Decision making in an interdisciplinary team

Decision making in an interdisciplinary team occurs at the interface between groups with varied backgrounds, orientations, interests, and goals. Most interdisciplinary teams attempt to identify the complex set of variables influencing their decisions and then utilize this knowledge to maximize efficiency in health care delivery. Models of information and decision analysis developed by general systems theory are suggested as a method for advancing the understanding of where, when, and how decisions are made by the interdisciplinary team. A university-affiliated psychiatric service in a private general hospital is studied. Here the following forces meet, complement, compete, and collide: the community, university, hospital administration, private practitioners, insurance companies, consultation and liaison psychiatrists, university staff psychiatrists and residents, nurses, aides, social workers, activities personnel, patients and their families, the patient group, the ward milieu. Considering these factors, we describe: (1) the flow of information and feedback loops into, within, and out of the psychiatric service; (2) the location of decision nodes; (3) decision-making echelons. The general systems theory concepts utilized in this analysis are proposed as pragmatic tools for improving interdisciplinary team function.