Effective Interprofessional TeamBased Working The Basis of Collaborative Practice

1
Effective Interprofessional Team-Based
WorkingThe Basis of Collaborative Practice

• CRNBC, October 28 2008
• Lake Okanagan Resort
• Kelowna
• John H.V.Gilbert, Ph.D., FCAHS

2
The CRNBC Requirement
3
Presentation Objectives

• Examine the three key concepts inherent in the
  definition of interprofessional education
• Differentiate between
• Cooperate
• Coordinate
• Collaborate
• Explore some key concepts of effective
  interprofessional team based working (eITBW)

4
Avoiding A Problem with Words
5
Interprofessional Education

• Occasions when two or more professions learn
  with, from and about each other to improve
  collaboration and the quality of care.
• (Centre for Advancement of Interprofessional
  Education, 2002)
• ( using a BROAD definition of
  professions/al)

6
Hierarchy of cooperation, coordination and
collaboration

• Cooperation requires a minimum of interaction
  communication
• Coordination requires more complex interaction
  and communication
• Collaboration requires the highest levels of
  interaction, and most complex communication

7
Cooperation

• Willingness to work with others to achieve a
  common purpose which means
• Being available in
• space,
• time, and
• complementary expertise.
• Being receptive
• having interest,
• being willing to engage in give and take
  communication active listening, openness, and
  questioning,
• trust and respect.
• (after Baggs Schmitt, 1997)

8
Coordination

• Getting the work of a a team in synch to
  achieve the best
• timing, and
• sequencing of efforts to achieve the highest
  levels of
• efficiency, and
• completeness

9
Collaboration Its Uncritical Use

• General descriptor for interaction that involves
  efforts to work together.
• In the context of interprofessional it means
  efforts across disciplines.
• Often used synonymously with other words, e.g.
  cooperation, coordination, and teamwork.

10
Collaboration Technical Use

• Based on concept analysis a specific and high
  level set of
• knowledge,
• skills,
• attitudes, and
• behaviours
• for working together across disciplines.
• It is different from, but related to,
  cooperation and coordination.

11
Collaborative Practice

• An interprofessional process for
• communication and decision making that
• enables the separate and shared knowledge and
  skills of different care providers to
• synergistically influence the care provided
  through changed attitudes and behaviours.
• (after Way, Jones Busing, 2000)

12
Why is a more precise definition of
collaboration important to practice?

• Because it helps practitioners to understand
  and explain how best to provide
• access to care,
• efficient care, and
• effective care.
• (NOTA BENE collaboration is not required for all
  clinical activities)

13
Avoiding the Humpty Dumpty Semantic Trap

• When I use a word, Humpty Dumpty said, in a
  rather scornful tone, it means just what I
  choose it to mean neither more nor less.
• (Lewis Carroll, Through the Looking Glass,
  Chapter VI)

14
Key Concepts of eITBW

• Working as part of an IP team
• Does the team have clear objectives?
• Do team members need to work together frequently
  to meet their objectives?
• Do team members have different roles?
• Is the team recognized by the organization as a
  team?
• If the answer is yes to all, this is a
  well-structured team.
• If no to one or all, considered a pseudo-team.
• eITBW measured as the proportion of staff
  working in well-structured teams.
• (after Dawson, J.F., West, M.A., M.R.Carter
  (2007). Team-based working and innovation at
  multiple levels. (Unpublished MS))

15
Related Concepts of eITBW

• Individual autonomy on the team
• Individual innovation in the team
• Extent of the teams community

16
BUT- Its never this obvious!

• From an examination booklet!

17
eITBW What to Conclude

• eITBW can have benefits for
• individual,
• team level, and
• organizational level innovation.
• HOWEVER
• eITBW needs to be supported by individual job
  autonomy and a positive sense of community in
  order for these benefits to be maximized.

18
CRNBC Continuing Competency Requirements

• Translate the words into actions
• Communicates, collaborates and consults with
  other members of the health care team about the
  clients care.
• A Short Guide to Meeting Continuing Competency
  Requirements for Registered Nurses
• (CRNBC, page 5)

19
References

• Nurses' and resident physicians' perceptions of
  the process of collaboration in an MICU.
• J. G. Baggs M. H. Schmitt
• Research in Nursing Health (1997), 20, 1,
  71-80.
• Implementation Strategies Collaboration in
  Primary Care-Family Doctors and Nurse
  Practitioners.?D Way, L Jones N Busing
• Toronto Ontario College of Family Physicians
  (2000)
• Team-based working and innovation at multiple
  levels.
• Dawson, J.F., West, M.A., M.R.Carter (2007).
  (Unpublished MS))

20
References

• Aliota, S. (2003). Coordination of care. Case
  Manager, 14(2), 49-52. Bender, N. (2004). An
  Analysis of the Processes and Outcomes of
  Coordination of Care A Home Care Agency
  Initiated Case Management Intervention in a
  Medicare Population. (Unpublished dissertation).
  University of Rochester, Rochester, NY.
• Baggs, J., Schmitt, M.H.  (1997). Nurses' and
  resident physicians' perceptions of the process
  of collaboration in the MICU.  Research in
  Nursing and Health, 20, 71-80.
• Baggs, J.G., Schmitt, M.H.  (1988).
  Collaboration between nurses and physicians.
  Image Journal of Nursing Scholarship, 20,
  145-149.

21
(No Transcript)