Studies have shown that interprofessional collaboration in healthcare can help to reduce preventable adverse drug reactions, decrease mortality rates, and optimize medication dosages. Much of healthcare is a waiting game. Patients wait for physicians, while physicians wait for other physicians to provide consultations, or for radiology to send back lab results. Communication delays frustrate patients and waste valuable time, giving conditions time to worsen.
Again, interprofessional collaboration bridges the gaps. So does clinical communication technology. Overall a care team collaboration platform delivers the right information to the right people at the right time via secure messaging, voice, or video.
Interprofessional collaboration in healthcare helps to prevent medication errors, improve the patient experience and thus HCAHPS , and deliver better patient outcomes — all of which can reduce healthcare costs.
It also helps hospitals save money by shoring up workflow redundancies and operational inefficiencies. By improving the interprofessional collaboration model between its nurses and physicians, one hospital cut its fall rate in half, decreased average length-of-stay by 0. At another hospital in the study, interprofessional collaboration significantly improved surgical start times and prevented delays that led to wasted hours over the previous four years.
Every health profession has its own subculture, knowledge base, and philosophy. Interprofessional collaboration levels the playing field and acknowledges that everyone plays a vital role on the care team. Interprofessional teamwork refers to the cooperation, coordination, and collaboration expected among members of different professions in delivering patient-centered care collectively.
Getting team members on the same page—or even getting them together in the same place, as Kate hopes to do—can be difficult. Helping team members get past their day-to-day duties, conflicts, and communication problems to attain the goal of working together effectively is a significant leadership challenge. Nowhere are the stakes higher than in health care, where good patient outcomes hinge on team synergy and interdependence.
Most medical errors involve communication breakdowns among team members. Ineffective interprofessional teamwork jeopardizes patient safety, and some experts believe it correlates strongly with higher mortality. An interprofessional-team approach could benefit many situations.
Opportunities for team effectiveness exist in many key areas, including medication reconciliation, discharge planning, length of stay, care transitions, end-of-life issues, error disclosure, and reducing day readmissions.
In any setting, high-performance work teams rarely occur naturally. They must be created and managed. To instill effective teamwork into health care, leaders need to recognize and emphasize its importance.
They play a key role in helping a team develop the ability to collaborate effectively, build relationships and trust, innovate, and achieve results at a consistently high level. Effective teams share the following characteristics:.
Achieving this level of teamwork can be challenging. Communication breakdowns and conflict are inevitable, especially if team members keep changing. When managed effectively, teams provide an opportunity for growth. The most common obstacles to effective teamwork are blaming others, turf protection, mistrust, and inability to confront issues directly.
Without complete trust, members are more likely to withhold their ideas, observations, and questions. People also are more likely to leave a team that has trust issues. Trust begins with communication. Without open and frank communication, things can and do go wrong on teams. Also, never assume healthcare professionals completely understand the unique knowledge, skills, and abilities that members of other disciplines bring to the team.
Each discipline has a unique culture, language, and model through which it approaches patient situations. As a leader, you can assess whether your team is working effectively. With healthcare reform, interprofessional practice has become even more crucial. Maintenance rolesare another type of functional role that helps to establish and preserve good interpersonal relations and cooperation among team members. Maintenance role communication activities include expressing support and encouragement, making comments to reduce tension, and encouraging cooperation.
Dysfunctional roles, however, can limit team progress, and should be minimized to improve group process because they include overly aggressive and blocking behaviors, such as hostile comments or refusing to respond to others' requests, that reduce team effectiveness.
Effective interprofessional health care team leaders balance task and maintenance roles, while minimizing the expression of dysfunctional roles. They try to give all team members an opportunity to communicate, so team interactions are not dominated by one or a few team members. It is important to maintain confidentiality of sensitive and private health issues discussed by the team.
It is also important for team members to be receptive to the ideas of other team members and to treat each other with respect. Failure to follow these expectations can cause serious impediments to accomplishing group goals.
There are many challenges to working on health care teams. One of the major challenges is finding the time for busy team members to meet and share information. Scheduling of meetings needs to be responsive to team members' schedules and it is often best to have a standing weekly or bi-weekly meeting schedule that team members can place on their agendas.
Meeting remotely via conference call, Skype, or video conferencing can often make it easier to accommodate team member schedules and travel demands. There are also time demands in preparing for team meetings, reviewing relevant background materials patient charts, lab results, medication information, research findings, etc.
It is important for each team member to be committed to actively preparing and participating in team activities. Another major challenge to working effectively on health care teams is learning how to interact effectively with other health care professionals and health care consumers. Team members typically come from very different professional backgrounds, and sometimes have other differences based upon education, age, gender, and cultural background, that can make team interactions complicated.
Different health care professionals bring unique perspectives, strategies, and language to examining health care situations. For example, pharmacists, social workers, surgeons, and nurses are likely to perceive health care situations from their own unique professional backgrounds [ 22 , 23 ]. It is important for these different team members to explain their perspectives in language and with examples that other team members can understand.
It is also important for different team member to be receptive to considering the different points of view that are likely to be expressed by different team members. Even among different branches of medicine internal medicine, psychiatry, oncology, cardiology, surgery, etc.
Health care providers and consumers are likely to have very different perspectives on health care issues, complicating team communication [ 8 ]. Consumers are likely to have very personal issues about the implications of different treatment, such as will the treatments be painful, debilitating, or expensive, that will guide their evaluation of different treatment options [ 9 ].
These different consumer and provider perspectives are all important and need to be considered in making the best team decisions. That is why it is so important for the different members of the health care team including consumers to share their ideas and concerns with the group. Consumer participation on health care teams is crucially important to ensure that the wishes and concerns of patients are taken into account when making team decisions [ 9 ].
Sometimes the actual patient may not be able to participate actively in health care teams due to their conditions. In these cases, it is important to include patient advocates, such as family caregivers, in health care teams to make sure the patient's point of view is included in team deliberations. In addition, health care team members often have to consult with support staff this includes clerical, technology, administrative, housekeeping, food services, security, and other staff members to effectively deliberate and make good decisions about complex health issues.
Support staff members often possess specialized operational information about patients and health issues. They can contribute important insights into the history and background about the issues the team is examining, how things are accomplished within health care delivery systems, and what resources and strategies are available to address health issues. Health care teams sometime need to enlist the help of key support staff in implementing team decisions.
For example, if a decision is made by the health care team to deliver specialized health information about medical procedures to patients via television to address patient concerns about these treatments, they probably will have to work with hospital administrative and technology staff members to find out how to accomplish and implement this decision.
Consulting with support staff can increase the effectiveness of teams by framing team decisions in the real operational constraints of the health care system and ensuring that decisions can be translated into actual health care system practices [ 24 ]. There are a number of challenges to effective interprofessional communication among team members [ 25 ]. Differences between team members due to distinct health care professional backgrounds, with different training, unique expertise, lead to different approaches to addressing health issues.
These differences can be understood as unique professional cultures and team communication can be seen as a form of intercultural communication [ 26 , 27 ]. Cultural groups, including professional cultures, socialize members through ongoing communication and reinforcement to see the world through the lens of established cultural norms rules about how things work and how members of the culture should behave [ 26 ].
The professional training that different health care providers have experienced orients them to different key aspects of health care. For example, nurses are educated to focus on delivering care to patients, physicians are educated to focus on diagnosing and treating health problems, and pharmacists are educated to focus on the medications and related therapies needed to address health issues [ 28 ].
These are different, but complementary parts of health care delivery that are all relevant to health care team deliberations. However, sometimes cultural groups do such a good job socializing their members to accept cultural norms, they tend to think their areas of focus are most important and valid, discounting the importance, or even the validity, of other professional approaches.
This tendency for health care providers to over-value their own cultural perspective in comparison to other professional cultural approaches is known as ethnocentrism and can be a major barrier to interprofessional communication in health care teams. It is important for team leaders to develop strategies for overcoming ethnocentrism that stems from intercultural and interprofessional differences. To do this, the leader must establish a team norm for interprofessional respect and receptivity.
The leader can express interest in hearing different professional points of view and encourage the expression of different professional perspectives during group deliberations. Team members can also show appreciation for learning about different relevant approaches to addressing health issues and describe how the unique perspectives helped lead to responsive team decisions.
In essence, the best health care teams demonstrate interprofessional cultural sensitivity and cooperation [ 26 ]. Team members must be ready and able to share relevant information with other team members to accomplish team goals. Relevant health information is one of the most important resources available to health care providers and consumers in making their best health decisions [ 9 ].
Timely, accurate, and appropriate health information enables team members to carefully consider the different aspects of health issues and to make informed health decisions about how to best respond to these issues. Often, pertinent information is not easy to access in complex health care situations. It is the job of health care team members to seek relevant information, share it with team members, and use the shared information to analyze the health issues under deliberation.
Sometimes team members have access to relevant information about a health issue due to their experiences with the issue. For example, nurses may have noticed changes in the ways that a patient has responded to treatments over time from direct bedside observations that other team members might not have access to.
Pharmacists might have access to the history and range of medication prescriptions for a patient that other members of the team might not have access to.
Moreover, the pharmacist might have access to specialized information that could help identify any potentially dangerous interaction effects across these prescribed drugs. So, team members can share relevant information based upon their unique experiences with the case under examination by the team, as well as from their specialized knowledge about health issues.
It is important for team members to provide usable health information that can lead to important team decisions about addressing health issues. It is not enough just to share general information about a medication or therapeutic procedure.
The team members must be able to apply relevant health information to the specific health cases under investigation by the team. How can we use this information to address this issue?
For example, in a case where team members are exploring next steps for therapeutic steps for addressing a serious health problem a patient is being treated for when the current treatments that are being used are not helping the patient, team members can help achieve team goals by suggesting specific evidence-based treatment options that can be implemented to improve the care for this patient.
The treatments recommended can be based upon team members' personal expertise, their knowledge about new treatments that are available, or even about clinical trials research about new treatments that the patient may be eligible for.
Finding and sharing relevant information is a primary goal of the interprofessional health care team! Team members must not only be ready to gather relevant information, but they must learn how to carefully encode their messages so that others can understand their points of view. Encoding is the process of strategically planning the messages we send to achieve our communication goals.
Team members need to present their health information clearly, succinctly, and persuasively to other team members so the team members can determine how to best use the information to address the health issues under examination [ 29 ]. In addition to information provision, it is imperative for team members to be good listeners so they can evaluate the information other team members hare with them. While the results of the IMPACT study are positive, we do not yet know which components are essential to successful teamwork and improved patient outcomes.
While several manuscripts regarding interprofessional team-based care have been published in recent years, none of these studies provided any insights regarding the association of patient health outcomes and team functionality.
Possible essential factors for a high-functioning interprofessional team likely include mutual respect and trust, common goals, shared decision-making, clear roles and responsibilities, and a willingness to collaborate. Interprofessional teams that do not have a strong leader who is passionate about the effectiveness of the collaboration are more likely to loose their cohesiveness and structure over time.
What does all this information mean and how should it impact our practices? I believe that before we can claim that IPC is the best model to provide primary care, we need to determine what makes an interprofessional team functional and accumulate more evidence about which components of the model lead to improved health care outcomes.
Many questions remain. Should we adopt a standardized nomenclature and coding for team-based interventions? How should team functionality be reported? How do we describe the components of the IPC practice model so that readers clearly know what was done? You must be logged in to post a comment.
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