In the context of rehabilitation, integrated team approaches have been considered the standard form of treatment for over five decades. Ostensibly, team approaches are the optimal method of healthcare delivery, yet little attention has been paid to how these team concepts can be more efficiently translated into primary and tertiary care environments. The current article attempts to extrapolate and extend strengths and weaknesses of team concepts from the rehabilitation context to primary and tertiary care settings. Specific issues warranting attention include the need for theory-driven models of team functioning, careful definition of teams, concerns related to team leadership and interprofessional relationships, the need to assess the impact of team interventions, potential burdens placed on family members, and the need for an expanded educational curriculum for healthcare personnel.