Interprofessional Practice Promoting Partnerships inHealth

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<ul><li> Slide 1 </li> <li> Interprofessional Practice Promoting Partnerships inHealth </li> <li> Slide 2 </li> <li> Learning Objectives Define Interprofessional Practice Drivers of IPP Barriers to IPP Examples of IPP </li> <li> Slide 3 </li> <li> Being Professional today means being Interprofessional Inter- between, across, beyond -professional- a way of behaving </li> <li> Slide 4 </li> <li> Types of Teams MultidisciplinaryMultidisciplinary InterdisciplinaryInterdisciplinary TransdisciplinaryTransdisciplinary </li> <li> Slide 5 </li> <li> Interprofessional Teams An interprofessional team is made up of members of different professions and positionsAn interprofessional team is made up of members of different professions and positions Individuals bring to the team the specialised knowledge, skills, methods and attitudes of their disciplinesIndividuals bring to the team the specialised knowledge, skills, methods and attitudes of their disciplines Members integrate their observations, bodies of expertise and spheres of decision making to coordinate, collaborate, and communicate to optimise client careMembers integrate their observations, bodies of expertise and spheres of decision making to coordinate, collaborate, and communicate to optimise client care </li> <li> Slide 6 </li> <li> Working Together for Health World Health Report 2006 Shift from tertiary hospital to patient centred, home based and team driven careShift from tertiary hospital to patient centred, home based and team driven care Increasing incidence of chronic conditionsIncreasing incidence of chronic conditions Core competencies include: patient centred care, partnering, quality improvement, information and communication technology and a public health perspective.Core competencies include: patient centred care, partnering, quality improvement, information and communication technology and a public health perspective. </li> <li> Slide 7 </li> <li> Bio-psycho-social Model (Roberts, 1994) the human being as a complex mix of internal physical, psychologic, social, and cultural variables living within an equally dynamic environmental mixture of social, cultural, interpersonal, economic, and political variables (Kielhofner, 1985 as cited in Peloquin, 1997, p. 167) </li> <li> Slide 8 </li> <li> Interprofessional Team /Multidisciplinary Team (Sheehan et al., 2007) Cooperative work, common understandings and goals Worked in parallel, noticed others contributions, passed on information Commitment to joint communication, genuine valuing and interest Clinical decision making drew on other health professionals information Clear communication processes and understanding of roles Lack of common understanding of patient management issues Language inclusive, frequent use of we and team Minimal use of inclusive language but all contributions valued </li> <li> Slide 9 </li> <li> National Patient Safety Data (2006) ( Nisbet, 2007) Contributing factor WANSWQLD Policy &amp; Procedure26%25%23% Communication23%25%20% Human factors (scheduling/training)18%14%20% Information (availability/completeness)13%12% Knowledge &amp; skills18% </li> <li> Slide 10 </li> <li> Tragedies in Collaboration Bristol inquiry Kennedy Report Victoria Climb Laming Report Every Child Matters </li> <li> Slide 11 </li> <li> Patient/ Client/ Service User Identify a situation where you have been a service user. </li> <li> Slide 12 </li> <li> Community Rehab Services To maximise independence and community participation To achieve durable outcomes and improved quality of life for clients To reduce admissions and re-admissions To improve continuity of care </li> <li> Slide 13 </li> <li> Barriers to IPP Differences in history and cultureDifferences in history and culture Historical interprofessional and intraprofessional rivalriesHistorical interprofessional and intraprofessional rivalries Differences in language and jargonDifferences in language and jargon Differing professional routinesDiffering professional routines Varying levels of preparation, qualifications and statusVarying levels of preparation, qualifications and status Fears of diluted professional identityFears of diluted professional identity </li> <li> Slide 14 </li> <li> Professional Cultures Culture: the social heritage of a community. Values, beliefs, attitudes, customs and behaviours Autonomy Beneficence Confidentiality Dilemma Duty Ethics Fidelity </li> <li> Slide 15 </li> <li> Professional Culture Justice Morality Non-malfeasance Veracity </li> <li> Slide 16 </li> <li> Stereotypes Stereotyping is a natural human process Positive : guide their intergroup behaviours efficiently deal with an outgroup with minimum expenditure of energy Negative : generate false or negative expectations of another groups attitudes or behaviours </li> <li> Slide 17 </li> <li> Stereotypes in Health Care Many allied health professionals work with patients for episodes of care. They have a distinct and purposive range of activities that can be easily explained and their contribution to patient care within the team can be clearly demarcated. Scholes, 2002. I see the occupational therapist as someone who walks around with a roll of Velcro in one hand and a lump of Blutak in the other. I think they try and stick Velcro anywhere they can. The doctors do what the consultants do which is to be standoffish and give very vague answers to your question in a rather imperial manner. </li> <li> Slide 18 </li> <li> Health Care Stereotypes Nursing Medicine Physiotherapists Occupational Therapists Speech Pathologists Pharmacists Dentists </li> <li> Slide 19 </li> <li> Granny Draggers Physio terrorists Massage Therapists </li> <li> Slide 20 </li> <li> Changing Health Professions Move from traditional inward-looking, reactive culture to outward-looking, proactive culture Shift from profession-centred to patient-centred culture Blurring professional boundaries Changes in law re scope of practice/responsibilities Increased expectations of interprofessional collaboration in education and practice Focus on evidence-informed practice Increasing demands for accountability/transparency Internationalization </li> <li> Slide 21 </li> <li> Professional Cultures as Barriers Social work perspective: Problem externalSocial work perspective: Problem external Change the world Change the world Health care perspective: Problem internalHealth care perspective: Problem internal Change the person Change the person </li> <li> Slide 22 </li> <li> Policy drivers The Multidisciplinary Health Team must adopt interprofessional practice to address: the changing needs of the population; the changing needs of the population; changes in the incidence and treatment of disease; changes in the incidence and treatment of disease; changes in technology; and changes in technology; and changes in consumer expectations.changes in consumer expectations. WHO: Framework for Action 2010 The World Health Organization recognizes interprofessional collaboration in education and practice as an innovative strategy that will play an important role in mitigating the global health crisis. </li> <li> Slide 23 </li> <li> Collaborative Skills for Teamwork CooperationCooperation AssertivenessAssertiveness ResponsibilityResponsibility CommunicationCommunication AutonomyAutonomy CoordinationCoordination </li> <li> Slide 24 </li> <li> Interprofessional competencies Interpersonal and Communication SkillsInterpersonal and Communication Skills Patient/Client/ Service user centred and Family focussed care (Relationship-based care)Patient/Client/ Service user centred and Family focussed care (Relationship-based care) Collaborative PracticeCollaborative Practice </li> <li> Slide 25 </li> <li> Interpersonal and Communication Skills I effectively express my own knowledge and opinions to others involved in care.I effectively express my own knowledge and opinions to others involved in care. I actively listen to the knowledge and opinions of other team membersI actively listen to the knowledge and opinions of other team members I use information systems and technology to exchange relevant information among all professionals to improve care.I use information systems and technology to exchange relevant information among all professionals to improve care. </li> <li> Slide 26 </li> <li> Relationship-based Care I involve the service user and family (carers) in group decision making processesI involve the service user and family (carers) in group decision making processes I ensure continuous integration of service users and families (carers) in the team in order to maintain optimal, evolving careI ensure continuous integration of service users and families (carers) in the team in order to maintain optimal, evolving care </li> <li> Slide 27 </li> <li> Collaborative Practice I take part in and supportI take part in and support collaborative decision-making collaborative decision-making I understand and respect roles and responsibilitiesI understand and respect roles and responsibilities I actively contribute to team functioningI actively contribute to team functioning I participate actively in continuous quality improvementI participate actively in continuous quality improvement </li> <li> Slide 28 </li> <li> CR Interdisciplinary Competencies 1. Frameworks of understanding 2. Networks and teams-collaborative practice 3. Cultural awareness 4. Holistic focus 5. Consumer engagement </li> <li> Slide 29 </li> <li> ICF (WHO 2001, p.18) </li> <li> Slide 30 </li> <li> CR Interdisciplinary Competencies 6. Service continuity 7. Reflective practice 8. Community engagement 9. Boundaries and personal safety 10. Systems advocacy </li> <li> Slide 31 </li> <li> Interprofessional Education Interprofessional Education (IPE) occasions where 2 or more professions learn with, from and about each other to improve collaboration and the quality of care lack of coordination between the education and health areas of government, leading to mismatches between education and training places and service delivery requirements Productivity Research Report (2005:p.xxiv) </li> <li> Slide 32 </li> <li> Children's Services Multi-agency working acknowledges the inter- relatedness of family needs in the fields of health, social services, law enforcement, child welfare, housing and education.Multi-agency working acknowledges the inter- relatedness of family needs in the fields of health, social services, law enforcement, child welfare, housing and education. "there is a terrible danger here is there not, doctor of social services on the one hand and you on the other each expecting the other to do the investigation, with the result that nobody does". </li> <li> Slide 33 </li> <li> IP &amp; Palliative Care Origins of palliative care lie in religious care and nursing rather than medicine (Crawford &amp; Price, 2001). </li> <li> Slide 34 </li> <li> Community Rehabilitation Holistic framework Consumer Driven Advocacy Role Seamless Service </li> <li> Slide 35 </li> <li> Interprofessional Practice in Health Interprofessional Practice is a partnership between a team of health professionals and a client in a participatory, collaborative and coordinated approach to shared decision making around health issues Together everyone achieves more </li> <li> Slide 36 </li> <li> Interprofessional practice is reaching out beyond the team </li> <li> Slide 37 </li> <li> Point 6 APA Code of Conduct APA members must communicate and cooperate with colleagues and relevant agencies in the best interests of their clients and the wider community. Members shall collaborate professionally with all relevant providers to achieve optimal client outcomes. </li> <li> Slide 38 </li> <li> Longstanding fragmentation of health service delivery and the global health workforce shortage make collaborative teamwork an imperative. The drive for collaborative teamwork is a World Health Organisation priority for action. Collaborative teamwork is a sophisticated skill and some individuals are better at it than others; others may need staff development. The main challenges to collaborative teamwork are understanding others roles, and effective communication. If quality care is the goal for patients and families clinical competence must be balanced with collaborative competence. Strategies to improve the effectiveness of service delivery need to be political, organisational and professional. </li> <li> Slide 39 </li> <li> APA (2008) APA Code of Conduct http://www.physiotherapy.asn.au/images/APA_Corporate_Documents/apa_code_of_conduct.pdf http://www.physiotherapy.asn.au/images/APA_Corporate_Documents/apa_code_of_conduct.pdf Australian Health Ministers Conference National Health Workforce Strategic Framework 2004 Beauchamp, T. L., &amp; Childress, J. F. (2001). Principles of biomedical ethics (5th ed.). New York: Oxford University Press. Crawford, G. &amp; Price, S. (2003) Crawford, G. &amp; Price, S. (2003)Team working: palliative care as a model of interdisciplinary practice MJA,179: S32S34 Hindle, D., Braithwaite, J., Travaglia, J. &amp; Iedema, R. (2006) Patient Safety: A comparative analysis of eight enquiries in six countries. http://www.cec.health.nsw.gov.au/files/patient- safety/publications/patient-safety-report.pdfhttp://www.cec.health.nsw.gov.au/files/patient- safety/publications/patient-safety-report.pdf Meads, G. &amp; Ashcroft, J. (2005) The Case for Interprofessional Collaboration. In Health and Social Care CAIPE Blackwell Publishing. Nisbet, J. (2007) Interprofessional Learning: the Australian Perspective. http://www.clinicalsenate.health.wa.gov.au/presentations/doc/Aug07_Nisbet.pdf http://www.clinicalsenate.health.wa.gov.au/presentations/doc/Aug07_Nisbet.pdf Roberts P (1994). Theoretical models of physiotherapy. Physiotherapy 80: 361-6. Scholes, J. (2002) Cross-boundary working : implications for the multiprofessional team. Journal of Clinical Nursing 11 (3) 399-408. Sheehan, D., Robertson, L. &amp; Ormond, T. (2007) Comparison of language used and patterns of communication in interprofessional and multidisciplinary teams. Journal of Interprofessional Care.21 (1), 17-30. World Health Organisation (2010) Framework for Action on interprofessional education and collaborative practice. http://www.who.int/hrh/resources/framework_action/en/ http://www.who.int/hrh/resources/framework_action/en/ </li> </ul>

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