Date post: | 07-May-2015 |
Category: |
Documents |
Upload: | bachchu-kailash-kaini |
View: | 623 times |
Download: | 2 times |
Interprofessional Team
Collaboration (IPTC) in Hospitals
Bachchu Kailash Kaini
PhD Student (Part Time)
Business School
University of Greenwich
Context
• Health care is multifaceted and complex activity
• Changes in demographic structure and disease pattern
• Increased cost of care
• Concept of specialties and sub-specialties emerging
• Expansion of roles of health care professionals (HCPs)
• Well informed patients and more choices
• Changing health care environment requires new ways of working & collaborative practice
Hospital Environment
Medical Nursing
AHPs
Organisational Policies
Organisational Structures
Resources Available
Boards & Functional
Teams
Voluntary Sectors
Professional Groups
Legislations Community
Government
Regulatory Bodies
Other Service Providers
Commissioners
Service Users
Admin & Mgmt
• Occupation refers to someone’s job
• Occupation can become profession when:
– It gains full status and identity
– It goes through various stages of training, education
and qualifications
– It is recognition by a regulatory body or authority
– It gains high degree of autonomy
• Profession is special type of occupation
Occupation and Profession
• A group of people who have undertaken a given
programme of education and/or training, and as
a result of this are permitted to become part of
much larger and somewhat exclusive group (Hammick et al, 2009).
• Characteristics of profession
– Intellectual activities
– Based on science and learning
– Used for practical purposes
– Can be taught
– Organised internally
– Altruistic (Flexer, 1915; quoted in Ducanis and Golin, 1979)
Profession
• IPC is a collaborative working (Leathard, 2003;
HFO, 2007; Hawley, 2007) in which HCPs share
common purpose of developing mutually
negotiated goals (Payne, 2000; Pietroni, 1992)
which are achieved through agreeing a care
plan, the management of it and procedures
(Colyer, 2012).
• IPC to happen in practice, HCPs:
– Pool their skill, knowledge and expertise
– Shared professional view points
– Make joint decision
– Learn from each other
Interprofessional Care
IPC, Teamwork and Collaboration
Collaboration
Teamwork
Differing forms of interprofessional work (Reeves et al, 2010; p.44)
Different but Shared Approaches
Medical
AHPs Nursing
Knowledge
Professional Contribution
Skills
Expertise
Personal Attributes
Care Philosophies
Problem-solving Styles
Professional Culture
Interprofessional Team Collaboration
IP Team Formation •Team composition •Hierarchies •Roles and responsibilities •Protocols and strategies •Resources
IP Team Development •Leadership •Support for team •Training & development •Regular review •Reward
IPTC •Collaboration •Co-ordination •Co-operation •Commitment •Communication •Cohesion •Openness & trust
Desired Outcome of IPTC
For Service Users Satisfied Service Users
Healthy Life Improved Health Status
For HCPs Satisfied Workforce Professional Growth Employee Retention
Shared Goal of Interprofessional Team Collaboration (IPTC) (Effective Delivery of Health Care)
Impact of IPTC
Team Performance Wider range of expertise & shared decision making
Burden and challenges shared Tasks divided between members
Greater efficiency in the use of resources
Staff Satisfaction
Satisfied work force Professional growth Employee retention
Support and motivation from each other
Quality of Care
Consistent and continuity of care Timely and appropriate referral Reduced harms and incidents Reduced ambiguous message
Satisfied service users
Better Interaction, Communication and Co-operation
Communicate closely and clearly Honest and open interaction
Authenticity of communication Procedural documents
Delivery of Health Care Holistic approach
Improve standards of service delivery
Impact of IPTC
Team Performance Wider range of expertise & shared decision making
Burden and challenges shared Tasks divided between members
Greater efficiency in the use of resources
Staff Satisfaction
Satisfied work force Professional growth Employee retention
Quality of Care
Consistent and continuity of care Timely and appropriate referral Reduced harms and incidents Reduced ambiguous message
Satisfied service users
Better Interaction, Communication and Co-operation
Communicate closely and clearly Honest and open interaction
Authenticity of communication Procedural documents
Delivery of Health Care Holistic approach
Improve standards of service delivery
Theoretical Constructs of IPTC
Division of Labour
(Specialisation and Increased Productivity,
Social & Technical Div. of Labour)
Role Theory
(Roles & Responsibilities,
Leadership, Decision Making,
Training & Education)
Human Factors
(Communication, Interaction, Professional
culture, Ethics, Personality)
Theory of Profession
(Professional Power, Identity,
Autonomy, Boundaries etc.)
• Realising the value of IPTC
• Interprofessional education & training
• Different professional cultures
• Professional identity, power and structures
• Roles and responsibilities
• Human factors
Issues and Challenges
Focus of the Study
Medical
Nursing AHPs Collaboration
Teamwork
Interprofessional Care
HCPs Satisfied Workforce Professional Growth Employee Retention
Impact to HCPs Interprofessional Team
Collaboration Input for Health Care
Research Questions
• How do various health care professionals
interact and collaborate in hospitals?
• What is the impact of IPTC on HCPs’ job
satisfaction, employee retention and
professional growth?
• To identify and analyse various factors that
support and hinder IPTC
• To examine the understanding of and
perceptions of IPTC among health care
professionals
• To examine the impact of IPTC on job
satisfaction, employee retention and
professional growth
• To make recommendations for improving
interprofessional team collaborative practices
Research Objectives
First Exploration – Pilot Study
• Team of HCPs – medical, nursing and AHPs
• Qualitative and quantitative study, semi-structure interview schedule & questionnaire used
• Observation of the clinical practice
• Findings of the pilot study – IPTC is part of their professional life
– Roles and responsibilities of HCP well defined
– Variety of personal and interprofessional skills and competencies are required to deliver effective interprofessional care
– Professional autonomy is accepted and respected
– IPTC is desirable as it brings many benefits to service users and HC professionals
– IPTC boost employee morale and increase job satisfaction
– Few opportunities for interprofessional learning and training are available at the organisational level
Research Methodology
• Mixed methods - qualitative and quantitative methods
• Purposive sampling
• Three hospitals in Nepal – public, private and voluntary hospitals
• Different teams with a different composition and types of professionals
• Survey - questionnaire
• Interviews with HCPs - semi structured schedule
• Documents and secondary data analysis
• Cross tabulation, frequency, descriptive analysis and correlation
• Phenomenological approach
References
• Bope, E.T., & Jost, T.S. (1994). Interprofessional collaboration: factors that affect form, function and structure, in R. Michael Casto and Maria C. Julia, Interprofessional care and collaborative practice. California: Brooks/Cole Publishing. pp 61 – 69.
• Canadian Health Services Research Foundation (2006). Teamwork in Health Care: Promoting effective teamwork in health care in Canada. CHSRF. http://www.chsrf.ca/Migrated/PDF/ResearchReports/CommissionedResearch/teamwork-synthesis-report_e.pdf. Accessed on 4 September 2012.
• Colyer, H. (2012). Responsibilities and accountabilities in interprofessional working. In G. Koubel and H. Bungay (eds.), Rights, risks and responsibilities: Interprofessional working in health and social care. Basingstoke: Palgrave Macmillan.
• Duncanis, A.J. and Golin, A.K. (1979). The Interdisciplinary Health Care Team: A Handbook. Maryland: Aspen Systems Corporation.
• Hammick, M., Freeth D., Copperman, J and Goodsman. D. (2009). Being Interprofessional. Cambridge: Polity.
• Hawley, G. (ed.) (2007). Ethics in clinical practices: an interprofessional approach. Essex: Pearson Education.
• Health Force Ontario (HFO), (2007). Interprofessional Care: A Blueprint for Action in Ontario, Interprofessional Care Project. Ontario: Health Force Ontario.
• Leathard, A. (2003). Interprofessional Collaboration: From Policy to Practice in Health and Social Care. East Sussex: Routledge.
• Payne, M. (2000). Teamwork in Multiprofessional Care. New York: Palgrave.
• Pietroni, P. (1992). ‘Towards reflective practice – the language of health and social care’, Journal of Interprofessional Care. 1: 7 – 16.
• Reves, S., Lewin, S., Espin, S. and Zwarenstein, M. (2010). Interprofessional teamwork for health and social care. West Sussex: Wiley-Blackwell.