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When Roberto Dañino, former World Bank General Counsel, arrived in the institution, he found a department perceived to be at the verge of ‘marginalization’ – a dire state he diagnosed and soon attributed to the rigid ‘culture’ of legal practice. In tracing Dañino’s efforts to ‘make the department relevant again’, we get a glimpse of the situated, material, embodied institutional life of international law: the changes Dañino instilled were not manifested in formal legal sources but in the introduction of new cultural codes, professional prototypes (the ‘how to’ lawyer) and technical routines of risk management. In the domain of international institutional law – often oriented towards abstraction, comparison, or aspiration – such prosaic legal practices tend to be underplayed. This chapter signals two productive entry points for a turn to practice: (i) a focus on the shared and contingent criteria of competence – the ‘social grammar’ – that mark professional postures and performances, and (ii) a heightened attention for the practices of relationality, translation, and materiality through which law is composed – the string of ‘people and things’ that it assembles. This methodological orientation to professional scripts and material routines also offers a perspective on ‘critique’ that differs from familiar structuralist modes of analysis and intervention.
Palliative cancer care is by definition multi-professional in nature. An interdisciplinary approach to disease management emphasising continuity of care results in increased quality of life for patients and families. Complex disease management demands the provision of a full spectrum of high-quality care; requiring both specialist and generalist services. Appointed keyworkers are knowledgeable about patient preferences enabling effective coordination of care and promotes collaborative team-working. The need for diversity in the provision of palliative care is recommended but can challenge effective interdisciplinary collaboration by creating tension and limiting the interdisciplinary team (IDT) from reaching its full potential resulting in adverse outcomes.
Purpose
The purpose of this paper is to review the literature available regarding how IDTs and keyworkers influence high-quality palliative care; evaluate how professional culture barriers can influence team collaboration; discuss the keyworker role in minimising these barriers and clinical implications.
Methodology
A review of the English literature from 2003 to 2013 was performed using the databases PubMed (NML), OVID Medline and Google Scholar.
Results and conclusion
Keyworkers can help overcome professional culture barriers that result from ineffective team communication. Facilitating improved communication regarding professional roles fosters mutual understanding among team members. The dissemination of relevant and timely information minimises fragmentation, prompting team decision-making and promotes continuity of high-quality palliative care.
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