Coming together is a beginning; keeping together is progress; working together is success.
The notion of working together to achieve a goal is hardly a new concept. From our youngest ages, we are taught to communicate, share our resources, compromise, and share in the satisfaction of having met a goal. As health care professionals, we often find ourselves working in professional “silos” due to the demands of high caseloads, the pressure of productivity, and the challenge of working with fewer staff and resources than needed. Although we recognize the importance of communicating and collaborating with our colleagues, it can be difficult to find the time.
But be that as it may, our patients and clients rely on their health care professionals to provide the most comprehensive, client-centered care to meet their individual needs. Geriatric clients face challenges that younger clients may not: declining performance in physical tasks, declining participation in work and recreational tasks, ever-changing government health care programs, and fewer options for community participation. And that is where we, the health care professionals, come in.
Each of us chose our respective professions because the method of caring for others and treating medical issues were the right fit for us. We are trained to look at our patients' problems through our individual professional lenses, and we proudly recognize the unique value that we bring to our patients' care and progress. But have we become complacent when it comes to collaboration? Do we truly understand the indispensable skills and contributions of our colleagues? As an occupational therapist, I am no stranger to having to explain my role to others. No, I am not a “job coach”; “occupations” refers to the meaningful activities that occupy your day. No, I am not a nurse or certified nursing assistant; the activities of daily living tasks we performed this morning were a part of your therapy. Despite this experience, I could not say that I fully understand the roles of all of my colleagues. I am certain I am not the only one.
This issue of Topics in Geriatric Rehabilitation takes a step toward understanding the lenses though which various health care professionals view patient care. The authors are nurse practitioners, physician's assistants, registered nurses, occupational therapists, physical therapists, pharmacologists, MDs, MBBSs, registered health information administrators, doctors of osteopathic medicine, and PhDs—many with certifications and degrees in specialized areas of their fields. Katherine Kogler, PT, DPT, NCS; Natalie Howard, PT, DPT, GCS; Heather Knight, PT, DPT, NCS, CBIS; and Margaret Schumacher, PT, DPT, GCS, provide a comprehensive review of the literature on decreasing the risk of falls in older adults through the implementation of an intervention technique known as variable surface training. Occupational therapists and occupational therapy students Beth O'Rourke, OT; Rebecca Upchurch, OTDS; Jennifer Bain, OTDS; Jamison Staley, OT; Lauren Tirey, OT; Steven Vrchota, OT; and Katie Watson, OT, approach fall risk from another angle: by comparing the self-reports and physical assessments of older adults at risk for falls. Hamdeep Singh, MBBS; Brian Henriksen, PhD; Manju Kanikumel, MD; Syed Hasan, MD; Zachary Waterson, DO; Amy Dawson, MD, MPH; and Nathan Stuckey, PharmD, collaborate to review the implications of preventing falls and other adverse drug effects by utilizing the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. These 3 articles alone address different approaches to similar issues affecting older adults.
The article “Review of Roles and Responsibilities of Health Care Providers Providing Care to the Geriatric Population” makes a case for interprofessional collaboration in addressing the unique health care needs of the geriatric population. The authors of “Using Quality Measure for Performance Improvement in the Skilled Nursing Facility/Long-Term Care Setting” and “Effects of Transitional Care Management Services From an Interprofessional Team on 30-Day Readmission Rates” look at health care services overall, exploring ways of improving the management and delivery of health care services.
All of these components of geriatric rehabilitation are vital to providing the best care and outcomes for the geriatric population. No one profession alone can provide the complex and comprehensive care that any patient requires and deserves. There needs to be communication at all levels of the health care system between all of the professionals involved in patient care. As the authors featured in this issue demonstrate, it starts with recognizing a need and taking action, taking action to educate each other about our roles and professions, and reaching out to each for the benefit of our patients. We hope that this issue will inspire you to improve interprofessional communication and collaboration in your professional community.
—Sara Best, OTD, CAS
Huntington University, Fort Wayne, Indiana