Interprofessional Collaboration & Teamwork

Definition: "Collaborative practice in health-care occurs when multiple health workers from different professional backgrounds provide comprehensive services by working with patients, their families, caregivers and communities to deliver the highest quality of care across settings" (WHO, 2010).
Importance: Working together as a team and addressing conflicts makes the healthcare process stronger, benefiting patients, the team, and individual team members.

Literature Evidence: High functioning teams improve outcomes of care.
- 70% of errors are related to poor communication within and across teams.
- 85% of providers report that adverse outcomes have resulted from uncoordinated care.
Current Education Model: Students are educated in silos, with no opportunities to learn and practice together.

Interprofessional Education serves as a tool to bridge the education system and healthcare delivery.
- Objective: Address the "Triple Aim" to achieve:
- Better patient care.
- Better public health.
- More efficient and affordable healthcare (lower costs).

Domains:
- Values and Ethics: Understanding the importance of treating patients and team members with dignity and respect.
- Roles and Responsibilities: Appreciating the roles and responsibilities of different disciplines enhances collaboration.
- Communication: Standards for effective communication include clarity and timely information transfer.
- Teams and Teamwork: Ability to function effectively as part of a team.

Importance of recognizing the roles of healthcare workers from various backgrounds:
- Medicine: Focuses on diagnosis and treatment of illness, including medical history, physical examination and diagnostics, and physiological aspects of illness.
- Nursing: Involves holistic assessment (physical, emotional, mental, spiritual) and advocacy for individuals, communities, and populations, focusing on health promotion and prevention.

Effective communication principles include:
- Complete: Convey all relevant information.
- Clear: Ensure the information is easy to understand.
- Brief: Communicate succinctly and concisely.
- Timely: Share information when it is most relevant and needed. verify authenticity, and validate or acknowledge information

Definition: A handoff is the transfer of responsibility and accountability for patient care.
Root Causes of Sentinel Events: Poorly conducted handoffs can lead to critical errors in patient care.
1/25 patients are harmed by medical treatment
medical mishaps are the 3rd leading cause of death

SBAR: A structured communication model used for effective patient information transfer.
- Components include:
- S - Situation: Identify yourself and outline the current situation clearly.
- B - Background: Provide relevant patient history and changes.
- A - Assessment: Offer conclusions about the patient's current state.
- R - Recommendations: State what actions should be taken based on the situation and assessment.
Why Use SBAR?: Validated tool to:
- Reduce adverse patient events.
- Improve communication and patient safety.
- Recommended by agencies such as AHRQ and WHO.
- framework for communicating qquickly and effectivly
- enhances communication between the healthcare team

Components of SBAR Skills

observation: gathering necessary information for appropriate recommendation
ciritical thinking: considering patients situation, background, assessment data when formulating patient problem
Decision Making: based on review of patient status and information, is consult required
interpersonal skills: establish positive relationships to promote positive rapport and healthcare team effectiveness
communication: achieved by providing accurate. patient-centered , evidence based information in timely manner

handoff = transfer of responsibility and accountability
- clarity of information
- verbal communication of information
- acknowledgement by receiver
- opportunity to review

Components of effective hand-off reports include:
- Identifying patient info: name, room number, diagnosis, attending physician.
- Current health status and orders.
- Review of any abnormal occurrences, patient concerns, and plan for subsequent care.

Shared mental models help teams

leads to mutual understanding of situation
leads to more effective communication
enables backup behaviors
help ensure understanding of others roles and how they interplay
enable better prediction and anticipation of needs
- always thinking what to do next
create commonality of effort and purpose

Feedback for improving teamwork should be:
- Timely, specific, directed towards future improvements, respectful, and considerate of feelings.
Continuous constructive feedback is vital for enhancing team dynamics.

Civil leadership in healthcare

TeamSTEPPS Principles:
- Situational Monitoring
- CUS (Concerned, Uncomfortable, Safety issue)
- Two Challenge Rule
  - when an initial assertion is ignored:
    - it is your responsibility to assertively voice concern at least 2 times to ensure it has been heard
    - the team member being challenged must acknowledge
    - if the outcome is still not accepted:
      - take a stronger course of action
      - utilize supervisor or chain of command
    - empowers all team members to “Stop the like” if they sense or discover an essential safety breach.
- DESC
  - D- describe the specific situation or behavior; provide concrete data
  - E- express how the situation makes you feel/what your concerns are
  - S - Suggest other alternatives ans seek agreement.
  - C - consequences should be stated in terms of impact on established team goals ; strive for consensus.

Elements essential for high-quality patient care teams include:
- Leadership, Communication, Mutual Support, Situation Monitoring, Knowledge, and Attitudes.

Interprofessional Collaboration

Emphasis on coordination for individuals with:
- Disabilities or chronic conditions.
- Mental health challenges.
- Cultural and socio-economic factors.