Interprofessional team collaboration in hospitals by b k kaini final jan 2013

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Interprofessional team collaboration in hospitals by b k kaini final jan 2013

  1. 1. Interprofessional TeamCollaboration (IPTC) in Hospitals Bachchu Kailash Kaini PhD Student (Part Time) Business School University of Greenwich
  2. 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. 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. 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. 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. 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. 7. IPC, Teamwork and Collaboration Collaboration Teamwork Differing forms of interprofessional work (Reeves et al, 2010; p.44)
  8. 8. Different but Shared Approaches Knowledge Professional Skills Contribution Medical Professional Expertise Culture Nursing AHPs Care Personal Philosophies Attributes Problem-solving Styles
  9. 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. 10. Impact of IPTC Team Performance Staff SatisfactionWider 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 usersBetter 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. 11. Impact of IPTC Team Performance Staff SatisfactionWider 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 usersBetter 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. 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. 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. 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 RetentionNursing AHPs Collaboration
  15. 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. 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. 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. 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. 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.

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