Interprofessional Collaborative Teams

Week 5

Interprofessional Collaborative Teams

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Sept 18, 2024

N532 Advanced Practice Roles, Ethics & Policy

Joey Vazzana

Denise M., 52yo Female

Denise presents to your clinical practice for a scheduled appointment. She suffers from Bipolar I disorder with rapid cycling. She is HIV+ and obese, and has medical diagnoses of cirrhosis, atherosclerosis, and Type 2 DM. Denise lives with her partner, who regularly brings Denise to her appointments, but Denise spends much of her appointment time explaining why her health concerns are insurrmountable and "not her fault." Today, Denise's CD4+ count is 170 and her viral load is 130,000. Who should be a part of Denise's care team?

Meet Denise

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By one estimate, primary care physicians caring for Medicare patients are linked in the care of their patients to, on average, 229 other physicians yearly.

Mitchell et al., (2012)

Defining "Team"

Multidisciplinary

Team members assume a heirarchical role that is governed by professional identities.

Transdisciplinary

Team members cross disciplines, and individual expertise "blurs" the roles of team members.

Team:

Interdisciplinary / Interprofessional

Care provided by two or more healthcare professionals who have different skill and expertise and who work together on common goals to provide quality patient-centered care. (Mitchel et al., 2012)

Roles are interdependent and synergistic, characterized by open communication, collaboration and task-driven leadership.

Collaboration

A partnership to include patient, family and healthcare providers who engage in a unified, coordinated approach with shared decision making regarding health and social issues (Blair, 2019)

Competency Domains

Teams & Teamwork

Communication

Roles & Responsibilites

Values & Ethics

The Interprofessional Education Collaborative Expert Panel (2011) synthesized national and global literature and findings among health professions organizations and academic institutions in the United States to determine the competency domains that must be incorporated into professional identity.

Core Elements

Knowledge & Skills

Communication

Leadership

Cooperation & Negotiation

Understanding & Strength in Professional Role

Appreciation of the Roles of Others

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(Patrician et al., 2012; Templeton, Robinson, & McKenna, 2016.)

Barriers to collaboration

Micro-level Factors

Macro-level Factors

• Lack of clarity of roles
• Clinican competence
• Clinical territory and ownership of specific knowledge and skills
• Lack of conflict resolution skills

• Classic physician-driven model
• Liability concerns
• Regulatory issues
• Billing practices and reimbursement systems
• Professional socialization

Professional Socialization

"The developmental stage when a student learns about the profession from historical and social perspectives and incoprates the values and attitudes of that profession." (Blair, 2019)

The Physician-Nurse Relationship

"Given the centrality of the nurse-physician relationship within healthcare, and the importance of congeniality to professional and organizations outcomes, promoting interprofessional respect and collaboration between nursing and medicine is of critical importance." (Price, Doucet, & McGillis-Hall, 2014)

Role for APRNs

Specific

General

Every Day Choices

Practice Philosophy

• Address unconscious social biases.
• Counter the pervasive notion that medicine is superior to nursing.
• Challenge the belief that nurses only function within caring, nurturing, and holistic model.
• Recognize that the practices of medicine and nursing overlap and the roles compliment rather than compete.
• Reconceptualize the APRN role as the liaison between and among team members and as the coordinator of care.

Clearly articulate what you know and do

Promote early professional socialization about the role and function of APRNs.

Work with leadership and technology experts to design systems and practices that foster support for ICTs

Become involved in local health policy discussions.

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Blair, 2019

ICT Education

Incorporating ICTs into didadactic & clinical experiences

From a student perspective, ICT education must not be perceived as "bolted on" to curricula that is already full and exhausting. ICT threads should be woven into existing material and must give students the opportunity for hands-on application that can translate easily to real clinical practice (Blair, 2019).

SUMMARY

APRNs play a critical role in establishing ICTs and acting as change agents.

The current state of healthcare demands strong ICTs to acheive positive outcomes.

Questions?

Works cited

Blair, Kathryn A. (2019). Advanced Practice Nursing Roles: Core Concepts for Professional Development (6th ed.). Springer Publishing Company.

Interprofessional Education Collaborative Panel. (2011). Core competencies for interprofessional pracice: Report of an expert panel. Washington, DC: Interprofessional Education Collaboritive. Retrieved from https://ipec.memberclicks.net/assets/2011-Original.pdf.

Mitchell, P., Wynia, M., Golden, R., McNBellis, B., Okun, S., Webb, C. E.,... Von Kohorn, I. (2012). Core principles and values of effective team-based health care. Discussion Paper. Washington, DC: Institute of Medicine. Retrieved from https://nam.edu/wp-content/uploads/2015/06/VSRT-Team-Based-Care-Principles-Values.pdf.

Patrician, P. A., Dolansky, M., Estrada, C., Brennan, C., Miltner, R., Newsom, J., ... Moore, S. (2012). Interprofessional education in action: The VA Quality Scholars Fellowship Program. Nursing Clinics of North America, 47, 347-354. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22920425/.

Templeton, K., Robinson, A., & McKenna, L. (2016). Advancing medical education: Connecting interprofessional collaboration and education opportunities with integrative medicine initiatives to build shared learning. Journal of Complementary and Integrative Medicine, 13(4), 347-355. Retrieved from https://web-p-ebscohost-com.suproxy.idm.oclc.org/ehost/pdfviewer/pdfviewer?vid=0&sid=28b6802c-1a98-42cd-95ad-2f225d67bebc%40redis.

Bibliography