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Journal of Nursing

Importance of Interprofessional Collaboration, Communication and Teambuilding,

Kaitlin Graye, BSN, RN [email protected]


Healthcare has undergone a massive transformation in the past decade. Medicine is no longer physician-centric or disease-centered. Healthcare has shifted toward a patient focus and places an emphasis on quality, satisfaction, value, and utilizing a holistic approach to promote overall wellness. The purpose of this paper is to discuss the significance of collective competence and interprofessional collaboration within healthcare systems.

Collective Competence


Collaboration is an evolving process that calls for active participation from contributing individuals who engage in shared problem-solving and decision-making to achieve a common goal (Hamric, Hanson, Tracy & O’Grady, 2014). Collaboration is especially significant in the healthcare environment to meet the increasingly complex demands of patients with multiple co-morbidities. Collaboration pools resources to facilitate improvements in cost, availability, and quality of care (Tsakitzidis et al, 2016).

The concept of collaborative competence is characterized by collection of diverse knowledge from a multitude of collaborating contributors (Gilbert, 2013). The differing expertise offered by specialty providers complements the care of the primary care provider. Collaborative competence involves various professionals and non-professionals sharing skills and experience from their scope of practice to enhance the delivery of a comprehensive care plan that incorporates input from patients and families for shared decision-making (Interprofessional Education Collaborative Expert Panel, 2011). Interprofessional collaborative practice requires learning to skillfully consult and communicate with colleagues. Engaging in interprofessional education has been proven to enrich collaborative practice through improved clinical outcomes, adherence to practice guidelines, and higher patient satisfaction ratings (Reeves et al., 2013).

Collaboration


The essential characteristics of collaboration include a shared common purpose, humor, effective communication, interpersonal and clinical competence, and accountability (Hamric, Hanson, Tracy & O’Grady, 2014). Mutual respect, trust, and the appreciation and recognition of diverse, complementary knowledge are also considered essential elements of collaboration; however, these characteristics develop over time (Hamric, Hanson, Tracy & O’Grady, 2014). The author scored one in both the interprofessional interaction domain and the values domain after taking the Interprofessional Education Collaborative’s Competency Self-Assessment Tool.

The author has committed to improving two interprofessional collaborative practice goals, both of which are community and population oriented. The motivation behind the selection of the two above mentioned goals results from the author’s self-reflection and identification of areas where improvement is warranted. The first goal, selected from the interprofessional communication competency domain, is to strengthen communication skills information with healthcare professionals, patients, and families in an easily understood format (Interprofessional Education Collaborative Expert Panel, 2011). This concept is critical for avoiding misunderstandings that can result in reduced patient satisfaction, omissions in treatment plans, and unfavorable clinical outcomes (Howard, Jacobson, & Kripalani, 2013). The author has treated multiple patients for adverse reactions related to misunderstood patient care instructions.

From the teams and teamwork domain, the second goal is to utilize existing evidence to enhance the team-based approach (Interprofessional Education Collaborative Expert Panel, 2011). Evidence-based practice has provided a plethora of research on strategies to improve teamwork. Effective teamwork enhances patient safety and care efficiency (Weller, Boyd, & Cumin, 2014). Using evidenced-based teamwork methods can assist individuals with constructively expressing different viewpoints to optimize communication and collaboration. Incorporating the personal leadership strengths of being a relator and a communicator has assisted the author with engaging positive and productive teamwork.

Collaboration Barriers


Challenging factors that inhibit effective collaboration include a lack of role clarification, limited availability, time constraints, misunderstandings in scope of practice or responsibilities, miscommunication, power differentials, distrust, and conflicting perspectives (Lancaster, Kolakowsky-Hayner, Kovacich, & Greer-Williams, 2015). The author has personally encountered a number of the previously mentioned barriers to collaboration.

A specific hinderance to collaboration that is commonly experienced by the author is difficulties in transferring patients to the behavioral facility from the emergency department after they have been medically cleared. Psychiatric nurses often question the appropriateness of medical clearance for fear of accepting a patient with medical complications. Several instances have occurred where patients have been held for lengthy amounts of time due to the psychiatric nurse’s reluctance to accept patients. The situation unfortunately has escalated in the past resulting in the emergency department nurse consulting with supervisors to intervene.

Reflecting on the situation, interference from supervisory staff was unnecessary and harmful to interprofessional collaboration. If the situation were to reoccur, the emergency department nurse should use understandable terminology to provide a thorough explanation regarding the patient’s medical clearance and stability for a safe transfer to the psychiatric facility. If patient transfer delays persistently occur, the emergency department nurse should use effective communication to reiterate the shared purpose of providing effective and efficient patient-centered care.

Personal Experience


The emergency department encounters a diverse patient population with a multitude of clinical, financial, social, emotional, and supportive needs. An example of an instance requiring interprofessional collaboration that comes to mind is an event involving a two-year-old patient who experienced acute respiratory distress. The facility where the author is employed does not regularly treat pediatric patients. Prior to the patient’s arrival, the staff expressed anxiety and stress related to their uncertainties and inexperience with the pediatric population. Additional resources were called in for the situation, including a respiratory therapist, a former pediatric nurse practitioner, and a flight nurse. Recognizing limitations in scope of practice and knowledge of an appropriate resources led to a safe transfer following the infant’s stabilization.

Looking back on the situation, further education in pediatric emergency services is needed. Providing time to reflect on the stressful event as a team is also important. Factors promoting effective team work in this situation included an established rapport, mutual respect, transparent communication, and a shared common goal of achieving quality continuity of care.

Conclusion


Healthcare delivery is a continuously changing due to new discoveries in evidence-based research through the collaborative efforts of researchers, healthcare providers, and non-clinical contributors. A common purpose unites providers from various disciplines to achieve the development patient-centered treatment plans that promote a holistic approach to the patient’s overall well-being. Successful interdisciplinary collaboration requires the knowledge of how to facilitate effective teamwork within the clinical setting through interpersonal communication and mutual respect for diverse ethics, values, and role responsibilities.

References


Gilbert, D. (2013). Collaborative competence: Redefining management education through social construction. Journal of Psychological Issues in Organizational Culture, 4(3), 26-43. doi:10.1002/jpoc.21116

Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E.T. (2014). Advanced practice nursing: An integrative approach (5th edition). St. Louis, MO: Saunders Elsevier

Howard, T., Jacobson, K., & Kriplani, S. (2013). Doctor talk: Physicians’ use of clear verbal communication. Journal of Health Communication, 18(8), 991-1011. doi:10.1080/10810730.2012.757398

Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, D.C.: Interprofessional Education Collaborative.

Lancaster, G., Kolakowsky-Hayner, S., Kovacich, J., Greer-Williams, N. (2015). Interdisciplinary communication and collaboration among physicians, nurses, and unlicensed assistive personnel. Journal of Nursing Scholarship, 47(3), 275-284. doi:10.1111/jnu.12130

Reeves, S., Perrier, L., Goldman, J., Freeth, D., & Zwarenstein, M. (2013). Interprofessional education: Effects on professional practice and healthcare outcomes (update). Cochrane Database of Systematic Reviews, 6. doi:10.1002/14651858.CD002213.pub3

Tsakitzidis, G., Timmermans, O., Callewaert, N., Verhoeven, V., Lopez-Hartmann, M., Truijen, S., Meulemans, H., & Van Royen, P. (2016). Outcome indicators on interprofessional collaboration interventions for elderly. International Journal for Integrated Care, 16(2), 5. doi:10.5334/ijic.2017

Weller, J., Boyd, M., & Cumin, D. (2014). Teams, tribes and patient safety: Overcoming barriers to effective teamwork in healthcare. Postgraduate Medical Journal, 90(1061), 149-154. doi:10.1136/postgradmedj-2012-131168

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