Interprofessional Care: Building on Collaborative Teams Mandy Lowe Faculty Lead, IPE Preceptorship & Facilitation Office of Interprofessional Education

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  • Interprofessional Care:Building on Collaborative Teams Mandy LoweFaculty Lead, IPE Preceptorship & FacilitationOffice of Interprofessional EducationUniversity of TorontoInterprofessional Education LeaderToronto Rehabilitation InstituteLowe.mandy@torontorehab.on.ca

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  • ObjectivesDefine teams and collaboration Recognize the importance of team collaborationConsider individual and team-based strategies to enhance collaboration*

  • What is team?A collection of individuals who: are interdependent in their tasksshare responsibilities for outcomesare seen by others as an intact social entity embedded in one or more larger social systemmanage their relationships across organizational bordersOandasan et al. (2006)Ehpic course, June 2009*

  • What is interprofessional collaboration (IPC)?an interprofessional process of communication and decision-making that enables the separate and shared knowledge and skills to synergistically influence the care provided

    Way , Jones & Busing (2000)

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  • What does Interprofessional Education (IPE) Mean?

    Members (or students) of two or more professions associated with health or social care, engaged in learning with, from and about each other (Geissler, 2002)

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  • It is believed by many that if we train competentcollaborative practitioners, more collaborative practice settings will be developed over time Hence practice is linked with education. p. 12, DAmour & Oandasan (2005)Capacity to CollaborateEhpic course, June 2009*

  • *Drivers for IPE and IPCInternational Research and programs e.g. UK, USANational Health Canada Romanow, 2002Provincial/Local Health Force Ontarios Interprofessional Health Education Innovation Funds 2007 and 2008Regulation of Health Professions in Ontario: New Directions (HPRAC, 2006 and 2008)U of T Office of IPE - research, practice, curriculaEnhance careCollaborative Practice improves outcomes in specific populations

  • Teamwork Positively Impacts OutcomesImproved Outcomes in specific populationsNeonatal ICU, STD screening, geriatrics, fractured hips (Zwarenstein et al., 2005) Stroke Functional Outcome (Strasser et al., 2008)

    Improved Patient SafetySBAR Communication Tool (Velji et al., 2008)Fewer deaths when in true team (West, 2006)

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  • Teamwork Positively Impacts OutcomesImproved Cost Efficiency (DAmour, 2005)Improved Health Professional Satisfaction (Cohen & Bailey, 1997)Leads to a Healthy Workplace (Shamian & El-Jaradali, 2007)www.cihc.cawww.chsrf.ca Promoting effective teamwork in healthcare in Canada

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  • DiscussionThink about a time when you were part of or observed a highly collaborative team.What do you think made such successful collaboration possible? *

  • *7 Essential Elements for Collaboration Way , Jones & Busing (2000)Ehpic course, June 2009

  • What elements define team collaboration in pediatric rehabilitation?Communication open, clear, regular, jargon free Decision making shared, effective problem solving strategiesGoal setting shared, clear, prioritized, regularly evaluatedOrganization coordination of planning (e.g. single plan of care), structure, resourcesTeam process evaluation, mutual respect and role understandingParent involvement critical team members Nijhuis et al, 2007*

  • How can team collaboration be fostered? *

  • Three Key Questions for Collaborative TeamsWhat is the goal of our team?

    How will our team communicate? How will our teamwork be coordinated?

    How will our team repeatedly review what we are trying to achieve and how effective we are?Balance of task/content (the what) and process (the how)Adapted from Aston West OD& Schmidt, 2006

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  • 1. What is the goal of our team?

    Shared goal and visionAll team members are clear about rolesRoles reviewed regularly to ensure satisfaction and optimal useOpportunities for team members to get to know each other to find out what contributions team members can make

    Government of Ontario, Family Health Team Guide to Collaborative Team Practice (2005)

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  • 2. How will our team communicate and coordinate?

    Strategies may include:Team members meet regularlyMembers involved in planning for activities in which they will be involvedThere is an effective decision-making method Issues are confronted and problems resolved as they ariseThere is a process for identifying/clarifying role overlap Role of leader is understood by team members Leader encourages active participation of all team members

    Government of Ontario, Family Health Team Guide to Collaborative Team Practice (2005)

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  • 3. How will our team repeatedly review what we are trying to achieve and how effective we are?Accomplishments and achievements are celebratedThere is an evaluation process for follow-up, to ensure goals are being metTeam process is reviewedGovernment of Ontario, Family Health Team Guide to Collaborative Team Practice (2005)

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  • Team FunctionHigh performance requires BALANCE

    TASKPROCESSTask what is done and the problems associated with completionProcess- How the team functions how the task is accomplished, what happens between the members, the way decisions are made PROCESS affects OUTCOMEEhpic course, June 2009

  • Health Professional Collaborator Competencies

    KNOWLEDGE*roles of other health professionals

    SKILLS*communicating with others*reflecting upon my role and others

    ATTITUDES*mutual respect*willingness to collaborate*openness to trust

    *Oandasan & Reeves (2005)Ehpic course, June 2009

  • Collaboration: What can you do?Knowledge of RolesProvide opportunities for clarifying your role (e.g. interview, education, shadow opportunities)Request opportunities to clarify team members rolesOrientation for new team members? Or changes in roles over time?

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  • Collaboration: What can you do?Communicate and reflectEnhance your own collaborative communication e.g. giving and receiving feedback, conflict resolution, monitor for jargon, etc.

    Invite feedback re: specific collaborative competencies

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  • Collaboration: What can you do?We may look in the same direction, even at the same lines, and not see what our colleague sees.McKee (2003)Reflect on your own ways of knowing, e.g.What assumptions am I making? Where did I learn these values?What values orient me?How might someone whose role is different than mine look at this?McKee (2003)

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  • Collaborative Attitudes: An IDEA Interact with others whose role differs from my ownCollect Data about others roles e.g. how others are educated; competencies others possess; the many settings in which they may workExpertise - open to the views and approaches of their colleagues (and) altering perceptions via the discussion when appropriateAttention to ones own professional and personal background, biases, stereotypes and assumptions - including skills in exploring and appreciating others approachesPecukonis (2008)*

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  • ObjectivesDefine teams and collaboration Recognize the importance of team collaborationConsider individual and team-based strategies to enhance collaboration

  • Learning from Teams: DisplaysWhat has enabled your team to collaborate so effectively?How did your team successfully address challenges to collaboration?What was your shared goal as a team? How did you arrive at this goal?What approaches/strategies did you find most successful for coordinating and communicating as a team?How did you learn and benefit from your collective experience? How did you repeatedly review your work and experiences?*

  • To talk well and eloquently is a very great art, but that an equally great one is to know the right moment to stop.

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  • Thank you!

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  • ReferencesAston West, OD. The Aston team performance toolkit (2007). In Jelphs, K & Dickinson, H (2008) Better Partnership Working: Working in Teams. The Policy Press: UK.Cohen, SG & Bailey, DE (1997). What makes teams work: Group effectiveness research from the shop floor to the executive suite. Journal of Management, 23(3):239-290.DAmour, D & Oandasan, I (2005). Interprofessionality as the field of interprofessional practice and interprofessional education: An emerging concept. Journal of Interprofessinal C are, 19(Suppl 1):8-20.Government of Ontario (2005). Family Health Teams - Advancing Primary Health Care: Guide to Collaborative Team Practice. Available at: http://www.health.gov.on.ca/transformation/fht/guides/fht_collab_team.pdf*

  • ReferencesLemieux-Charles, L., & McGuire, W. L. (2006). What do we know about health care team effectiveness? A review of the literature. Medical Care Research and Review, 63(3), 263-300. McKee, M. (2003). Excavating our frames of mind: The key to dialogue and collaboration. Social Work, 48(3):401-8. Nijhuis, BJG et al. (2007). A review of salient elements defining team collaboration in paediatric rehabilitation. Clinical Rehabilitation, 21:195-211.Oandasan et al. (2006) Teamwork in Healthcare: Promoting Effective Teamwork in Healthcare in Canada Policy Synthesis and Recommendations, CHSRF. Available from www.chsrf.ca Oandasan, I & Reeves, S (2005). Key elements for interprofessional education. Part 1: The learner, the educator and the learning context. Journal of Interprofessional Education, 19(Suppl 1):21-38.

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  • ReferencesPecukonis E; Doyle O, & Bliss, D.L. (2008). Reducing barriers to interprofessional training: Promoting interprofessi

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