Health Care Collaboration

last authored Sept 2009, David LaPierre

 

 

"We're your team, but you (the patient) lead us"

Health care professionals have roles to play at every level of health care. Effective interprofessional education is fundamental to training new generations of health care providers and changing the way that existing providers think.

 

 

Members of the Interprofessional Health Care Team

 

 

 

 

What is Interprofessional Health Care?

 

Interprofessional health care is "the continuous interaction of two or more professionals or disciplines, organized into a common effort, to solve or explore common issues with the best possible participation of the patient." - Dr. Carol P Herbert, Dean of Medicine, University of Western Ontario.

 

It is designed to promote the active participation of each discipline. enhancing patient- and family-centred goals and values, increases communication, optimizes team-based clinical decision making, and increases respect.

 

No one person or profession has all the answers. To be successful, health care providers must be able to translate and share what they know.

 

The challenge of managing chronic illnesses is best met through multiple levels, working together.

 

Interprofessional care occurs when members of the team share their views and understanding of a health concern, allowing them to work together to deliver care. Transprofessional care occurs when members share decisions, roles, and professional responsibilities.

 

Well-functioning teams have the patient at the centre, communicate easily and frequently, have shared objectives and clear roles and responsibilities, and make decisions together.

The Principles and Framework for Interdisciplinary Care are:

 

 

 

Evidence for Interprofessional Health Care

There is "significant weakness" in the literature, as there are no real RCTs evaluating them.

 

 

 

Moving Towards Interprofessional Health Care

 

we need to recognize that power exists, and then address.

 

Policy is important in determining how resources are allocated.

 

get pharmacy and medicine to do COPS together during pharmacology.

COPS cases need to be very much rewritten to have interprofessional care.

 

Here is a presentation I made to the Nova Scotia College of Physicians in Dec 2007.

 

Need to also get CME involved: Centre for Faculty Development

 

There is a real history of power differential and twisted social relations. This needs to be discussed - brought into the open.

Hierachies continue to persist and are fundamental barriers to effective interprofessional practice.

 

Turf wars are fundamental barriers to change. Address these. Having people sit in different camps at the same time creates overlap and breaks down silos.

 

Patient interviews need to be streamlined such that they can be shared.

 

Knowledge translation among professionals is a necessity.

 

Scopes and Roles

We need to name tasks

Regulation and legislation is very important

 

 

Information

The patient interview and data synthesis is a critical central piece; we don't all need to interview patients.

Multiple interviews, chart reviews, and data entry is a horrific means of operating; it is a terrible resource allocation and slows things down as well.

 

 

Shifts, temps, and scheduling make it hard to build a relationship with so many people.

 

 

 

 

 

 

Models of Interprofessional Care

 

The HIV clinic at the QE2

 

 

 

 

Resources and References

 

Canadian Health Services Research Foundation

CIHC: Canadian Interprofessional Health Collaborative

InterEd: International Association for Interprofessional Education and Collaborative Practice