Sandee: Thank you very much. I look forward to spending this time with you all for the next hour on a topic that I really enjoy, appreciate, and am passionate about.
Introduction
Freeth states in his article that:
"Genuine client centered service can only be achieved with interprofessional collaboration and effective teamwork." D.S. Freeth
All of us are on a type of team whether it is in academia, in the clinic, or in the community. Even home health care clinicians have to communicate with other people. Some of what I say will be very applicable for the academic setting while other things will be applicable for clinical settings. I hope you will reach and stretch, and realize that regardless of what entity or context I may be referring to, you will be able to make some generalization that might be helpful for you in your work.
This is the World Health Organization's main definition written in 2010.
Interprofessional Education – “When students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes.” (WHO, 2010)
Many people feel that for interprofessionalism, you have to get a whole lot of different disciplines or professions together. However, the World Health Organization really advocates for at least two learning about, from and with each other. Those three things we really need to think about. We often stop at the learn about. We want an OT to know what a PT or an SLP does when we are training students, but this is an add-on when we are learning from them. How often do our students really interact with other students enough to learn from them, and then with each other? This is not just placing them in a lab together, but really having them interact with each other through that learning experience. This can this happen in the academic side as well as the clinical side. We will talk about interprofessional practice as a differentiated entity from interprofessional education.
Benefits of Interprofessional Education (IPE)
There are many known benefits of IPE. When I first heard about it many years ago, I wondered what the big deal was. I really took it for granted. Of course we have to work with other people, and many of us have been or are on rehab teams where you really are talking to each other and learning from each other. I began to study it, learn more about it, and now I am implementing it. I realize that it is a bit more complex than meets the eye, and in order to do it effectively, you have to have a certain frame of mind.
Benefits include many different things, but this article by Karim & Ross states:
"Students trained using an IPE approach are more likely to become collaborative interprofessional team members who show respect and positive attitude towards each other and work towards improving patient outcomes." Karim & Ross, 2008.
If we expose them in the academic setting, they are more likely to be successful as a team member in a clinical setting. I am sure those of you that are in clinical settings can think of really positive team members who are very respectful. You probably can even name people who are really dysfunctional team members, and the literature does talk about dysfunctional teams. Lencioni has a great book that talks about the dysfunctional teams and what to do with it. We can all think of people who either sabotage good work, try to get all the credit, or really are not as honest or have good integrity. All of those things really thwart interprofessionalism and effective teaming which then impairs patient outcome. This is why it is important to be intentional and really think through what we want to do.
Interprofessional Practice
Interprofessional practice differs from the education.
Interprofessional collaborative practice – “When multiple health workers from different professional backgrounds work together with patients, families, and communities, to deliver the highest quality of care.” (WHO, 2010)
It is with this integration that we deliver the best care. OT is a wonderful profession, and we have such a variety of skills, but if we need help understanding what dietary needs are then we call on a nutritionist or dietician, and so forth. It is of the mindset that everybody participates in interprofessionalism. In 2001, a recommendation was made by the Institute of Medicine Committee on the quality of healthcare in America. They suggested that healthcare professionals working in interprofessional teams can best communicate and address the complex and challenging needs of today. We have far more complex medical situations that we are dealing with now than we dealt with 20 years ago, not just within the health systems, but also in regards to disease processes and comorbidities. The Institute of Medicine is saying that the more you collaborate and work together, the more you can address these complexities.
Also in 2010, the Commission on Education of Health Professionals for the 21st Century published a list of recommendations for instructional and institutional innovations to nurture a new generation of health professionals who would be best equipped to address present and future health challenges. These macro organizations, The World Health Organization, Commission of Education, and The Institute of Medicine are all encouraging the same thing.
Interprofessional Education Collaborative (IPEC)
The Interprofessional Educational Collaborative is something of which you need to be aware. IPEC published a new document in 2016 and that is where we are getting our definitions for the core competencies. They go a step further beyond interprofessional collaborative practice, and they define interprofessional team based care.
Interprofessional Team-based Care – "The intentional creation of a small work group with a collective identity, and who share responsibility for a patient or group of patients."
(IPEC, 2016)
For example I used to be on a feeding team. Everybody on that feeding team, within our medical center, had a focus of enhancing oral feeding in children who had been tube fed. We would bring them in for an intense inpatient program and transition them off of their tubes. There was a collective identity with an intentional way of coming together and having that process. This is a step beyond interprofessional practice where we might just sit in a team meeting. This was a collective identity that had a unified goal. These types of teams tend to be very strong so we should not take them for granted.
Interprofessional Core Competencies- IPEC 2016
The actual document is called Core Competencies for Interprofessional Collaborative Practice, and it was first published in 2011. Several professionals got together and created an executive summary. The first group that worked on this included dentistry, nursing, medicine, osteopathic medicine, pharmacy and public health. AOTA joined the collaborative, and there are now 15 associations that are apart of this. In 2016, they revamped the document, and this is available free online. As occupational therapists, we want to impact global health. If other types of therapists are on the call or will listen to future recordings, this is aligned with other things that are going on in other professions as well. We are not just concerned about our small entity, but rather we need to have a much larger view of population health and see how we can globally impact on society's occupational needs. This still aligns with our current vision in occupational therapy. We are moving into a new vision, but I think we still should have that goal of impacting global occupational, societal needs.
They came up with these four entities for competencies:
- Values/Ethics
- Roles/Responsibilities
- Communication
- Team functioning
