Collaboration in healthcare

1. Collaboration
Jerome Richard, RN, BSN
PMHNP Student
Northwestern State University
Spring 2024

2. Collaboration Defined
• What it is:
• An interactive process where nurses, patients, providers, and other healthcare members form
a team to solve healthcare problems
• Involves sharing, teamwork, and respect, which develops over time.
• Includes communication and interprofessional partnering, leading to positive outcomes
• Involves sharing emotional satisfactions and frustrations while developing way to support
each other.
• Requires managing conflict and having important conversations amongst team members
Tracy et al. (2022)

3. Collaboration Defined
• What it is NOT
• Parallel Communication
• Parallel functioning
• One-sided Compromise
• Faux Collaboration

4. Hamric’s Core Competencies of APN Framework
• Hamric’s framework includes:
• Primary Criteria
• Graduate education
• Certification
• Practice Focused on patient/family
• Central Competency
• Direct Clinical Practice
• Core Competencies
• Guidance and coaching
• Consultation
• Evidence-based practice
• Leadership
• Collaboration
• Ethical decision-making skills
• Critical Environmental Elements affecting Advanced Practice Nursing
• Regulatory and credentialing requirements
• Business aspects
• Health policy
• Payment mechanisms
• Outcome evaluation and performance improvement
• Marketing and contracting
• Organizational structure and culture

5. Characteristic Traits of “Collaboration”
• Clinical competence and accountability
• Trust and respect develop when clinicians rely on each other's competency, and shared leadership allows for learning. Accountability
for practice also enhances collaboration.
• Common purpose
• Collaboration is founded on a shared purpose, which may evolve over time, ranging from specific patient care goals to broader
quality improvement agendas. Partners in collaboration are both independent and reliant on each other, pooling individual skills to
create comprehensive care plans, with a shared vision and commitment enhancing the potential for successful interprofessional
collaboration.
• Interpersonal competence and effective communication
• Interpersonal competence emphasizes openness and clarity in effective communication in a variety of contexts, including typical
interactions, disagreements, and stressful circumstances. Open information sharing and acknowledgement of current problems are
components of transparency, which is essential for cooperation and the development of trust. It also encourages
accountability. Assertiveness is an important component of interpersonal competency that APRNs must possess in order to handle
conflicts, take calculated risks, own up to their mistakes, and face issues head-on.

6. Characteristic Traits of “Collaboration” Continued
• Trust and Mutual Respect
• Successful collaboration hinges on mutual trust, respect, and integrity among partners, which are nurtured through clinical
competence and supported by environments conducive to learning for novice APRNs.
• Recognition and valuing of diverse, complementary knowledge and skills
• High-quality patient care hinges on recognizing and valuing the diverse knowledge each team member brings, fostering mutual trust
and respect to develop effective collaboration, particularly in acknowledging and appreciating the overlapping skills and expertise of
various disciplines, which is essential for optimal healthcare delivery.
• Humor
• Humor in the collaborative process is suggested to have positive impacts on patient care and nurses' well-being, potentially reducing
stress and burnout especially in times of personnel shortage, fostering communication and problem-solving, connecting groups,
improving accessibility to patients in APRN practice, and facilitating defusing of conflict situations, yet its contextual nature can
lead to misinterpretation and negative responses.

7. Let’s Look at
Some Examples

8. Working with other Healthcare Professionals
APRN’s play a crucial role in consultation and collaboration with other
physicians and specialists, leading to improved resident care, reduced
hospitalization rates, and a better working environment. However, informal
collaboration can result in lack of funding, inadequate educational preparation,
and unclear role definitions. Existing collaborative models, such as the Evercare
model and the Missouri Quality Initiative, have been developed, but a
comprehensive review and comparison are needed to identify gaps in the
literature.
Rawlinson et al. (2021)

9. A Collaborative Effort
For instance, let's consider a patient with multiple chronic conditions such
as diabetes, hypertension, and heart disease. In this scenario, an APRN
may collaborate with a primary care physician, a cardiologist, a dietitian,
and a pharmacist to develop an integrated care plan tailored to the
patient's specific needs.
The NP may take the lead in conducting comprehensive health
assessments, coordinating care transitions, and providing patient
education on medication management, lifestyle modifications, and self-
care strategies. Meanwhile, the physician may oversee medical
management and treatment adjustments, while the cardiologist may
provide specialized expertise in managing the patient's heart disease.

10. The Outcome of Collaboration
A study by Vaseghi et al. (2022) of a systematic review of 7267 articles
concerning interprofessional competencies in healthcare demonstrated that since
interprofessional collaboration can assist in addressing current issues and
accomplish healthcare objectives, establishing interprofessional skills for effective
collaboration is vital for healthcare systems. Determining interprofessional skills is
still in its early stages and focuses solely on interpersonal relationships.
Effective interprofessional collaboration and the institutionalization of
interprofessional competencies require both in-service training and the
incorporation of interprofessional competencies into various professional
programs. In order to facilitate interprofessional collaboration among healthcare
providers, educational programs and training models should be created.
Vaseghi et al. (2022)

11. A Second Look
Another study assessed how healthcare professionals from various
disciplines felt about interprofessional collaboration in terms of patient
care and the healthcare team, as well as how they behaved and
experienced it. The study found was that these professionals thought that
effective communication within the team, an awareness of role limitations,
and mutual respect and trust among team members from different
disciplines were essential to the success of interprofessional
collaboration. A collaborative atmosphere that fosters teamwork and
improves patient-centered care is created through effective collaboration.
The study's results show that healthcare professionals strongly endorse
interprofessional collaboration, which translates to better outcomes for
patients.
Ansa et al. (2020)

12. References
◦ Ansa, B. E., Zechariah, S., Gates, A. M., Johnson, S. W., Heboyan, V., & De Leo, G. (2020). Attitudes
and Behavior towards Interprofessional Collaboration among Healthcare Professionals in a Large
Academic Medical Center. Healthcare (Basel, Switzerland), 8(3), 323.
https://doi.org/10.3390/healthcare8030323
◦ Tracy, M. F., Anp, E. T. O. P. R., & Phillips, S. J. (2022). Hamric and Hanson’s advanced practice
nursing: An Integrative Approach.
◦ Rawlinson, C., Carron, T., Cohidon, C., Arditi, C., Hong, Q. N., Pluye, P., Peytremann-Bridevaux, I., &
Gilles, I. (2021). An Overview of Reviews on Interprofessional Collaboration in Primary Care:
Barriers and Facilitators. International journal of integrated care, 21(2), 32.
https://doi.org/10.5334/ijic.5589
◦ Vaseghi, F., Yarmohammadian, M. H., & Raeisi, A. (2022). Interprofessional Collaboration
Competencies in the Health System: A Systematic Review. Iranian journal of nursing and
midwifery research, 27(6), 496–504. https://doi.org/10.4103/ijnmr.ijnmr_476_21