On The Quick
Why is Interprofessional Collaboration Such a Challenge?
Four Practical Steps
Interprofessional collaboration is a popular topic in healthcare these days, but it often remains more a talking point than a reality. Earlier this year, UCSF School of Nursing’s Science of Caring blog looked at why — and offered some tips for how to help to change that.
A Road Full of Roadblocks
A Science of Caring article by writer Diana Austin, published online in January, offers an overview of the difficult 40-year history of interprofessional collaboration and its necessary adjunct, interprofessional education (IPE).
Although there’s an emerging consensus that strong interprofessional teams are good for patients, it’s only been since the passage of the Affordable Care Act — with its new rules on “value-based” reimbursement — that financial trends have begun to promote rather than stymie the development of collaborative models of care.
As a result, real collaboration of the kind central to the patient-centered medical home model is still the exception rather than the rule. A host of practical problems remain largely unresolved, ranging from regulatory barriers to the jealous territoriality that often rears its head when physicians are asked to view non-physicians as partners rather than subordinates.
Even where the will exists, just bringing interprofessional learners together to practice teamwork can be like pushing a boulder up a hill. “Academic calendars vary greatly by discipline,” says American Association of Colleges of Nursing President and CEO Deborah Trautman, RN, Ph.D., FAAN, “so scheduling IPE opportunities can be a challenge.”
Polite Is Not Enough
A popular misconception is that individual competence and cordiality are the main ingredients of good teamwork.
The truth is that collaboration techniques must be formally taught — placing unique demands on educators and preceptors. UCSF School of Nursing Associate Clinical Professor Angel Chen, RN, MSN, PNP, co-chair of UCSF’s IPE curriculum development working group, says clinical preceptors aren’t always up to the challenge.
Chen has found that preceptors in one profession are often in the dark about other professions’ functions and goals. A common complaint, she says is, “‘We don’t know what their objectives are. We don’t know what they’re here to learn.’”
In an accompanying editorial, Chen laments that interprofessional collaboration is still not a mandatory component of healthcare training. “An IPE curriculum should be part of the core curriculum for all learners,” she says, “rather than the add-on it remains in many settings.”
Nonetheless, she says there are some practical steps all healthcare professionals can follow:
1. Mind the jargon. Jargon, acronyms and institutional slang are often hard to avoid, but can be a major barrier to interprofessional communication. Non-nursing
professionals may not understand a particular piece of jargon or, worse, may use it in a very different way.
2. Encourage questions. Any group effort involves the potential for confusion and uncertainty, especially when it comes to language. That makes it vitally important, says Chen, “to create an environment where learners can freely ask for clarification without fear of embarrassment.”
3. Move beyond us vs. them. The basic premise of interprofessional teamwork is that each team member plays a distinct but complementary role with unique responsibilities and competencies. Collaboration improves when members are willing to share what they do and what they know — and are open to learning what teammates bring to the table.
4. The role of the preceptor. Chen encourages preceptors to take responsibility for all learners, regardless of discipline. She says preceptors should also continue their own professional development “so they can model interprofessional collaboration among themselves.”
Read Diana Austin’s complete article here. Read Angel Chen's complete commentary here.
This article is from workingnurse.com.