Implications for promoting interprofessional collaboration in health care settings and implications for advanced nursing practice
ASSIGNMENT INSTRUCTIONS
*DNP Class: Collaboration in Healthcare Delivery
* Textbook: Collaboration Across the Disciplines in Health Care by Brenda Freshman, Louis Rubino, and Yolanda Reid Chassiakkos. 2010 (SEE UPLOADED COPIES OF TEXBOOK REGARDING THIS TOPIC/ASSIGNMENT
*ASSIGNMENT:
- Discuss the implications for promoting interprofessional collaboration in healthcare settings. Please include implications for advanced nursing practice.
* See below articles and information that can help you to write the paper. Also see uploaded textbook copies and articles. (the last article below will help you with the Advanced nursing practice implications.
* I’m a nurse practitioner (Advanced practice nurse). This assignment is for a DNP (Doctor of nursing practice) class and the grading is rigorous including grammar and APA style.
*Remember reference must be scholarly, peer reviewed article. Please include DOI numbers on the reference page (It’s required in APA). References MUST be scholarly journal articles (Nothing from conferences, goggle, .com). References must be within 5 years, except textbook.
*Please don’t start with sentences that start with “this, these, it…etc” this is vague and not use in formal writing. Need to specify what we are talking about. Also don’t use citations in the middle of the sentence. Avoid “as well as” as much as possible.
Thank you!
*ARTICLES AND INFORMATION:
Babur, M. N., & Liaqat, M. (2017). INTERPROFESSIONAL COLLABORATION AMONG REHABILITATION PROFESSIONALS. Pakistan Armed Forces Medical Journal, (6), 908-913.
Interprofessional collaboration is the way toward maintaining and creating effective interprofessional working associations with learners, experts, patients/customers families and groups to enable optimal health outcomes. According to the World Health Organization (WHO), multiple disciplines, if work together as a team, can work more efficiently to help enhance the patient’s condition by the implementation of interprofessional collaboration. They can figure out how to cooperate and respect each other's perspectives in healthcare in a more productive manner. Healthcare does not depend solely on one health professional but various disciplines are involved that work together to meet the needs of patients. There is a lot of research available to demonstrate that patient results, nature of care
and cost of care conveyance are altogether improved when multiple disciplines work as a group toward a shared goal that focuses on the patient1. Interprofessionalism was not a part of the traditional health science education system. In our system there is a particular school for each speciality for each health care discipline i.e. school of nursing, school of medicine, pharmacy school and was immersed in a single point of view. The ultimate goal of each speciality is to provide best care to patients and it is possible only when healthcare providers identify themselves as a fundamental part of a larger healthcare team and not just learning roles specific to their discipline. The inefficiencies in patient care can be reduced when we refocus our work through a lens of interprofessionalism. This means that treatments and assessments should be done together. And instead of focusing on specific diagnosis or treatment the focus should be on the patient as a whole. The benefits of interprofessional collaboration cannot be denied in developing countries and barriers to development of multidisciplinary team are huge. We need to step forward to overcome these barriers and play our role in development of multidisciplinary teams so that our patients and team members get benefit from this already research proven approach.
*** Inman, W. H., PhD., Briggs, R., D.H.A., Theriot, Rosemary,EdD., M.S.P.H., & Heaston, Alexis,EdS., M.S.P.H. (2016). TRAINING FUTURE HEALTH CARE PROFESSIONALS TO WORK IN TEAMS: THE NEED FOR INTERDISCIPLINARY PROFESSIONAL EDUCATION. Journal of the National Society of Allied Health, 13(1), 48-57.
The ever-changing health care field demands increased interprofessional collaboration and practice to provide safe, patient-centered care. Patients have complex health care needs and typically require more than one discipline to address the issues regarding their health status (ASAHP, 2010). According to the Institute of Medicine Committee on Quality (2001), healthcare professionals working in interprofessional teams can best communicate and address these complex and challenging needs. This allows sharing of expertise and perspectives to form a common goal of restoring or maintaining an individual's health and improving outcomes while combining resources.
If practitioners are expected to function in an interprofessional practice, schools and colleges must provide their students with the skills needed, through IPE opportunities. The Institute of Medicine (2003) defines interdisciplinary professional education as a collaborative approach to develop healthcare students as future interprofessional team members. Complex medical issues are best addressed by interprofessional teams. Training future health care providers to work in teams will help facilitate this model and result in improved healthcare outcomes for patients (Bridges et al., 2011, p.l).
Interdisciplinary professional education is an approach to teaching and learning that brings together students from two or more professions to learn from and with each other to enable effective collaboration. Students from several different disciplines are educated within the same class environment; they learn about the specialty of each discipline from faculty; they learn from each other about patient care approaches; and they learn how to work together to provide better patient care. This collegiality and collaboration extends to interprofessional practice (IPP) where students from various disciplines learn how to care for patients as a collaborative team. The goal of IPP is to improve health outcomes through the education of a collaborative practice-ready workforce that is prepared to respond to local health needs (WHO, 2010).
Interdisciplinary professional education and collaborative practice can play an important role in improving patient care, quality, satisfaction, safety, and efficiency. Health professions training, continuing education, continuing professional development, faculty development, and community-based training must change to provide healthcare professionals, educators, and students with the collaborative care tools needed to improve the health of populations. Interdisciplinary professional education (IPE) is an approach to develop healthcare students for future interprofessional teams. Students trained using the IPE approach are more likely to become collaborative interprofessional team members who show respect and positive attitudes toward each other and work to improve patient outcomes (Buring et ah, 2009).
*** Landry, A., & Erwin, C. (2015). PERSPECTIVES ON MULTIDISCIPLINARY TEAM PROCESSES AMONG HEALTHCARE EXECUTIVES: PROCESSES THAT FACILITATE TEAM EFFECTIVENESS. Journal of Health and Human Services Administration, 38(3), 350-380.
Team Processes Research has demonstrated that processes can directly influence team outcomes and effectiveness. Team processes include the various interactions that occur between team members and others (Cohen and Bailey, 1997). In a healthcare setting, processes including good communication, coordination, high levels of collaboration, cooperation, low levels of conflict, and participation among team members with various levels of influence facilitate effective team functioning (Pinto and Pinto, 1990; VinokurKaplan, 1995; Poulton and West, 1999; Shortell, Marsteller, et al., 2004; Temkin-Greener, Gross, et al., 2004). Although these team processes have not been evaluated in the context of an executive leadership team, they do influence MDT team functioning among healthcare professionals. Therefore, healthcare professionals of various disciplines functioning at an executive level are likely influenced by the same processes.
INCLUDE THESE PROCESSES*************
Communication. Communication is defined simply as the way that individuals share information. This team process is particularly important in the context of MDTs, which involve the participation of individuals from different disciplines, educational, and functional backgrounds (Pinto and Pinto, 1990). The quality of team communication, including the accuracy of information, effectiveness of communication process, and openness in sharing information, influences team effectiveness. In healthcare, these components are thought to influence both technical quality and perceived ability to meet patient needs (Temkin-Greener, Gross, et al., 2004). When communication is effective, midsunderstandings may be reduced. An open flow of information among team members helps mitigate misinformation or bad information that might otherwise harm team effectiveness.
Coordination. Coordination refers to a team’s ability to organize work activities, agree upon and implement protocols and plans, and facilitate team member interaction. In a healthcare delivery context, the lack of coordination by MDTs has proven to have a negative influence on clinical outcomes including increased readmissions and mortality rates (Temkin-Greener, Gross, et al., 2004). MDTs with effective coordination are able to recognize the complexity of situations and view the organization from an integrated perspective rather than from the bias of one’s particular discipline or domain. Additionally, well-coordinated MDTs also increase individual team member awareness of all stakeholders and the relationships they have.
Interdisciplinary collaboration. The effectiveness of MDTs in healthcare is directly related to a team’s ability to function in a collaborative manner (Temkin-Greener, Gross, et al., 2004). Interdisciplinary collaboration in the context of health care has been defined as an interpersonal process involving healthcare professionals representing multiple disciplines who have shared objectives, decisionmaking, responsibility and power working together to solve problems in the healthcare organization or setting (Petri, 2010). Inter-professional education is key to facilitating interdisciplinary collaboration with the goal of promoting an environment that is characterized by mutual respect, trust, effective and open communication, and the awareness and appreciation of the roles, skills and responsibilities of all participating parties. When interdisciplinary collaboration is appropriately facilitated, MDT team members benefit by increasing their knowledge base about individuals coming from different professions (Irwin, et. al, 2012; Petri, 2010). However, literature suggests that professionals employed in complex organizations can face a professional-bureaucratic conflict. This may result in competing loyalties one might feel between his/her profession and their organization or team (Sorensen and Sorensen, 1974). Interdisciplinary collaboration may prove to be disadvantageous when individuals from a particular discipline exhibit more loyalty to their profession than to a particular team or organization.
Cooperation. Cooperation is defined as “joint behavior toward some goal of common interest”(Pinto and Pinto, 1990). In MDTs, cooperation is critical as individual members from different backgrounds must join forces in achieving a common goal -- this often requires the use of multiple skills that can only be garnered from a team composed of individuals from various backgrounds (Pinto and Pinto, 1990). When team members cooperate, activities aimed at achieving a certain shared goal lead to increased commitment to mutual goals. Additionally, when individuals from different backgrounds cooperate, it can increase trust of other disciplines.
Conflict. In theory, conflict is not necessarily good or bad. It becomes a problem when the individuals involved are unable to manage or resolve it in an effective manner (Capozzoli, 1995). Conflict resolution among teams, including problem solving, arbitration, and avoidance, is an important component in team effectiveness (TemkinGreener, Gross, et al., 2004). Two types of conflict have been identified in the literature on teams: (1) relationship conflict and (2) task conflict. Relationship conflict is that resulting from interpersonal differences or other incompatibilities. Conflict surrounding different approaches to problem solving is an example of relationship conflict. Task conflict results when team members disagree about the content of the work to be performed. Conflict due to ambiguous or competing goals is an example of task conflict (Cohen and Bailey, 1997).
Influence. Influence is defined as the perception of the individual team member of individual team members’ (including their own) power or ability to be a compelling force within the team. Often, status is determined outside of the team context based on discipline or organizational role. The power dynamics between teams and individual members can influence the perception of team effectiveness and the willingness of individuals to engage in team processes, particularly if they perceive that the influence of other members impedes the opportunity for collaboration and cooperation in order to achieve a shared goal (Lichtenstein, Alexander, et al, 2004). Adequate participation among team members of various levels of influence is linked to team effectiveness in a health care setting (Lemieux-Charles and McGuire, 2006). MDTs in healthcare consist of team members from different disciplines that might have status attached. Depending on the team goals, individuals from particular disciplines or functional backgrounds might be perceived to have higher status than others. Often, individuals might jockey for expert status in a team setting, and this can be counterproductive to team effectiveness.
*** Starck, Patricia L, PhD,R.N., F.A.A.N., & Rooney, Laura L, DNP, APRN, FNP-BC,D.C.C., F.A.A.N.P. (2015). Leadership for the integration of comprehensive care and interprofessional collaboration. Clinical Scholars Review, 8(1), 43-48. http://dx.doi.org/10.1891/1939-2095.8.1.43
*This can help with the advance practice nurse implications (Just a brief paragraph)
The clinically prepared Doctor of Nursing Practice (DNP) professional is uniquely prepared to
integrate the concepts of comprehensive care with interprofessional collaboration. Leadership
skills and team-based competencies can shift the academic paradigm from educating in silos to
interprofessional education, thereby addressing the problems originating from a fragmented health
care system. Interprofessional, Team-Based Care
The term interprofessional is typically segregated by reference
to its use in education, practice, and research.
Interprofessional in the literature is generally described
from the viewpoint of education. The World Health
Organization (WHO, 2010) defines interprofessional
education (IPE) as “action that occurs when students
from two or more professions learn about, from, and
with each other to enable effective collaboration and
improve health outcomes” (pp. 7–13). Each health professional
brings his or her profession-specific skills, attitude,
and knowledge to a team-based approach to care.
A collaborative practice-ready health care workforce requires
an IPE foundation.
Interprofessional collaborative practice takes place
when “multiple health workers from different professional
backgrounds work together with patients, families,
carers, and communities to deliver the highest quality
of care across settings” (WHO, 2010, p. 13). Interprofessional, team-based care is “care delivered
by intentionally created, usually relatively small
work groups in health care, who are recognized by
others as well as by themselves as having a collective
identity and shared responsibility for a patient or
group of patients, e.g., rapid response team, palliative
care team, primary care team, operating room team”
(Interprofessional Education Collaborative Expert
Panel, 2011, p. 2).
Interprofessional research or transdisciplinary research
is understood to mean inquiry incorporating two or
more professions to solve a problem. This approach is
highly favored by funding agencies.
Instead of segregating interprofessional into education,
practice, and research, perhaps the term interprofessional
collaboration is a better and more inclusive term.
D’Amour, Ferrada-Videla, San Martin Rodriguez, and
Beaulieu (2005) described five underlying concepts of
collaboration: (a) sharing, (b) partnership, (c) power,
(d) interdependency, and (e) process. Collaboration implies
“collective action oriented toward a common goal,
in a spirit of harmony and trust . . . Based on a comprehensive literature review, D’Amour
et al. (2005) described each of the five concepts:
- Sharing of health care philosophy, values, responsibilities,
decision-making, data, planning, intervention,
and professional perspectives.
- Partnership among professionals with authentic
and constructive collegial relationship based
on mutual trust and respect with open and
honest communication and with awareness of
the value of contributions and perspectives of
others.
- Interdependency rather than autonomy of each
team member; the synergy yields greater results
of the whole than the sum of individual parts.
- Power based on knowledge and experience rather
than positions or titles. There is symmetry and
sharing of power in team relationships.
- Process evolving in a dynamic, interactive way,
considering the contributions of all team members.
Although certain concrete steps may be
taken (checklists), the process is fitted to the
situation.
Interprofessional is distinct from other related
terms, such as multidisciplinary and intradisciplinary.
These differences are illustrated in Figure 2. An interprofessional
approach requires collaboration, coordination,
and cooperation. Care is integrated, not sequential. The approach is a “big picture” approach rather than one
of addressing one aspect of health.
Strong leadership and enthusiastic team participation
are required to shift the current paradigm of
educating health professionals in silos who practice
in fragmented health care systems to one of interprofessional
comprehensive care. The DNP clinician
was designed uniquely to achieve these ends. The
clinical DNP role is premised on the belief that there
is a common core of clinical knowledge needed for
comprehensive care. Indeed, certification as a diplomate
in comprehensive care (DCC) offers peer recognition
necessary for the DNP clinician as effective
team participants. (see http://nursing.columbia.edu/
dnpcert/index.shtml). Exemplars of clinical models
should be shared so that transformation of care can
be enhanced.
****This Article will help you with the Advanced nursing practice implication: SEE pg. e149 in this article… essential VI encourages the DNP advanced nurse to engage in interprofessional collaboration for improving patient and population health outcomes:
Garritano, N. F., Glazer, G., & Willmarth-Stec, M. (2016). The doctor of nursing practice essentials in action: Using the essentials to build a university-wide automatic external defibrillator program. The Journal for Nurse Practitioners, 12(4), e143-e150. DOI:10.1016/j.nurpra.2015.12.003
