Ch 7 | Interprofessional Issues: Collaboration and Collegiality

Triple Aim

(a) improve the patient experience (b) improve the health of populations (c) reduce the per capita cost of care

How many sources of magnetism were extracted from the Magnet Recognition Program?

- 14 - In 2008, these 14 were consolidated into 5 Magnet Model components and Interdisciplinary Relationships was merged into the component Exemplary Professional Practice

Cochrane Reviews on IPE found that

- 7 studies of IPE had positive outcomes (professional practice and/or patient care) - 4 studies had positive and neutral (mixed) outcomes - 4 studies reported no impact on practice or care

Interprofessional Education and Collaborative Core Competencies

- Values/Ethics - Roles/Responsibilities - Interprofessional Communication - Teams and Teamwork

Collaboration allows and promotes

- autonomy - professionalism - self-confidence - improved patient outcomes

Cochrane Collaboration

- community of experts that provides systematic reviews of primary research in the area of healthcare and is often used by healthcare experts in determining evidence-based practice

The Magnet Recognition Program

- designation awarded by the American Nurses Credentialing Center (ANCC) that recognizes that demonstrate nursing excellence and high-quality pt care

A team that works collaboratively is

- nonhierarchical - power is shared and each individual's input is valued equally - titles and roles are insignificant

Patient-Centered Primary Care Collaborative (PCPCC) concepts:

- patient centered - comprehensive - coordinated - accessible - committed to quality and safety

Interprofessional Education (IPE)

- places students in clinical settings where they observe and work with other professional disciplines - students learn about collaboration from highly functioning teams

University of Toronto's IPE curriculum

- prepares health professions students as interprofessional collaborative care providers ready for entry to practice - exposure (introduction), immersion (development), and competence (entry to practice)

The Richmond Health and Wellness Program

- project that demonstrates community-based IPE through healthcare delivery - well-organized, community-based IPE student model that fosters transdisciplinary and interprofessional collaboration

National Institutes of Health (NIH)

- represent all disciplines of healthcare providers collaborating to achieve improved public health of the nation - mission of NIH is to improve health and quality of live of all citizens

National Center for IPPE

- seeks to create partnership between practice/education to affect Triple Aim and improve collaborative practice for benefits of patients

Benefits of working collaboratively

1) improved patient care 2) better educated pts 3) pt involvement in decision making 4) overall improved quality 5) cost savings 6) decreased lengths of stay 7) emergence of collegial relationships

ANA released an executive summary related to collaboration as an intrinsic part of nursing

1) intrinsic to nursing is a the collaborative process 2) to provide effective and comprehensive care, healthcare professionals must collaborate with each other 3) each profession exhibits different areas of professional competence that, when combined, provide a continuum of care that the consumer has to expect

Actions to advance collaborative practice for improved health outcomes

1) structure that promotes shared decision making 2) environment that promotes collaborative practice 3) personnel policies that support collaborative practice 4) develop a delivery model 5) develop governance models that establish team-work

When was the first Cochrane Review on healthcare outcomes of IPE published?

2008

Picker Principles of Patient-Centered Care

8 dimensions of patient-centered care 1) respect for patient 2) coordination and integration of care 3) info, communication, education 4) physical comfort 5) emotional support and alleviation of fear/anxiety 6) involvement of family and friends 7) transition and continuity 8) access to care

Collegiality

Sharing authority and responsibility to reach a prescribed goal or outcome. Power and responsibility are shared, and mutual respect and collaboration are desired.

Interprofessional collaborative practice

When multiple health workers from different professional backgrounds work together w/ patients, families, carers, and communities to deliver the highest quality of care

Collaboration

Working jointly with other healthcare professionals in a collegial manner. A process whereby healthcare professionals work together to improve patient/client outcomes.

The IPEC recognized that the WHO model

identifies a learning continuum that begins with health professions education

Communication

is a key prerequisite to collaboration, collegiality, and coordination of care - "all the cognitive, affective and behavioral responses that can be used to convey a message to another person" - communication can be verbal, such as through one's words, and their pace, clarity, timing, and relevance - can also be nonverbal, where words are not used, but meanings or expressions are communicated via body language, facial expressions, and use of touch, space, and/or sound - can be varied through aspect of one's culture as well

The Patient Protection and Affordable Care Act (PPACA)

primary driver in HRSA's decision to fund the National Center for Interprofessional Practice and Education

To Err is Human (2000)

seminal report where experts in health care concluded that there were a tremendous number of medical errors causing human suffering and that collaborative interventions were a method to reduce these medical errors

Without collaborative care,

systems will remain fragmented and costly and continue to put patients at risk for medical errors

Collaborative practice model advanced by IPEC recognizes

the importance of patient and family-centered care as an outcome of interprofessional practice