Interprofessional Practice in Healthcare
Interprofessional collaborative practice has become one of the key ingredients in healthcare redesign and reform. The development of GITT 2.0 was guided by the Core Competencies for Interprofessional Collaborative Practice, a Report of an Expert Panel . This report outlines the concept of interprofessionalism, and provides key competencies for team members. The four core competencies are:
- Value/ethics for Interprofessional Practice: Patient-centered care, with a population or community orientation, providing a sense of shared purpose, and reflecting a shared commitment
- Roles/responsibilities: Understanding how other roles and responsibilities complement each other
- Interprofessional Communication: Developing basic communication skills as a core aspect of interprofessional collaboration
- Teams and teamwork: Learning to be a good team player
The Institute of Medicine’s report Best Care at Lower Cost  indicates that team-based care is an important tool for making the transition to a learning healthcare system. Traditionally, students learn uniformly within that profession’s invisible boundaries. Once a graduate, he/she works among other teams, often never formally exposed to the unique abilities of other professions. Not understanding and appreciating the unique nature of professional roles within our healthcare system serves to marginalize outcomes and fractionate care delivery models. Strategizing to leverage team-based opportunities will help to improve healthcare outcomes at a lower cost while delivering care that improves the experience for patients and their caregivers.
Interprofessional collaboration education and practice has evolved significantly over the past ten years, but not to the extent that we wish. The concept of practicing in silos still continues in many healthcare settings today. This model is deeply rooted in a rich history of hierarchical clinical practice perpetuated in silos of professional education throughout much of the world. In order for interprofessional models of care delivery to be a reality, we need to reshape how we educate our future healthcare workforce as well as those in practice today. Without educating the existing workforce, students will enter a work environment that still functions in silos and new graduates will quickly fall in line with old paradigms of care.
There has been significant interest recently in team-based healthcare approaches to issues that affect patients and their caregivers, especially those with chronic medical conditions. The ability to look at complex issues through multiple lenses is key to delivering care that is timely and well-coordinated. This allows healthcare teams to better manage patients who are older, frailer, and experiencing competing, diverse, and complex issues. Team based care eliminates professional silos which result in redundancies, burdensome costs, and ineffective results.
In order to fully integrate models of care delivery, which support the active involvement of many disciplines that work together, we must first begin at the student level. By introducing these key concepts to students early in their professional careers, we are assisting them in understanding, practicing, and valuing interprofessional collaborative practice.
Patient and caregiver-centered care is a critical aspect of effective care delivery, especially within the context of meeting the Institute for Healthcare Improvement’s Triple Aim . Thoughtful integration of the patient and their caregivers has never been more important. Even ‘inviting’ the patient and their caregivers into the healthcare team has been a significant paradigm shift. Full integration in patient and caregiver-centered care calls for them to not only become integrated into the healthcare team, but to be understood and recognized to be the most important people on that team. Moreover, thoughtful patient and caregiver engagement is essential to achieve full integration into this model. As members of the healthcare team, we must view their engagement as fundamental. True engagement allows care teams to leverage modalities of self-care into chronic disease management, which will assist to directly and positively impact the Triple Aim.
According to the Josiah Macy Foundation, “We envision a healthcare system in which learners and practitioners across the professions are working collaboratively with patients, families, and communities and with each other to accomplish the Triple Aim” . In order to successfully integrate interprofessional teams in the delivery of care, we need to recognize the need to adapt and teach these ideas and concepts to all members of the healthcare team. A critical aspect of this model is the approach to providing opportunities for interprofessional collaboration to both practicing professionals and the students in these professions. In doing so, we hope to secure the future of team-based care who will be challenged with emerging medical and social issues.
- Interprofessional Education Collaborative Expert Panel. (2011). Core Competencies for Interprofessional Collaborative Practice: Report of an Expert Panel. Retrieved from http://www.aacn.nche.edu/education-resources/ipecreport.pdf
- Institute of Medicine. (2012). Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. Retrieved from https://www.nationalacademies.org/hmd/~/media/Files/Report %20Files/2012/Best-Care/BestCareReportBrief.pdf
- Institute for Healthcare Improvement (IHI). (2016). Initiatives: The IHI Triple Aim. Retrieved from http://www.ihi.org/engage/initiatives/tripleaim/pages/default.aspx
- Josiah Macy Foundation. (2013). Proceedings from conference: Transforming Patient Care: Aligning Interprofessional Education with Clinical Practice Redesign. Retrieved from http://macyfoundation.org/docs/macy_pubs/JMF_TransformingPatientCare_Jan2013Conference_fin_Web.pdf
To find out more information on interprofessional practice in healthcare, please refer to the following sites:
- D'Amour D., Ferrada-Videla M., San Martin Rodriguez L., & Beaulieu M.-D. (2005). The conceptual basis for interprofessional collaboration: Core concepts and theoretical frameworks. Journal of Interprofessional Care, 19:sup1, 116-131. doi: 10.1080/13561820500082529. Retrieved from http://dx.doi.org/10.1080/13561820500082529
- Health Professions Regulatory Advisory Council. (2008). Interprofessional Collaboration: A Summary of Key Reference Documents and Selected Highlights from the Literature [Powerpoint slides]. Retrieved from http://www.hprac.org/en/projects/resources/hprac-collaboration.LitReviewENFINAL.feb1208.pdf
- Institute for Healthcare Improvement (IHI). (2016). Triple Aim for Populations. Retrieved from http://www.ihi.org/topics/tripleaim/pages/default.aspx
- Kaiser Family Foundation. Kaiser Fast Facts is a great health policy resource from the Kaiser Family Foundation featuring "Quick Takes" and "Kaiser Slides”, two tools providing direct access to facts, data and slides about the nation's health care system and programs, in an easy-to-use format. Available online at http://kff.org/kaiser-slides/
- World Health Organization. (2010). Framework for Action on Interprofessional Education & Collaborative Practice. Retrieved from http://apps.who.int/iris/bitstream/10665/70185/1/WHO_HRH_HPN_10.3_eng.pdf