Interprofessional collaboration in nursing entails multiple health workers from different backgrounds working together to deliver high-quality care to patients. As reported by the World Health Organization, collaborating and respecting one another’s viewpoint in healthcare means disciplines can work together as a team to improve patient outcomes. Health professionals must understand their scope of practice and be aware of their colleagues’ role in delivering optimal healthcare. Enhancing interprofessional collaboration can reduce errors and improve patient outcomes. Nurses can employ several strategies to improve teamwork skills and deliver comprehensive patient care through interprofessional collaboration.
In the past, doctors made the majority of decisions about patient care. With the increase of interprofessional collaboration, other medical team members, such as nurses and radiologists, can also make decisions and recommendations. Before collaborative practice was introduced and staff worked independently, symptoms could be missed, or there could be a miscommunication about patient’s requirements. Effective communication means ideas are shared about patient treatment, and the team works together to provide continuity of care.
An example of interprofessional collaboration would be a team in an emergency department comprising a triage nurse, physician, charge nurse, nurses, nursing assistants, administrative staff and allied health professionals such as radiographers, physiotherapists and social workers. To provide quality healthcare, nurses must collaborate with staff from other disciplines, and for this to happen, they must understand colleagues’ skills and scope of practice. This practice also involves communicating well with patients, families and healthcare staff, as well as planning, implementing and evaluating overall patient care. In the past, nursing students were trained without learning about other disciplines, but today, they are being prepared to work in interprofessional teams.
There are benefits to working collaboratively for patients, nurses and other healthcare professionals. Patient outcomes are improved, fewer errors occur, healthcare costs are reduced and relationships with other staff are enhanced. Better communication means reduced workloads through more knowledge and less duplication of work. There is much research to show that patient outcomes are optimized when disciplines work together toward shared goals that focus on patients.
Clinical work can be pressured with challenges and responsibility. Working closely with a team can make this work more manageable and less stressful. Being able to share responsibility and rely on colleagues can raise morale. All healthcare professionals aim to provide quality patient care, which is much more achievable when working together in a team. Instead of receiving care from individuals, patients benefit from having a cohesive team look after them.
Nurses with a master’s degree can advance their careers with Walsh University’s online Doctor of Nursing Practice, no GRE required. Students will expand their advanced nursing role and prepare to be nurse leaders. They will develop in essential areas such as quality improvement, evidence-based problem solving and healthcare policy. Post-graduate degree programs allow healthcare professionals to demonstrate their ability as an expert in their field. Many healthcare staff have busy careers, so an online qualification can provide the flexibility they need.
A working example
A private university in the US and its academic healthcare partner outlined and administered an interprofessional collaborative practice (IPCP) model in 2016 at a new outpatient unit. The research aimed to assess the benefits of the IPCP model by contrasting patient outcomes and charges in the year prior to the outpatient unit opening and the first year of the unit operating using IPCP.
They selected a group of high-risk patients to monitor over time who met one of these clinical criteria:
- A minimum of three emergency room visits in six months of the year
- A 9% or higher value for hemoglobin A1c
- A LACE score (length of stay, acuity, comorbidities, emergency room visits) with a readmission risk score of 10 or higher
Using electronic patient records, they found that 276 patients met the eligibility criteria. The measure of effect was comprised of patient charges, hemoglobin A1c, department visits and hospitalizations.
There were agreed definitions of interprofessional education and collaborative practice that informed the IPCP mode. The model was created using care conference planning, patient care preparation and staff training. Application of the model made a place of collaborative care. There was training for staff in conflict management before and after the unit opening. Every day, there were huddles for the whole team before clinics where team members were recognized, safety issues were reviewed and information was shared.
Following the huddle, a resident, a nurse practitioner or faculty member, and a medical assistant addressed pre-visit planning looking at patient needs and interprofessional care. Healthcare professionals collaborated continually throughout the shift. The clinician or medical assistant introduced all of the patients to staff at handover. Patient cases were presented at collaborative care conferences to the interprofessional team with care proposals put in the electronic patient records that everyone in the team could access.
The results indicate a link between IPCP and better patient outcomes and reduced costs. In this high-risk group, the IPCP model was linked to decreases of 48.2% in total medical charges, 16.7% in emergency room visits, 17.7% in hospitalizations and 0.8% in hemoglobin A1c levels. There were limitations, such as not examining the relation of different professions to outcomes, not looking at the funding of the model and not having a randomized controlled design. However, overall, the results were positive, and this model is still being used in the outpatient unit.
Strategies
An interprofessional healthcare team will complement one another’s expertise and work together to attain shared treatment goals. When different professions and specialties use effective strategies to work well together, they can ensure quality patient care. Nurses can employ strategies to improve teamwork and deliver comprehensive care, such as safety huddles, patient rounds and collaborative care plans.
Safety huddles
Safety huddles occur at the start of each shift and can last for less than 10 minutes. They are led by the most senior nurse or professional whose clinical perspective encourages the team to manage safety and quality. The team can share concerns and successes from the day before, discuss patient quality and safety issues for the coming day, update safety and quality measures, encourage input about any concerns and share other information. The successes shared by the team can be motivators for continued collaboration. Each member should contribute, and a checklist can ensure everything is covered.
Patient rounds
Interprofessional rounds can improve patient care and satisfaction among providers. Patient rounds aim to share clinical information with patients and families and create a collaborative care plan. These rounds often occur at the bedside and allow healthcare staff to coordinate care. Every team member should be asked to join the rounds, but those who are most often present are patients, families, nurses, physical therapists, pharmacists, social workers and doctors. The team discusses the patient’s health and any concerns, the care received during treatment and discharge plans. Quality and safety are reviewed, and all of the team contribute to decision-making.
Collaborative care plans
In the past, healthcare professionals would have their own care plan for patients. This made it harder to get an insight into a patient’s overall health. Nowadays, patient records are electronic, making it possible for staff from different disciplines and specialties to collaborate and have a wider view of a patient’s care. Each professional in the team will have input into the care plan, and the risks and benefits to the patient will be considered. The care plans concentrate on the patient’s condition, treatment objectives and ways to improve outcomes. To ensure the team’s effective functioning, the team members’ roles in care planning and delivery must be defined and negotiated. This requires trust and respect between team members, as well as a compelling mix of skills within the team. Systems for communication and interaction and clinical governance structures must be agreed upon among team members.
When developing a coordinated care plan, the interprofessional team might address the following points to improve healthcare:
- The patient’s symptoms and needs
- The staff addressing the patient’s needs
- The interventions required for a good outcome
- The goals of each intervention
More collaboration among healthcare staff, particularly between nurses and physicians, helps patients with interprofessional care plans by:
- Shortening the length of stay, regardless of diagnosis
- Decreasing numbers of conditions acquired in hospitals
- Reducing expenditure
- Decreasing overall mortality
Defining the aims of interprofessional meetings, along with patient goals and intended outcomes, is vital for creating a plan of care that meets the patient’s needs while including feedback from the team.
Having a leader to assist in making interdisciplinary discussions productive can be useful. Leaders can bring a system to care planning meetings by selecting goals for discussion, encouraging each team member to participate and discovering more information about the patient when necessary.
Conclusion
Interprofessional collaboration in healthcare enables staff from many disciplines and specialties to deliver high-quality patient care. Nurses are valuable members of healthcare teams and can use strategies such as collaborative patient rounds to ensure all relevant staff are involved in the patient’s treatment. Research has shown that when healthcare teams work collaboratively, patient outcomes improve, and healthcare professionals benefit from being part of a supportive team.
