Collaborative PracticeJacob Rohloff & Cherylyn Antymniuk

What is Collaborative Practice?• The “process of developing and maintaining effective

working relationships with learners, practitioners, patients/clients/families and communities to enable optimal health outcomes” (Canadian Interprofessional Health Collaborative, 2010)

• Enhancing collaboration among health care providers, individuals and their families is one of the approaches to improve quality of healthcare and sustainability of our healthcare system in the future. (Alberta Health, 2012)

What is NOT Collaborative Practice?

Source: Implementing Interprofessional Care in Ontario (2010)

At St. Mary’s, Collaborative Practice Means:

• Safe, quality care

• Patient and family centered care

• Joint decision making

• Respecting, valuing different roles

• Trusting and open communication

• Sharing accountability in a just and equitable way

• Preserving and building dignity and respect

Who Should be involved in Collaborative Practice

• Everyone who is in a position to provide care to patients/clients, whether directly or indirectly

• Relationships between Family Physicians and Nurse Practitioners has been extremely successful in areas in Eastern Canada

• All professionals and staff can play a role in shifting the tendency of dealing with patients only when they are ill to focusing on wellness and prevention.

Importance of Collaborative Practice

• Populations are aging with increasingly complicated health care needs

• The world is increasingly in desperate need of quality health care providers at a time where the workforce is diminishing and productivity is decreasing (KPMG, 2012)

• Alberta’s population has grown by one million people in the last 12 years alone. On top of that, many of our health providers are retiring or close to retiring.

• If AHS does not respond to this situation, by 2017 we’d need to hire about 35,000 more clinical staff simply to make up for retirements, turnover and growth (Alberta Health Services Workforce Transformation, 2016).

Benefits of Collaborative Practice

• Patients receive better care and better health outcomes within a collaborative practice model

• Job satisfaction would increase along with productivity

• Create a system that is sustainable and more cost-effective (Alberta Health Services Workforce Transformation, 2016)

Studies on the Benefits of Collaborative Practice

• Collaborative medication reviews between physicians and pharmacists decreased hospitalizations for heart failure by 45% and delayed hospitalizations for other patients (Roughead et. al, 2009)

• Collaborative care for patients with depression and coronary heart disease and/or poorly controlled diabetes showed a greater improvement in glycated hemoglobin levels, decreased LDL levels, an average decrease of 5.1mmHg systolic BP and better Symptom Checklist 20 scores. (Katon et. al, 2010)

Studies on the Benefits of Collaborative Practice

Katon e. al’s findings are reinforced by two separate studies that studied collaborative practices and interprofessional education that decreased HbA1c levels (Ching, Forte, Aitchison et. Al, 2016) and LDL levels (Shaffer & Wexler, 1995) more greatly compared to traditional care.

Implementing Collaborative Practice Pilot

Collaborative Practice has six competency domains we need to solidify before collaboration can be effective:

1. Role clarification

2. Interprofessional Communication

3. Patient/Client/Family/Community centered care

4. Collaborative Leadership

5. Team Functioning

6. Interprofessional Conflict Resolution

Implementing Collaborative Practice Pilot

• Using Collaborative Challenge Cards

• Posters that are in clear view of all hospital staff/professionals AND the public.

• Using floor decals that have “Did you know” information pieces on them about collaborative practice

• Humans of Covenant Health

Implementing Collaborative Practice Pilot

• Path to Home

• Accreditation

• Hospitalist Inpatient Care Team

• Employee Engagement

• CompassionNet tools

Assessment of Collaborative Practices

• Use the Queen’s University Collaborative Practice Assessment Tool

• Questionnaire that focuses on:• Mission, Purpose and Goals• Relationships• Team Leadership• General Role Responsibilities• Communication and information exchange• Community Linkages and Coordination of Care• Decision Making and Conflict Management• Patient involvement

Risk Management• Team members must have clear roles, responsibilities, and

accountabilities, and these should be supported by a policy and procedural framework. This will not only reduce liability risk but also the likelihood of adverse medical events caused by confusion or ambiguity (Canadian Medical Protective Association)

• The point of interdisciplinary collaboration is to ensure that patients have access to appropriate care from the most appropriate professional. Those who organize and oversee interdisciplinary care teams must take care to ensure that health professionals are not tasked with delivering care that is outside their competence or scope of practice (Conference Board of Canada, 2007)