Interprofessional Collaboration in Health PDF

- “When I was in medical school I spent hundreds of hours INTERPROFESSIONAL looking into a microscope - a skill I never needed to...

- “When I was in medical school I spent hundreds of hours INTERPROFESSIONAL looking into a microscope - a skill I never needed to COLLABORATION IN HEALTH know or ever use. Yet, I didn’t have a single class that taught me communication and teamwork skills – something I need every day I walk into the hospital.” Interprofessional Collaboration - The process of developing working relationships with Interprofessional Collaboration - Why Now? learners, practitioners, patients/clients/families and - Demographic changes – aging population communities to enable optimal health outcomes - Chronic health conditions – need more complex care - Elements include respect, trust, shared decision-making - Technological advances and partnerships - Specialization in health care - Patient safety and quality agenda Interprofessional Education - Workforce pressures and gaps - “When students from two or more professions learn - Healthcare and payment reforms about, from and with each other to enable e ective collaboration and improve health outcomes” (WHO, 1999 – the Institute of Medicine (IOM) urged the practice 2010) of IP team-based care to PREVENT ERRORS 2013 – the Journal of Patient Safety reported between Interprofessional Collaborative Practice 210,000 and 440,000 patients each year su er from - “When multiple health workers from di erent professional PREVENTABLE HARM when receiving hospital care backgrounds work together with patients, families, carers Center for Disease Control (CDC) – included [sic], and communities to deliver the highest quality of preventable medical errors as a disease category (3rd care” (WHO, 2010) leading cause of death in the US) Interprofessionality is NOT… Framework of Collaborative Practice - simply sharing electronic health records 1. Professional or Disciplinary Expertise Competencies - “professional teams” (ex: neurosurgeons, psychiatrists, Nursing radiologists, etc.) - learners having a talk about another profession Medicine - “reporting” out at interdisciplinary team meetings Physical Therapy - co-location without intentional collaboration Radtech - decision-making without client/patient input Medtech Pharmacy Dentistry Points to Ponder! Nutrition and Diet Respiratory Therapy 2. Common Competencies System thinking Critical thinking Patient-centered focus Safety Quality: Improvement, Innovation 3. Collaborative Competencies Team work Communication Roles and responsibilities Leadership Con ict management and resolution Bene ts of Interprofessional Collaborative Practice Educational - Students have real world experience and insights - Students learn and appreciate the work of other practitioners - Sta from a range of professions provide input into programme development Health Policy - Improved workplace practices and productivity - Improved patient outcomes - High or raised sta morale - Improved patient safety - Better access to health care Actual (Clinical) Practice Improvement on… - Access to and coordination of health services ff fl fi ff ff ff ff  - Appropriate use of specialist resources - reimbursement structures for di erent professions, - Health outcomes for people with chronic diseases including which services receive reimbursement - Patient safety - hierarchical administrative and educational structures that encourage interprofessional collaboration Decrease… - total patient complications 2. Team-Level - length of hospital stay - Lack of a clearly stated, shared, and measurable - tension and con ict among care givers purpose - sta turnover - Lack of training in interprofessional collaboration - hospital admissions - Role and leadership ambiguity - clinical error rates - Team too large or too small - mortality rates - Team not composed of appropriate professionals - Lack of appropriate mechanism for timely exchange Community Mental Health Settings of information - Increase patient and care satisfaction - Lack of commitment of team members - Promote greater acceptance of treatment - Di erent goals of individual team members - Reduce duration of treatment - Apathy of team members - Reduce cost of care - Inadequate decision making - Reduce the incidence of suicide - Con ict regarding individual relationships to the - Increase treatment for psychiatric disorders patient/client - Reduce outpatient visits 3. Individual Level Terminally and Chronically Ill Patients (At Home) - Split loyalties between team and own discipline - More satisfaction - Multiple responsibilities and job titles - Report fewer clinic visits - Competition naïveté - Present with fewer symptoms - Gender, race, or class-based prejudice - Report over-all improved health - Persistence of a defensive attitude - Reluctance to accept suggestions from team Reduced cost of… members representing other professions - redundant medical testing - Lack of trust in the collaborative process - setting up and implementing primary health - care teams with chronic illnesses Overcoming Barriers - implementing multi-disciplinary strategies for the - Agree on a unifying philosophy centered around primary management of heart failure patients care of the patient/client and the community - implementing total parenteral nutrition teams within the - Develop a commitment to the common goal of hospital collaboration - Learn about other professions Evidences on the Outcomes of Interprofessional - Respect others’ skills and knowledge Collaborative Practice - Establish positive attitudes about own profession 1. Critical Re ection - Develop trust between members Denmark – primary health care facilities maintain records - Be willing to share responsibility for patient/client care of each health workers’ services to facilitate re ection, - Establish a mechanism for negotiation and re-negotiation discussion and improvement of goals and roles over time - Process enables them to share their best practices - Establish method for resolving con icts between team and fosters a team spirit members - Be willing to work continuously on overcoming barriers 2. Health Workforce Satisfaction and Well-being Australia and UK – primary care teams have reported Parting Shots high levels of well-being - “It is no longer enough for health workers to be - They share problems and support each other professional. In the current global climate, health workers - Resulting cooperation bu ers individuals from also need to be interprofessional.” (WHO, 2010 p. 36) negative workplace interactions - “We all have a moral obligation to work together to improve care for patients.” (Pronovost & Vohr, 2010, p. Better access and continuity of care 137) Patient and professional satisfaction Superior care for diabetes patients Improved blood pressure control Reduction in medication side-e ects and improved adherence Barriers to E ective Interprofessional Collaboration 1. Organizational - lack of… - knowledge and appreciation of the roles of other health professionals - the need to make compelling arguments for team building to senior decision-makers - lack of outcomes research on collaboration - nancial and regulatory constraints - legal issues of scope of practice and liability fi ff ff fl fl ff fl ff ff ff fl fl  BENEFITS AND ADVANTAGES OF INTERPROFESSIONAL COLLABORATION - The previously mentioned bene ts/advantages clearly leads to CLIENT/PATIENT SATISFACTION as they notice improved or better health outcomes without necessarily spending more time in health care facilities and spending more to receive quality of care. - This refers to IMPROVED PATIENT OUTCOMES. - Patient participation also increases satisfaction - The picture shows patient’s progress and restoration to health/well-being. - IPC leads to HIGH HEALTH PROFESSIONALS JOB - This picture depicts the EARLY INITIATION and SATISFACTION and MORALE. CONTINUITY of CARE through proper management and - Sta and other personnel support and learn from each allocation of needed resources. other, easing the work load and at the same time building a strong sense of camaraderie. - This picture depicts REDUCED MEDICAL ERRORS and IMPROVEMENT in PATIENT SAFETY. - This refers to DECREASED HEALTH CARE COSTS brought about by the use of evidence-based care that ultimately avoids redundancy or duplication of diagnostics, medications, etc. from di erent health care professionals. - IPC supports QUATERNARY PREVENTION of CARE ff fi ff  PROFESSIONAL ROLES AND process where movement potential is assessed and goals are agreed upon, using knowledge and skills RESPONSIBILITIES unique to physical therapists. Roles and responsibilities of Physical Therapists Nursing as a Health Professions Undertake a comprehensive examination/assessment or As a Science evaluation of the patient/client or needs of a client group - It is the diagnosis and treatment of human responses to Formulate a diagnosis, prognosis, and plan; actual or potential problem Provide consultation within their expertise and determine - Is the systematic knowledge and skills in assisting when patients/clients need to be referred to another individuals to achieve optimal health healthcare professional - Is a blend of the most current knowledge and practice Implement a physical therapist intervention/treatment standards programme Determine the outcomes of any interventions/treatments As an Art Make recommendations for self management - It is composed of SKILLS pro ciency and expertise - It requires CREATIVE use of knowledge Thinking Like a Physical Therapist - It is IMPROVED by PRACTICE Assessment - It involves THERAPEUTIC USE of one’s self - Examination - It is an expression of CARE and COMPASSION - Evaluation Diagnosis Roles and Responsibilities of Nurses Prognosis Care giver – nursing is equivalent to caring Intervention/Treatment Teacher/educator Re-assessment Counselor Manager Radiologic Technology as a Health Profession Leader - Radiologic Technology is a health care profession and Communicator plays a continually growing role in medicine. Researcher - It is an “art and science” of creating images of the human Patient Advocate body using ionizing radiation, non-ionizing radio Collaborator frequency and sound waves, or even creating a 3- Perform physical exams and health histories before dimensional image from multiple cross-sectional images making critical decisions - Radiological science is a dynamic eld, it is perpetually Provide health promotion, counseling and education changing, improving and growing. Administer medications and other personalized interventions Roles and Responsibilities of Radiologic Technologists Coordinate care, in collaboration with a wide array of Perform a healthcare service by applying x-ray energy or health care professionals with the use of radionuclides to assist in diagnosis or treatment of disease Thinking Like a Nurse Perform radiographic or nuclear medicine procedures and Assessment related techniques to produce images for the Diagnosis interpretation by and the request of a licensed medical Planning practitioner Implementation Perform radiation therapy services as an essential Evaluation member of the radiation oncology treatment team and total quality care to each patient undergoing a prescribed Physical Therapy as a Health Profession course of treatment - Physical therapy is a health profession whose primary Assess and develop the department's quality control purpose is the promotion of optimal health and function. program and assist in maintaining records, thereby - This purpose is accomplished through the application of respecting con dentiality and established policy scienti c principles to the processes of examination, Express professional judgment in the performance of evaluation, diagnosis, prognosis and intervention to services and maintain a demeanor complementary to prevent or remediate impairments, functional limitations, medical ethics and disabilities as related to movement and health. Maintain values congruent with the profession’s code of - Physical therapy provides services to individuals and ethics and scope of practice and adhere to national, populations to develop, maintain and restore maximum institutional, and/or departmental standards, policies, and movement and functional ability throughout the lifespan. procedures in patient care, performance of diagnostic - This includes providing services in circumstances where procedures, and treatment delivery movement and function are threatened by ageing, injury, Demonstrate active participation in continuing education disease or environmental factors. Functional movement in professional practice and management skills and be is central to what it means to be healthy. able to produce quality research output - Physical therapy is concerned with identifying and maximising quality of life and movement potential within Thinking Like a Radiologic Technologist the spheres of promotion, prevention, treatment or Problem Solving and Patient Assessment intervention, habilitation and rehabilitation. This Data Collection encompasses physical, psychological, emotional, and Data Analysis social well being. Planning - Physical therapy involves the interaction between Implementation physical therapist, patients/clients, other health Evaluation professionals, families, care givers, and communities in a fi fi fi fi