Report Review: Lessons from the Field: Promising InterprofessionalCollaboration Practices

In this report the authors have written engaging and educational chapters that identify the practices and guidelines of interprofessional collaboration. The report is directed towards an audience who is involved or interested in the health care field, and looking for more information on improving collaboration based on a health care model of the United States.

The report focuses on identifying interprofessional collaboration in practice and the day-to-day activities health care organizations put into the concept of interprofessional collaboration. The authors of this report use a format and writing style that is easy to understand for readers.

The primary goal of the report is to identify the guiding principles and practices that provide practical ways to address and overcome barriers of interprofessional collaboration. The report helps readers to better understand the role interprofessional collaboration has and how it advances the health field. For example, the authors describe how interprofessional collaboration is transitioning from treating people who are sick to keeping people healthy. The report is a combination of both theoretical and practical types of interprofessional collaboration.

The authors have sought out seven organizations and implemented their theories into practice. Each organization provided their own input on the success of interprofessional collaboration so far, and the potential future of interprofessional collaboration as making a difference in the health care field by creating a safer environment for patients and providers, as well as enhancing the quality of care. The report is organized by sections, and each section builds off the previous one, providing more in depth information on six guidelines required to create an environment in which interprofessional collaboration can thrive. These six guidelines are: (1) putting patients first; (2) demonstrate leadership commitment as an organizational priority; (3) create a level playing field enabling team members; (4) cultivate effective team communication; (5) explore the use of organizational structure to hardwire interprofessional practice; (6) and train different disciplines together so they learn how to work together. These guidelines help the most potent set of practices to develop, foster and sustain interprofessional collaboration.

Each chapter of the report further describes each of the main guidelines, and contains its own principles for that guideline, while going into depth more on some more specific principles for that guideline. The sections conclude with cases that are relevant to the principle talked about in that chapter. The guiding principles, practices, and case examples, described in this report, provides practical ways to address and overcome many of the historical barriers that fall in interprofessional collaboration. Each chapter has practical features that are not always found in textbooks, such as quotes from different health care organizations, as well as an inside view on howeach of these organizations set out to identify interprofessional collaboration in practice.

The report provides substantive references for their claims, studies and statistics. Each organization the report focuses on believes their model if working and making a difference in the health care system. The book takes an ethnographic approach that allows them to compare and contrast what organizations say they are doing with observations to understand how interprofessional collaboration practices work on the ground, both tactically and explicitly. This allows the authors to identify the promising practices of interprofessional collaboration, and better understand the role interprofessional collaboration has, as it is advanced in the health field.

Overall, authors of this report have compiled an accessible and thorough addition to the area of interprofessional collaboration. It is a practical option for those interested in attaining an introduction to this topic, and I readily recommend it to health care workers interested.

Reviewed by  

Namira Dossa

Concordia University of Edmonton, Canada

Lessons from the Field: Promising Interprofessional Collaboration Practices

CFAR, Inc., Jennifer Tomasik, & Caitlyn Fleming.

White Paper, The Robert Wood Johnson Foundation

2015, 59 pages

Blog Article: Lessons Learned from the Development of an Annual Multi-Institutional Interprofessional Service Learning Health Expo

Lessons Learned from the Development of an Annual Multi-Institutional Interprofessional Service Learning Health Expo

Raymond Higbea (1), Jodie Elder (2); Katie Branch (1)

(1) Grand Valley State University, Grand Rapids, Michigan, USA

(2) Ferris State University, Grand Rapids, Michigan, USA

Introduction

To ensure that tomorrow’s healthcare professionals are prepared for and empowered to make future practice integration changes, today’s healthcare students must not only be witnesses to the benefits of interprofessional practice, but well versed in working within an interprofessional framework prior to graduation (World Health Organization 1998). The Midwest Interprofessional Practice, Education, and Research Center (MIPERC) founded in the fall of 2007 by Grand Valley State University, Grand Rapids Medical Education Partners, and Michigan State University College of Human Medicine is committed to educating health professionals by providing experiences in the development of skills in collaboration, communication, and team work that supports patient centered quality care.  

MIPERC’s mission is to identify ways that educational and practice partnerships can be developed to include: collaborative, innovative, and interprofessional initiatives across professions, learning institutions, and healthcare systems. The foundation of the MIPERC interprofessional education (IPE) model includes the Institute of Medicine’s (2001) core competencies of patient centered care, evidence-based practice, quality improvement, the use of informatics, and interprofessional teams. MIPERC has built its working infrastructure around six champion workgroups: clinical setting; curriculum; professionaldevelopment; scholarship; service-learning; and simulation to assist with refinement and implementation of the model.  Participation in a workgroup is voluntary and open to any area faculty, staff, or community healthcare professional.

Background

During the 2013 fall semester MIPERC Service-learning workgroup began planning for the workgroup’s primary service learning event for the academic year.  Students from the MIPERC’s student organization Promoting Interprofessional Education for Students (PIPES) were surveyed for interest and willingness to participate in an interprofessional community health fair in the spring of 2014.  PIPES students were also asked to choose a target population of interest.  Eighty-one percent of those surveyed (26/32) reported an interest and willingness to participate in an interprofessional community health fair.

Based upon survey feedback, the first MIPERC service-learning interprofessional health fair service learning experience was planned by the workgroup for March 2014.  Target populationfor the health fair was families with topical categories: healthy travel, healthy lifestyles, healthy sports and recreation, and success in school.  

Due to the success of the first multi-institutional interprofessional health fair (2014), the MIPERC Service-learning workgroup continued with the planning and execution of a second (2015) and third (2016) interprofessional health expo.  The word, “fair” was replace with word, “expo” in 2015 with the purposeful intention of drawing additional interest in participation.

Methods

Routine planning methods were employed to prepare for the fair/expo including: conducting a needs assessment; recruitment of faculty advisors, community advisors, and staff; recruitment of students; development of student support and incentives; development of health fair/expo theme; event planning activities, e.g., choosing a date, securing a site, and various logistical activities; and development of event evaluation and learning outcome assessment

Due to the report nature of this manuscript, it was not submitted to the Grand Valley State University Human Research Review Committee for review.  The evaluation and assessment for the 2015 health expo was submitted to the Grand Valley State University Human Research Review Board and received exempt status due to its lack of any personal identifying information. 

Currently, the program evaluation and assessment is under review of the Grand Valley State University Human Research Review Board for exempt status.

Results & Discussion

The first two years have produced the following results (year 3 results are pending): increased student participation (tripled); increased faculty advisor participation (tripled); increased university participation (quadrupled); and positive survey results indicating a high level of health fair/expo participant learning.

Planning and executing a multi-institutional interprofessional health expo can be challenging.  It is recommended institutions that seek to create a similar experience in their community: (1) start planning and recruiting early; (2) define goals, objectives, target audience, and theme of each year’s expo; (3) place student in teams based on topic of interest and education level; (4) keep student teams to a maximum of five student and a minimum of one faculty advisor; (5) obtain funding for the development of student exhibits; (6) provide advisor and student IPE trainingonline including role expectations and timelines; (7) obtain IRB approval early; and (8) give credit for service learning via a certificate of participation.

The planning trend with this event has been simplification and standardization.  This event has simplified its planning process based on previous experience and has as a result of these experiences simplified its target audience to college students on the university’s main campus, simplified it themes from a collection of topics to standardized dimensions of student wellness, and moved from an event that included speakers and project displays to only project displays.  Standardization activities have included training and recruitment of faculty advisors, theme development, student support, service learning certificate, and learning assessment.

Patient care models are moving from profession-specific provision of physician directed patient care to patient centric care delivered by interprofessional teams.  Due to this shift, it is imperative that today’s healthcare students learn how to deliver effective patient care from narrow lens of their profession and the broad lens of a team.  It is through events such as such this interprofessional service learning event that students will begin to develop team based skills, learn their role in a team, and begin to develop an understanding of what others have to offer patients through a team based delivery of care.  Activities such as this service-learning event and other similar activities will allow student to succeed within these emerging practice models.  It is the responsibility for those of us training these students to move beyond our professional silos and provide students with interprofessional events that will prepare them to develop the skills necessary to become team-based practitioners of patient care delivery.

References

World Health Organization (1988) Learning Together to Work Together. Geneva: WHO.

Institute of Medicine (2001) Committee on Quality of Health Care in America, editor. Crossing the Quality Chasm: a new health system for the 21st century. Washington, DC: National Academy Press.

Contact: Raymond Higbea (higbeara@gvsu.edu)

Book Review: Collaborative Caring: Stories and Reflections on Teamworkin Health Care

Teamwork is an important topic in health care organizations today. While there are many theoretical books that explore the issues of teamwork in a health care setting, the practical application of theory into practice continues to be increasingly complex. Teamwork is integral to providing quality patient care that is both efficient in minimizing costs and resources, and effective in decreasing errors and injuries. This book discusses the topic of teamwork and its nature in real world application. Editors Suzanne Gordon, David Feldman, and Michael Leonard have compiled fifty stories provided by people from various health care professions that give a first hand account of what effective teamwork, or the lack of it, means in the health care field. The book explores several different themes such as psychological safety, patient advocacy, barriers to effective teamwork and the organizational cultural traits that help to overcome such barriers and establish genuine teamwork models.

The book is comprised of eight parts that cover the different dimensions of teamwork, each having a brief introduction highlighting its key messages. Part 1 includes stories where health care personnel excel at working as part of a team, and insight and understanding of the team, team intelligence, is illustrated. The stories in Part 2 showcase ineffective teams and the damages or dangers that occur as a result of the absence of collaborative work. Part 3 shares stories that discuss the importance of the patient as a member of the team, and including the patient in discussions, and feedback. Part 4 discusses psychological safety, where one feels safe to voice concerns about patients or situations, being at the crux of effective team building. The stories within focus on leadership skills required for the creation of such an environment. The stories in Part 5 demonstrate that coaching and learning are crucial for team related evaluation and process improvement. Part 6 demonstrates patient advocacy not only being an essential component of high quality care, but also being at the heart of genuine team models that provide patient and family centered care. Part 7 looks at the barriers to effective teamwork. Barriers that have kept health care professionals working in silos as opposed to teams include organizational hierarchies, professional self-identities and incentives or reward structures. Part 8 concludes with stories that illustrate how organizations are adapting to transform themselves to create the systems and culture necessary for good teamwork.

This book is an excellent read for raising awareness of the practical application of team theory and its various issues. The stories increase understanding of the complexities involved inreal-world teamwork dynamics and what healthcare professionals and administrators can do to solve such issues. Ultimately, teamwork that is both efficient and effective is necessary for providing sustainable, quality health care.

Reviewed by

Naz Qureshi, BSc, BCom, MBA

Alberta Pensions Services Corporation

Collaborative Caring: Stories and Reflections on Teamwork in Health Care

Suzanne Gordon, David L. Feldman, and Michael Leonard

New York, USA, Cornell University Press, 2014

286 pages, $27.95

ISBN 978-0-8014-5339-7

Book Review: Work-based assessment of teamwork: An interprofessional approach

In this book, Thistlethwaite and colleagues report on the development and validation of iTOFT – the Individual Teamwork Observation and Feedback Tool. This is the culmination of a two-year international project (2012-2014) led by a team of researchers from five Australian, one UK and one Canadian university.

 

The report is structured in 10 Chapters, with a further six helpful appendices. Chapter 1 sets the scene for the project within the wider literature on interprofessional learning, which is followed by a review in Chapter 2 of accreditation standards, professional bodies and interprofessional learning frameworks. The educational ethos and theoretical backdrop of the project is explained in Chapter 3, positioning the iTOFT within constructivist learning theory and competency-based education.

 

Chapter 4 could be in itself a project output, providing a comprehensive review of existing teamwork measures building on and extending two existing reviews by the Harvard Business School and the Canadian Interprofessional Health Collaborative. They very helpfully provide an overview of the existing literature, summarize and extend the conclusions of previous reviews and illustrate the wealth and diversity of available tools. Tables 4.6 and 4.7 in this chapter are essential reading for scholars working in this field.

 

The groundwork for the development of the first iteration of the iTOFT is explained in Chapter 5, including a description of the Delphi approach used. The field testing is discussed in Chapter 6 and the results of this in Chapter 7. Data were drawn from 132 episodes of assessment, which occurred in hospital, primary/community care and school settings. Chapter 7 is a detailed analysis of that data, demonstrating the rigour and care of the project team in developing a sound instrument. The quantitative evaluation was complemented by a qualitative arm to the project, with a very brief summary of key themes and findings arising from that shown in Chapter 8.

 

Chapter 9 draws the strings of the work together and discusses the key principles of the final iTOFT and its two versions: there is a basic version meant for junior students, which covers 11 observable behaviours under the headings of shared decision-making and working in a team; and, an advanced version for senior students and junior health professionals with 10 observable behaviours under the headings of shared decision-making, working in a team, leadership and patient safety. Finally, Chapter 10 summarises the work, issues recommendations and cautions of its limitations.

 

The full report is a must read for those interested in using the iTOFT, although it also comes with a shorter ‘Resource Pack’ serving as a kind of manual for using either version of the tool. I remain skeptical about the utility of having two versions and find the advanced version to be more helpful. In particular, the basic version misses items on leadership and patient safety, which I would argue are important to feedback on regardless of the seniority of the student. The report, tool and resource pack is directed at interprofessional learners, teachers and program organisers all of whom would find this work interesting – whether they plan to use the tool or not.

 

Reviewed by

Dr. Andreas Xyrichis

Lecturer, King’s College London, UK

Work-based assessment of teamwork: An interprofessional approach

The iTOFT Consortium (Jill Thistlethwaite, Kathy Dallest, Lesley Bainbridge, Fiona Bogossian, David Boud, Roger Dunston, Donna Drynan, Diann Eley, Dawn Forman, Sue Fyfe, Monica Moran, Christopher Roberts, Jenny Strong, Robyn Dickie).

Canberra: Australian Government, Office for Learning and Teaching. 2015

163 pages, Freely available online

ISBN 978-1-76028-399-5

Book Review: Collaboration across Health Research and Medical Care

Reinforcing the title of this book, Collaborations across Health Research and Medical Care was written with 17 contributors. Each contributor fluently depicts their experience within different aspects of collaboration in research and medical care, while also delivering specified theories and examples pertaining to their focus. The information highlights social organization and content of collaboration through diversity of basic and applied forms of research. This volume is divided into 3 sections of varied approaches, supporting and arguing major focal points through progressive practices in collaborated research.

The first part of this volume is introductory, delving into the differences of opinion and motivation between scientists and methods of research. It highlights the evolvement and importance of collaboration internationally. Concisely, authors of the first section deliver enlightening information between research methods while also exemplifying complications that can arise through diverse collaboration.

Part two focuses on collaboration in health research, using the Virgo Consortium for Cosmological Supercomputer Simulations (in which scientists collaborate globally from the UK, Netherlands, Germany, USA, Canada, and China) as a good basis to support collaborative research with the idea that a global pandemic is bound to occur again. Additionally, it delves into genomics and bibliometric research as an effective method of study. The authors highlight pros, cons and complications that can occur with intellectual property when co-authoring. Further information is given on the evolution of collaboration with charts depicting overviews of international publications presenting the evolution of this practice. The last sub category addresses legitimacy and credibility of research methods using a relevant example which delivers insightful information pertaining to academic and government researchers with corporations and trade associations.

Part three focuses on collaborative health infrastructures, discussing benefits and complications of registry networks and its impact on developing clinical practice and assisting in evolving health policies. Leading into child index script and multidisciplinary collaboration, the author perceptively highlights current issues in regards to child welfare and how research for this paradigm is not scripted easily.

The last section of this volume discusses many topics, comprehended with ease while depicting the importance of different actors supporting research projects, directly or indirectly; varying research clusters with both intellectual and social reasons for collaboration, and distinguishing credibility and legitimacy. The portion ends with collaborative processes between physician and patient through analytical phases.

After completing this volume I can conclude that this piece of literature comprehensively identifies the advantages, motivations and complications of collaborative work, internationally or locally. The parts discussed and delivered are diverse enough to encompass different aspects of collaborative research while delivering specific examples. This book succeeded in reviewing numerous areas of focus candidly and providing sufficient references and footnotes to support their reviews. Each author conveys succinctly, resulting in the reader to ruminate each topic of discussion.

Reviewed by

Alisha Jordan

Freelance Writer/Author

Healthy Collaboration

Bart Penders, Niki Vermeulen & John N. Parker (eds.). Ashgate Publishing Ltd. Farnham, UK.

247 pages, $107.96

ISBN 9781409460954

 

Announcement: Journal of Interprofessional Care Baldwin Award Winner

 Introduction

The Baldwin Award is made in recognition of DeWitt ‘Bud’ Baldwin Jr.’s lifelong and distinguished contribution to interprofessional care. It was first awarded in 2009 for the best article of the 2008 volume of the Journal of Interprofessional Care. Each year since, a panel of judges recruited from the Journal’s editorial board assesses all the articles published in a single volume and decides upon the winner based upon five key criteria for quality. Below, we detail the process and outcome of the most recent winner of the Baldwin Award for volume 28.

The adjudication process

The judging panel changed a little this year as Alan Bleakley stepped down as chair after his six year involvement. We would of course like to thank Alan for all his hard work. The panel for this year’s award consisted of Journal editorial board members: Joanne Goldman (who has once judged on the award); John Toner (a long-standing award judge) and Scott Reeves (an award judge for the past few years).

In judging the quality of work published in the journal we used the following (well established) five criteria to select the winner. An article:

-Adds significantly to the evidence base informing interprofessional care and education worldwide

-Potentially has a significant impact on theory informing practice in interprofessional care and education

-Potentially has a significant impact on research design in interprofessional care and education.

-Is clear and cogent (written well, and clearly argued).

-Shows innovation in the field of interprofessional studies and practice.

Only articles (not commentaries, short reports, editorials) are considered for the Baldwin Award. Articles authored or co-authored by any of us (the judges) are removed from consideration.  Articles are scored on a scale from 1 to 10 on each criterion listed above. The six Journal issues that made up volume 28 were divided equally among the judges, (we each assess around 20 papers). However, one of us did read all the articles to get an overview of range and quality and to ensure parity across scores. One of us then collated results and discussed grades with the other two judges across two rounds. We took the top three articles from each judge to round two and assessed these articles, taking into consideration our shared summaries of the strengths and weaknesses of these articles.

The Baldwin Award winner

Based on the above process, we came to a unanimous decision on the winning article:

Paula Rowland & Simon Kitto. Patient safety and professional discourses: implications for interprofessionalism

http://www.tandfonline.com/doi/full/10.3109/13561820.2014.891574

Congratulations to both authors who provided a very thoughtful critical analysis of interprofessional patient safety practices which employed a sophisticated theorising of this project by drawing on Michel Foucault’s work on discourse.

Runners Up

We must also congratulate the two runners up which the judging panel felt were both very strong contributions to the Journal:

Christopher Green. The making of the interprofessional arena in the United Kingdom: a social and political history

http://www.tandfonline.com/doi/full/10.3109/13561820.2013.867840

Douglas Archibald, David Trumpower and Colla MacDonald. Validation of the interprofessional collaborative competency attainment survey (ICCAS)

http://www.tandfonline.com/doi/full/10.3109/13561820.2014.917407

It was felt that Green presented a very illuminating analysis key conceptual and theoretical elements in his discursive paper on the socio-politics of IPE in the UK, whereas Archibald and colleagues carefully detailed the validation process of a new innovative tool to assess collaborative competence.   

Honourable Mention

In addition, for their rare economic evaluation of Interprofessional student clinics, we agreed that an honourable mention should go to the following paper:

Terry Haines, Fiona Kent & Jennifer Keating. Interprofessional student clinics: an economic evaluation of collaborative clinical placement education

http://www.tandfonline.com/doi/full/10.3109/13561820.2013.874983

Congratulations again to all the authors whose papers have contributed to improving the scholarship of the interprofessional field.

Brief reflections

While it was agreed amongst the judges that the standard and quality of articles published in the Journal continues to improve, it was noted there were a few areas which authors should pay attention to in designing, implementing and writing-up their interprofessional studies:

-It was agreed that many of the quantitative papers could improve their quality if authors more effectively engaged with theoretical debate related to the work described.

-While qualitative papers were generally better at theorising, a number of these paper could have been improved through better use of an underpinning research methodology when designing the study.

-Of the small, but growing number of mixed methods papers submitted, it was felt that more effort was needed to ensure engagement with a clear research design (e.g. sequential, convergent) and also that approaches to data collection were more balanced with equal amounts of quantitative or qualitative data gathered.

Again judging on the Baldwin Award was both an insightful and illuminating process. We would like to congratulate again the winning authors as well as the runners-up on their stimulating articles. We would also like to acknowledge all authors who publish their work in the Journal of Interprofessional Care for continuing to make the journal such a vibrant and important medium of exchange and innovation in our field.

Scott Reeves

Joanne Goldman

John Toner

Baldwin Award Judges, Journal of Interprofessional Care

Book Review: Communicating in Hospital Emergency Departments

This book outlines the research findings of a three-year project. It effectively draws the reader into wanting to know more, causes the readers to reflect on their own practice, and clearly identifies which actions need to be taken by the readers to improve their practice. This book is written in such a way to achieve all of this.

 

The nine authors outline how seven experienced researchers undertook a research initiative conducted in five emergency departments over a three-year period.

 

The researchers were motivated to conduct the research project by concerns that failures in communication have been identified as “a major cause of adverse events, leading to avoidable patient harm”. The researchers collectively spent 1093.5 hours in the emergency departments and applied qualitative ethnographic methodology. This analysis, together with sociolinguistic and discourse analysis of the spoken interactions between clinicians and patients, enables the researchers to identify key features of successful and unsuccessful interactions between clinicians and patients and also between clinical staff. As a result, the authors identified systemic improvements that could lead to safer practices and improve the quality of patient care.

 

The research clearly examines all aspects of communication between the clinical team working with the patient (including spoken, gestured, written and electronic communication) and is therefore very relevant to readers interested in interprofessional care of patients in emergency departments.

 

The book is presented in seven sections which effectively: outlines the need for good communication, reviews the emergency department environment, examines the patient’s journey through the department, details the communication patterns, looks specifically at the communication of medical information between the patient and the clinical staff, explores strategies for bridging the communication gap, and suggests strategies to promote change in ways of working and communicating.

 

The authors provide detailed descriptions of all aspects of working in emergency departments, and present a series of vignettes and case studies which demonstrate the complexities of communication. The authors then identify key moments where effective communication is at risk. The use of tables, graphs and diagrammatic representations very effectively complements the text, and each chapter includes a comprehensive list of references.

 

This book is an essential text for anyone working in an emergency department, as well as being of interest to interprofessional researchers, educators, practitioners and students internationally. I am pleased to recommend this book to readers who want to improve their working relationships as a health care team or increase their knowledge of communication among interprofessional teams.

 

Reviewed by 

Dawn Forman, Visiting Professor, University of Derby and Chichester University and Adjunct Professor Curtin University and Auckland University of Technology

Communicating in Hospital Emergency Departments by Diana Slade, Marie Manidis, Jeannette McGregor, Hermine Scheeres, Eloise Chandler, Jane Stein-Parbury, Roger Dunston, Maria Herke, Christian M.I.M. Matthiessen

Springer, Heidelberg, New York, Dordrecht, London, 2015, 158 pages Price €99.99 (hard copy) or €83.29 (eBook). ISBN 978-3-662-46020-7