Interprofessional Collaboration

Interprofessional Collaborative Skills

A critical skill for healthcare professionals is the ability to work efficiently and effectively with other healthcare workers. For example, a person working in patient care may need to interact with their core team, contingency teams, ancillary and support services, administration, and the patient. A team consists of two or more individuals who interact dynamically, interdependently, and adaptively toward a common and valued goal, have specific roles or functions, and have a time-limited membership. Teams within healthcare must learn to communicate, coordinate, and effectively think and feel as a team by enacting necessary teamwork processes.

Teamwork processes can be defined as interrelated knowledge, skills, and attitudes that allow teams to work together to accomplish interdependent goals, such as problem-solving or providing optimal care to a patient. A team with the proper teamwork structure can anticipate the needs of other team members, dynamically adjust to a changing environment (including changing behaviors of team members), and have a shared understanding of what should happen.

• Knowledge: Teams whose members have strong communication, leadership, situation monitoring, and mutual support capabilities yield important team outcomes such as shared awareness about what is going on with the team and progress toward its goal. Team members will also be familiar with the roles and responsibilities of their teammates.
• Attitudes: When you work in teams in which the members have good communication, leadership, situation monitoring, and mutual support skills, team members are more likely to have a positive experience; you will enjoy working in teams and trust the intentions of your teammates.
• Performance: You’ll be able to adapt to changes in the care plan. Team members will know when and how to back up each other. You’ll be more efficient in providing care; you will have a plan, and you will know who is supposed to do what, and how they are supposed to do it. Finally, your team will be safer, allowing the team to more readily identify and correct errors if they occur.

The knowledge, skills, and attitudes of teamwork complement clinical excellence and improve patient outcomes, because teams use feedback cycles and clearly defined tools to communicate, plan, and deliver better quality care.

All healthcare students must prepare to deliberately work together in clinical practice with a common goal of building a safer, more effective, patient-centered healthcare system. The World Health Organization (WHO) (2010) defines interprofessional collaborative practice as multiple health workers from different professional backgrounds working together with patients, families, caregivers, and communities to deliver the highest quality of care.

Effective teamwork and communication have been proven to reduce medical errors, promote a safety culture, and improve patient outcomes (Agency for Healthcare Research and Quality [AHRQ], 2015). The importance of effective interprofessional collaboration has become even more important as healthcare professionals advocate to reduce health disparities related to social determinants of health (SDOH). In these efforts, healthcare professionals work with people from a variety of professions, such as physicians, social workers, educators, policymakers, attorneys, faith leaders, government employees, community advocates, and community members. Healthcare students must be prepared to effectively collaborate interprofessionally after graduation (National Academies of Sciences, Engineering, and Medicine, 2021).

The Interprofessional Education Collaborative (IPEC) has identified four core competencies for effective interprofessional collaborative practice. This section will review content related to these four core competencies and provide examples of how they relate to different health professions.

IPEC Core Competencies

The Interprofessional Education Collaborative (IPEC) established standard core competencies for effective interprofessional collaborative practice. The competencies guide the education of future health professionals with the necessary knowledge, skills, values, and attitudes to collaboratively work together in providing client care. See the Table below for a description of the four IPEC core competencies. Each of these competencies will be further discussed in the following sub-sections of this chapter.

Values and Ethics for Interprofessional Practice

The first IPEC competency is related to values and ethics and states, “Work with individuals of other professions to maintain a climate of mutual respect and shared values” (Interprofessional Education Collaborative, 2016). See the table below for the components related to this competency.

Imaging, nursing, medical, and other health professional programs typically educate students in “silos” with few opportunities to collaboratively work together in the classroom or in clinical settings. However, after being hired for their first job, these graduates are thrown into complex clinical situations and expected to function as part of the team.

One of the first steps in learning how to function as part of an effective interprofessional team is to value each healthcare professional’s contribution to quality, patient-centered care. Mutual respect and trust are foundational to effective interprofessional working relationships for collaborative care delivery across the health professions. Collaborative care also honors the diversity reflected in the individual expertise each profession brings to care delivery (Interprofessional Education Collaborative Expert Panel, 2011)

ROLES AND RESPONSIBILITIES OF HEALTHCARE PROFESSIONALS

The second IPEC competency relates to the roles and responsibilities of healthcare professionals and states, “Use the knowledge of one’s own role and those of other professions to appropriately assess and address the healthcare needs of patients and to promote and advance the health of populations” (Interprofessional Education Collaborative, 2016).

See the following box for the components of this competency. It is important to understand the roles and responsibilities of the other healthcare team members, and to recognize one’s limitations in skills, knowledge, and abilities. One should also ask for assistance when needed to provide quality, patient-centered care.

Healthcare professionals communicate with several individuals during a typical shift. For example, during inpatient care, nurses may communicate with the following: patients and their family members; pharmacists and pharmacy technicians; providers from different specialties; physical, speech, and occupational therapists; dietary aides; respiratory therapists; chaplains; social workers; case managers; nursing supervisors, charge nurses, and other staff nurses; assistive personnel; nursing students; nursing instructors; security guards; laboratory personnel; radiology and ultrasound technicians; and surgical team members.

Providing holistic, quality, safe, and effective care means every team member taking care of patients must work collaboratively and understand the knowledge, skills, and scope of practice of the other team members. The table below provides examples of the roles and responsibilities of common healthcare team members that nurses frequently work with when providing patient care. To fully understand the roles and responsibilities of the multiple members of the complex healthcare delivery system, it is beneficial to spend time shadowing those within these roles.

The coordination and delivery of safe, quality patient care demand reliable teamwork and collaboration across organizational and community boundaries. Patients often have multiple visits across multiple providers working in different organizations. Communication failures between healthcare settings, departments, and team members are the leading cause of patient harm (Rosen et al., 2018). Our healthcare system is becoming increasingly complex requiring collaboration among diverse healthcare team members.

The goal of good interprofessional collaboration is improved patient outcomes, as well as increased job satisfaction of healthcare team professionals. Patients receiving care with poor teamwork are almost five times as likely to experience complications or death. Hospitals in which staff report higher levels of teamwork have lower rates of workplace injuries and illness, fewer incidents of workplace harassment and violence, and lower turnover (Rosen et al., 2018). Valuing and understanding the roles of team members are important steps toward establishing good interprofessional teamwork. Another step is learning how to effectively communicate with interprofessional team members.

INTERPROFESSIONAL COMMUNICATION

The third IPEC competency focuses on interprofessional communication and states, “Communicate with patients, families, communities, and professionals in health and other fields in a responsive and responsible manner that supports a team approach to the promotion and maintenance of health and the prevention and treatment of disease” (Interprofessional Education Collaborative, 2016). This competency also aligns with The Joint Commission’s (2023) National Patient Safety Goal for improving staff communication. See the following box for the components associated with the Interprofessional Communication competency.

Transmission of information among members of the healthcare team and facilities is ongoing and critical to quality care. However, information that is delayed, inefficient, or inadequate creates barriers to providing quality care. Communication barriers continue to exist in healthcare environments due to interprofessional team members’ lack of experience when interacting with other disciplines. For instance, many novice MRTs enter the workforce without experiencing communication with other members of the healthcare team (e.g., providers, pharmacists, respiratory therapists, social workers, surgical staff, dieticians, physical therapists, et cetera). Additionally, healthcare professionals tend to develop a professional identity based on their educational program with a distinction made between groups. This distinction can cause tension between professional groups due to diverse training and perspectives on providing quality patient care. In addition, a healthcare organization’s environment may not be conducive to effectively sharing information with multiple staff members across multiple units. In addition to potential educational, psychological, and organizational barriers to sharing information, there can also be general barriers that impact interprofessional communication and collaboration. See the following box for a list of these general barriers.

Since teams and teamwork is a culmination of all that you have learned by reviewing the first three IPEC competencies, this book is dedicating an entire section to this topic next.