Multidisciplinary team interaction: An ethnographic study of a neonatal intensive care multidisciplinary team

This ethnographic research study was conducted in a neonatal intensive care unit in a large medical complex. Much of the literature on multidisciplinary teams in health care is prescriptive. This study offers a descriptive investigation of a team in action. The research questions were: (A) How do multidisciplinary teams make decisions about patients? (B) How does the reorganization of service delivery affect team functioning? The data collection consisted of video and audio taping of weekly team meetings over an eight-month period. A field journal was also maintained. Analysis involved reviewing the data in relation to the research questions. The data were arranged chronologically and cross indexed according to hypotheses. Video tape, audio tape, and field notes were constantly examined in relation to existing and developing hypothesis in keeping with the constant comparative method. This research discovered that the team made decisions in a consistent fashion. The team made decisions based upon a constructed reality. The construction of reality involved having team members conduct assessments on patients and families. These assessments were then presented to the team through narrative storytelling. Additionally, the team culture established intergroup aspects of their decision-making process. During this study, service delivery was reorganized based on internal as well as external environmental changes. The team was forced to deal with managed care requirements, staffing changes, as well as philosophical changes, and conceptual changes aimed at improving service delivery. This team, whose primary goal was discharge planning, sought to provide high quality patient care while also managing change. This study identified important issues in multidisciplinary teamwork that are of relevance for social work practice and medical care