The multidisciplinary renal team: who makes the decisions?

Area of Science:

• Nephrology
• Healthcare Management
• Sociology of Health

Background:

• Multidisciplinary renal unit teams involve various occupational groups and patients in treatment decision-making.
• Understanding team dynamics and perceived roles is crucial for effective patient care and team functioning.

Purpose of the Study:

• To explore the perceptions of occupational groups and patients regarding involvement in treatment decision-making within renal units.
• To compare actual versus ideal team involvement and identify discrepancies.

Main Methods:

• Survey administered to members of renal unit teams in Canada and Michigan.
• Assessed perceptions of involvement for different occupational groups and patients in actual and ideal settings.

Main Results:

• A shared belief in an egalitarian team structure with nephrologists leading decision-making was reported.
• Nephrologists perceived reality aligning with their ideal, with greater perceived involvement for other members than those members reported.
• Ambiguity in decision-making roles for semiprofessional staff and under-involvement of nurses and patients were noted by non-physicians.

Conclusions:

• As technology in renal units becomes routinized, the ideal multidisciplinary team approach may be challenged.
• Dissonance between perceived ideal and actual team roles can lead to job stress and negatively affect job performance.