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Quantifying Interdisciplinary Management in Hand Surgery: A Review of the Literature and Pan-Canadian Survey
Stefan Padeanu, MD, MEd
1,2; Claudia Boucher, MD
3; Maude Vincent-Matteau, OT
2; France Archambault, OT, CHT
4; Nathalie Brisebois, OT
5; Dominique Tremblay, MD, FRCSC, OT
1,21Université de Montréal, Montréal, QC, Canada; 2Hôpital Maisonneuve Rosemont, Montréal, QC, Canada; 3Université Laval, Québec, QC, Canada; 4Hôpital Santa Cabrini, Montréal, QC, Canada; 5Centre professionel d'ergothérapie, Montréal, QC, Canada
IntroductionHand surgeons are involved in the management of numerous pathologies, including both traumatic and degenerative injuries. Management does not only include surgery, with non-surgical and rehabilitation processes as important as an intervention. Rehabilitation therapy is commonly undertaken by a multidisciplinary team, involving surgeons and hand therapists. As with any multidisciplinary team, communication is essential; however, research on the subject is sparse. In order to better quantify the working relationship between surgeons and therapists, a literature review was conducted, followed by the implementation of a pan-Canadian survey.
Materials and Methods A literature review was first conducted exploring relevant literature regarding surgeon and therapist communication through the PubMed database. Subsequently, a survey was designed using input from both surgeon and therapist teams to measure referral practices, communication methods and satisfaction scores regarding their relationship. The survey was distributed to The Canadian Society for Surgery of the Hand (CSSH) and the Canadian Society of Hand Therapists (CSHT). Survey design included a mixture of multiple choice, short answer and Likert scale questions.
Results The literature search revealed limited objective studies (n=5), all of which originated from the OT literature. Notably, one study highlighted how 91% of OT felt the surgeon-therapist relationship to be essential for patient outcomes. No data existed on surgeon metrics. Early survey results demonstrate a strong preference between both surgeons and therapists for in-person (100%), phone call (100%) or text message (67%) communication when discussing patient care. Surgeons and therapists both indicated frequent (
every 1-2 days – 100 and 67% respectively) communication with the other profession. Satisfaction scores for interpersonal relationships averaged 4 out of 5 (range: 3 – 5) for both professions regarding interprofessional communication. Data collection is still ongoing and final survey results will be available in the upcoming weeks.
Conclusions Hand therapists play an integral role in the management of patients with hand pathologies. Hand surgeons should have an interest in optimizing the relationship with therapists to provide more effective patient care. This survey aims to educate and demonstrate the current interprofessional communication that occurs between these two professions to provide more insight into the current standard of care.
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