Interdisciplinary team models are the new standard in skilled nursing facilities and if you have not already begun to establish them, your patients are missing out. Effective interdisciplinary care minimizes gaps in service and increases the quality of patient care and satisfaction. At Medrina, it is a crucial part of every patient-forward treatment plan we devise.
Discover why this unique strategy is becoming the new normal and let Medrina join you in improving care quality at your center today.
What Are Interdisciplinary Care Teams?
Interdisciplinary care teams consist of a variety of medical professionals and supporting personnel, including physicians, therapists, nurses, social workers, dieticians, case managers and anyone else deemed necessary to help a patient recover from an acute injury or thrive in their current condition. Interdisciplinary care teams work together from the start, establishing goals and treatment plans that incorporate specialty practices with general care standards.
Unlike multidisciplinary care — where many specialists work with the same patient — interdisciplinary care is built on communication between specialties. This allows your team of professionals to work side by side and create unified plans that incorporate many practices simultaneously. Interdisciplinary team models are especially effective in inpatient rehab hospitals and skilled nursing facilities (SNFs), where patients often need to meet with a number of specialists to achieve their goals.
Benefits of Interdisciplinary Care Teams in Skilled Nursing Facilities
Care coordination strategies are vital for SNFs and rehabilitation facilities. Ultimately, the goal of any center like yours is to get patients back on their feet, and applying an interdisciplinary care model does precisely that — often sooner and more effectively than a traditional approach. At Medrina, we help you take advantage of every benefit, including:
- Improved patient outcomes: By working with physicians in a range of specialties, you learn how to attack an issue from every angle. When you take advantage of everyone's knowledge, you can create a tailored plan that leads to faster recovery rates and reduced readmissions.
- Enhanced communication: Interdisciplinary care gives you direct access to your patient's entire care team, removing the middleman while saving time and mitigating misunderstandings. By working together, you can share information seamlessly, reducing errors and eliminating gaps in care.
- Personalized care plans: At Medrina, we pride ourselves on developing care plans tailored to every patient's precise needs. Throughout our history of integrating interdisciplinary teams, we've watched patient recovery rates and satisfaction improve as you learn to address physical, emotional and social needs simultaneously.
- Better operational efficiency: The more people you bring onto a team, the less stressful it is for everyone. Interdisciplinary teams are an advantage to any healthcare provider as they allow for streamlined, highly specific workflows that utilize resources more effectively.
Improving Post-Acute Care Outcomes With Team Collaboration — Strategies for Success
Working in teams can be easier and more fulfilling, but most people find the transition from individual to team-based care challenging. Here’s how your SNF can build the foundation for more collaborative work for your patients.
1. Define Clear Roles
While working in a group can make things easier for everyone, it also raises a lot of questions, such as:
- Who's in charge?
- Who is tasked with handling what?
- How will you make sure no one misses any steps?
Establishing roles within every patient's care team from the start can help avoid confusion.
Naturally, the “leader” or person who has the final say should be the primary doctor or whoever is most familiar with the patient's goals. You may also want to appoint someone to be in charge of the patient, taking blood samples, discussing new care opportunities and any other regular tasks.
2. Establish Effective Communication Practices
One of the main benefits of interdisciplinary teams is the lack of communication barriers. Still, that doesn't mean communication happens without effort. From the start, open communication channels through emails, IMs and texts. At the very least, establish regular team meetings where everyone can gather and update one another on your patient's progress in varying areas.
3. Collaborate on Care Plans
Your care plans should be as individual as your patients, and when you have a team of professionals to help, crafting the right treatment path is easier than ever. When you first bring on a new patient, at least one of your physicians should meet with the patient to get an understanding of their goals for recovery. If they have loved ones or other caregivers involved in their decisions, take the time to hear their concerns as well.
From there, your entire team can meet and create a care plan that balances the patient's goals with what each team member wants to see based on their specialty. The team should meet both with and without the patient regularly to manage expectations and keep the patient and loved ones updated on the progress.
4. Build Confidence Through Training
Developing a treatment plan that appeases your team and patient is a significant part of the process, but ongoing training and development are necessary for true post-acute success with interdisciplinary care. Make sure everyone is up to date on the latest industry protocols to ensure treatment cohesion and give your team a chance to connect outside of patient care through team-building activities or even just a get-together outside of working hours. The more everyone gets to know one another, the better they'll be able to anticipate each other and work together.
The Impact of Interdisciplinary Team Models in Inpatient Rehab Hospitals
Team-based models like interdisciplinary care bring advantages to all aspects of your center — patients receive more informed and specialized care, while your specialists can focus on their area of expertise without getting caught up in other objectives. At Medrina, we've watched the introduction of interdisciplinary team models in inpatient rehab hospitals lead to:
- Faster recovery times: Individualized care means you can address specific concerns from the start, leading to faster healing and discharge.
- Lower readmission rates: Faster recovery means fewer opportunities for complications and a lower chance of long-term effects.
- Improved patient satisfaction: Individualized care helps your patients feel understood and tended to, resulting in a better perception of the care they receive.
The Role of Physiatry in Interdisciplinary Team Models at SNFs
Interdisciplinary care has become a foundational approach in post-acute recovery. As patients in skilled nursing facilities (SNFs) present with more complex medical and functional needs, the importance of coordinated care across disciplines has never been greater.
At Medrina, we view physiatry as a vital part of the interdisciplinary team—not in place of it, but in support of it. Our physiatrists help bring clinical structure, functional insight, and rehabilitation-focused decision-making to the center of care delivery. In doing so, we help SNF teams align more effectively around patient goals and clinical outcomes.
Interdisciplinary Care in Context
An interdisciplinary team is more than a collection of providers—it’s a coordinated model built around collaboration. Physicians, advanced practice providers, therapists, nurses, case managers, dietitians, and social workers all contribute unique expertise to a shared treatment plan.
In the SNF setting, this collaboration is essential. Medical issues, therapy progression, discharge planning, and psychosocial dynamics often overlap. Without structured coordination, care can become fragmented, duplicative, or misaligned with patient needs.
Where Physiatry Fits In
Physiatrists specialize in function, recovery, and therapy-aligned medical management. When integrated into the IDT model, they offer focused leadership on key rehab-related decisions.
Medrina’s physiatrists frequently:
- Participate in or help structure IDT meetings
- Offer insight into therapy interference, pain, spasticity, and mobility challenges
- Guide rehab trajectories for medically complex or slow-to-progress patients
- Support documentation and planning aligned with PDPM and clinical best practices
While every facility has its own workflow, our providers consistently serve as clinical anchors within the interdisciplinary model, providing the kind of focused leadership that keeps teams aligned and patients progressing.
Impact on Recovery and Efficiency
When physiatry is well-integrated into the care team, SNFs often see:
- Fewer delays in therapy due to unmanaged medical issues
- More personalized care plans grounded in functional goals
- Enhanced communication between therapy, nursing, and medical staff
- Improved discharge readiness and post-discharge outcomes
Physiatry doesn’t replace other providers. It strengthens what’s already in place and helps each discipline work more effectively within their scope.
Building Stronger Teams Together
The best interdisciplinary care happens when roles are clear, communication is routine, and leadership is shared across disciplines. Medrina works to complement and enhance each facility’s existing structure, bringing consistent clinical leadership that’s flexible to your team’s needs.
Our goal is always the same: to improve patient recovery by aligning care around the functional, medical, and rehabilitative needs of the people we serve.
Interested in exploring how physiatry can support your team’s recovery goals? We’re here to collaborate.
How Medrina Can Help
At Medrina, we champion interdisciplinary care by working with your staff to develop new practices and implement individualized care programs. We plan strategically to optimize care coordination and bring in specialized medical support. Our physiatrists offer years of experience to every center we work in, resulting in improved services that can lead to financial gain.
We align our strategies to integrate seamlessly with yours, ensuring we meet your requirements for value-based care models and patient driven payment models (PDPM). Let us join you today and enable you to do more for your patients — contact us so we can get started together.
Chief Clinical Officer
Dr. Cowling is Board Certified in Physical Medicine and Rehabilitation, with a specialized focus on Subacute Rehab, Orthotics and Prosthetics, and the non-surgical management of Musculoskeletal Injuries. He graduated from Michigan State University College of Osteopathic Medicine and completed his residency and specialty training in PM&R at the University of Wisconsin.
Dr. Cowling has a deep passion for teaching and advancing the field of Physiatry in post-acute care. As Chief Clinical Officer at Medrina, he works to spearhead the advancement of physician protocols, education, and communication within the clinical team.
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