The document discusses interprofessional team collaboration (IPTC) in hospitals. It covers several topics including the context of changing healthcare needs, definitions of occupation and profession, models of interprofessional care and collaboration, theoretical constructs of IPTC, issues and challenges of IPTC, and the focus and objectives of the author's study on the impact of IPTC on healthcare professionals' job satisfaction, retention, and professional growth. The study will use mixed qualitative and quantitative methods including surveys, interviews, and document analysis with healthcare professionals in several hospitals in Nepal.
2. 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
3. Hospital Environment
Professional
Groups
Organisational
Policies
Voluntary Regulatory
Sectors Bodies
Medical Nursing
Boards & Service Resources
Community Functional Legislations
Teams Users Available
AHPs Admin & Mgmt
Commissioners Government
Organisational
Structures
Other Service
Providers
4. Occupation and Profession
• 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
5. 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)
6. Interprofessional Care
• 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
7. IPC, Teamwork and Collaboration
Collaboration
Teamwork
Differing forms of interprofessional work (Reeves et al, 2010; p.44)
8. Different but Shared Approaches
Knowledge
Professional
Skills
Contribution
Medical
Professional
Expertise
Culture
Nursing AHPs
Care Personal
Philosophies Attributes
Problem-solving
Styles
9. Interprofessional Team Collaboration
Shared Goal of Interprofessional Team Collaboration (IPTC)
(Effective Delivery of Health Care)
IPTC
IP Team Formation IP Team Development •Collaboration
•Team composition •Leadership •Co-ordination
•Hierarchies •Support for team •Co-operation
•Roles and responsibilities •Training & development •Commitment
•Protocols and strategies •Regular review •Communication
•Resources •Reward •Cohesion
•Openness & trust
Desired Outcome of IPTC
For Service Users For HCPs
Satisfied Service Users Satisfied Workforce
Healthy Life Professional Growth
Improved Health Status Employee Retention
10. Impact of IPTC
Team Performance Staff Satisfaction
Wider range of expertise & shared decision making Satisfied work force
Burden and challenges shared Professional growth
Tasks divided between members Employee retention
Greater efficiency in the use of resources 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- Delivery of Health Care
operation Holistic approach
Communicate closely and clearly Improve standards of service delivery
Honest and open interaction
Authenticity of communication
Procedural documents
11. Impact of IPTC
Team Performance
Staff Satisfaction
Wider range of expertise & shared decision making
Satisfied work force
Burden and challenges shared
Professional growth
Tasks divided between members
Employee retention
Greater efficiency in the use of resources
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- Delivery of Health Care
operation Holistic approach
Communicate closely and clearly Improve standards of service delivery
Honest and open interaction
Authenticity of communication
Procedural documents
12. Theoretical Constructs of IPTC
Division of
Labour
(Specialisation
and Increased
Productivity,
Social & Technical
Div. of Labour)
Human Factors
(Communication,
Interaction,
Professional
culture, Ethics,
Personality)
Role Theory Theory of
(Roles & Profession
Responsibilities,
Leadership, (Professional
Power, Identity,
Decision Making,
Autonomy,
Training &
Education) Boundaries etc.)
13. Issues and Challenges
• Realising the value of IPTC
• Interprofessional education & training
• Different professional cultures
• Professional identity, power and structures
• Roles and responsibilities
• Human factors
14. Focus of the Study
Interprofessional Team
Input for Health Care Impact to HCPs
Collaboration
Medical
Interprofessional Care
HCPs
Satisfied Workforce
Professional Growth
Teamwork Employee Retention
Nursing AHPs Collaboration
15. 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?
16. Research Objectives
• 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
17. 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
18. 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
19. 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.