Journal of Research in Interprofessional Practice and Education (JRIPE)
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The Timely Open Communication for Patient Safety Project
Get PDFBackground: Concern is growing over increased numbers of adverse events experienced by patients when admitted to acute care hospitals in Canada due to breakdowns in communication. The purpose of the Timely Open Communication for Patient Safety (TOC) project was to create a culture of patient safety through enhanced interprofessional communication by developing resources for caregivers and patients. Methods and Findings: The research was framed by a mixed methods design that included pre- and post-surveys and focus groups, online educational modules, face-to-face activities, and the development of patient orientation materials. Three clinical sites participated in the study. The findings indicate that supporting healthcare teams to identify strengths, challenges, and future directions of communicating, clarifying roles, functioning, and collaborating, coupled with educational interventions that raise awareness of patient safety,may enhance patient safety. The study was limited by the absence of data regarding the incidence of adverse events during the research period. Conclusion: The data showed improvement in team members' perceptions of interprofessional collaborative practice within the participating Collaborative Learning Units (CLUs). If the CLU model of care is adopted within the healthcare system, the safety of patients/clients may improve
A Team Observed Structured Clinical Encounter (TOSCE) for Pre-Licensure Learners in Maternity Care: A Short Report on the Development of an Assessment Tool for Collaboration
Get PDFBackground: Despite the support for Interprofessional Education (IPE) among policymakers, educators and professional regulating bodies, the research literature is limited with respect to the evaluation of effective assessment strategies. This short report outlines the development of a Team Observed Structured Clinical Encounter (TOSCE), which brings together learners from three health professions involved in primary care obstetrics-family physicians, midwives, and obstetricians-as a strategy for assessing collaborative competencies.Methods: An interprofessional research team was brought together to develop and implement the TOSCE. The process by which the team generated TOSCE scenario stations is outlined, including the consensus-building process, based on a modified Delphi technique, to include expert input from others in the field of practice.Findings: The scenarios developed by the research team for the TOSCE are highlighted including the assessment criteria, based on the Canadian InterprofessionalHealth Collaborative's National Competency Framework.Conclusions: The TOSCE is an emerging and innovative learning tool that encourages the development of essential collaborative competencies. The process of developing a TOSCE outlined in this report offers an affordable, streamlined approach that could be used by educators in many disciplines as a summative or formative assessment strategy
Interprofessional Shared Decision Making in the NICU: A Survey of an Interprofessional Healthcare Team
Get PDFBackground: The purpose of this study was to determine how different membersof an interprofessional (IP) team (nurses, physicians, respiratory therapists, and other professionals) perceived collaboration and satisfaction with the decisionmaking process across three decision types (triage, chronic condition management, values-sensitive decisions) in a neonatal intensive care unit (NICU).Methods and Findings: All members of the team at a tertiary NICU in Canada who consented to the study received a modified version of the Collaboration and Satisfaction about Care Decisions (CSACD) instrument. A total of 96 completed surveys were returned (response rate of 81.4). Collaboration scores were calculatedfor each participant, professional group, and the IP team. The Pearson product-moment correlation coefficient was used to investigate the relationship between perceived collaboration about decision making and satisfaction with the decision-making process. Inter-group comparisons across different decision types were also calculated. The majority of statistically significant differences in professional perspectives about decision making were about triage decisions. Nurses and respiratory therapists were more likely than other groups to feel the decision-making process was inadequate. There was a strong, positive correlation between perceived collaboration in decision making, satisfaction with the decision-making process, and satisfaction with the decision.Conclusions: Findings from this survey suggest that healthcare professionals' views differ about what constitutes optimum interprofessional shared decision making(IPSDM), and the decision type is an important influencing factor for IPSDM
Implementation of a Mental Health Guideline in a Long-Term Care Home: A Participatory Action Approach
Get PDFAbstractBackground: The goal of this pilot study was to implement a Canadian mental health guideline in a long-term care residence in order to improve interprofessional care of clients with mood and behavioural issues.Methods: Using a participatory action approach, this pilot study engaged staff/physicians, residents, and families in identifying key priorities for action related to the goal of improving interprofessional care. This resulted in the implementation of educational interventions, a mandate for non-registered nursing staff to attend interprofessional rounds, and enhanced interprofessional collaboration through unit-based huddles. A staff satisfaction survey and focus groups were conducted to assess perceptions of change.Findings: The staff satisfaction survey revealed statistically significant improvements in perceived job satisfaction, leadership, and workplace resources. Focus group findings indicated improved interprofessional collaboration, teamwork, support, and communication. Staff noted a stronger perception of being valued and increased confidence in their own contributions.Conclusions: Both qualitative and quantitative improvements were noted in staffjob satisfaction. Despite some limitations, these findings suggest that further dissemination of this initiative with rigorous evaluation is warranted
Teaching and Learning Interprofessionally: Family Medicine Residents Differ From Other Healthcare Learners
Get PDFAbstractBackground: In recent years, interprofessional education and collaborative patient centred care have been promoted to improve efficiency and quality of healthcare service. Teaching interprofessional education has been challenging. There are fewmature curricula, a lack of standardized teaching approaches, and our healthcare learners are educated in different institutional systems. The objective of this study was to explore how one interprofessional educational initiative impacted different healthcare learners from college and university.Methods and Findings: A day-long interprofessional cognitive behavioural therapy (CBT) workshop was presented to learners from multiple disciplines. Within aframework of collaborative, experiential, and reflective learning, the workshop aimed to promote interprofessional teamwork skills, professional roles, and collaborative behaviours. A mixed-methods design using pre- and post-workshop questionnaires was used to evaluate the effectiveness of the workshop. Significant differences were found between family medicine (FM) residents and healthcare learners of other disciplines in three domains: a) satisfaction with the CBT content area of the workshop, b) attitude toward interprofessional learning and collaboration, and c) the interprofessional learning experience.Conclusions: The results resonate with longstanding, taken-for-granted roles and attitudes in the culture of healthcare. This study invites serious consideration of when best to embed interprofessional education in healthcare curricula, so that learners will come to shape a professional identity that includes interprofessional collaborative care
Barriers to the management of Heart Failure in Ontario Long-Term Care Homes: an Interprofessional Care perspective
Get PDFBackground: With population aging, the prevalence of heart failure (HF) is risingin long-term care (LTC) homes. Given this burden, there is an urgent need to establish effective HF management programs.Methods and Findings: To understand what barriers would need to be addressed to develop such a program, we conducted a series of consultations among various LTC staff, as well as residents and their family caregivers. This article uses data obtained from the consultations to describe the interprofessional (IP) barriers that exist among the various LTC staff roles. Consultation methods included a Delphi survey followed by focus group interviews of LTC staff, and then personal interviews with LTC residents with HF and their family caregivers. Data were interpreted using an IP care framework in which interpersonal relationships among LTC staff provide the most direct influence on collaborative resident-centred practice, within the broader context of conditions within the LTC home, which in turn are housed in the broader context of systemic determinants.Conclusion: Across all data sets, the most consistently mentioned determinant was communication between the resident and the healthcare team, between different healthcare providers, between shifts, between medical specialists, and between the long-term care home and the hospital
Student-Run Clinics: Opportunities for Interprofessional Education and Increasing Social Accountability
Get PDFBackground: Collaborative practice is a necessary component of providing effective, socially responsive, patient-centred care; however, effective teamwork requires training. Canadian student-run clinics are interprofessional community service-learning initiatives where students plan and deliver clinical and health promotion services, with the assistance of licensed healthcare professionals.Methods and Findings: In this article, we use a reflective approach to examine the phenomenon of student-run clinics in Canada. First, we briefly review the history of student-run clinics and then describe one particular clinic in detail. Then, drawing on the experiences of student-run clinics across the country, we identify common themes and challenges that we believe characterize these programs.Conclusion: Student-run clinics in Canada emphasize health equity, interprofessionalism, and student leadership. As more student-run clinics are developed, both nationally and internationally, co-ordinated research efforts are needed to determine their effects on students, institutions, communities, and healthcare systems. If educators can learn to collaborate effectively with student leaders, student-run clinics may be ideal sites for advancing learning around interprofessionalism and social accountability
Evaluation of a Simulation-Based Interprofessional Educational Module on Adult Suctioning Using Action Research
Get PDFAbstractBackground: Interprofessional collaboration in healthcare contributes to patientwell-being. The purpose of this action research study was to evaluate an innovative interprofessional simulation educational module for pre-licensure healthcare students on adult suctioning skills.Methods and Findings: Two suctioning scenarios were developed to provide multiprofessional groups of students the opportunity to collaborate in applying basicsuctioning skills within complex patient care situations. One group of nursing students (N= 23) and one group of physiotherapy students (N= 23) learned suctioning skills uniprofessionally in the usual programs of their respective schools. A third group of students (N= 45; 21 nursing, 24 physiotherapy) learned suctioning in the new, interprofessional simulation-based curriculum. Qualitative data were collected through direct observation of laboratory sessions, open-ended surveys, and focus groups. A thematic qualitative analysis was conducted, and four major themes emerged: instructors’ role expectations, prior student learning, student collaboration, and instructor communication. In addition, quantitative analysis of students’ readiness for interprofessional collaboration, confidence, and performance of suctioning skills revealed no significant differences between learners in the interprofessional labs and those in the uniprofessional labs.Conclusions: Development of the educational module using action research allowed for further development of a pedagogical approach to interprofessional education to increase its effectiveness
Advancing Translational Research by Enabling Collaborative Teamwork: The TRACT Approach
Get PDFBackground: The work of multidisciplinary research teams (MDRTs) is vital for translational research. The objectives of this study were 1) to understand the structure and function of MDRTs, and 2) to develop effective strategies to enhance collaboration among team members. Methods and Findings: Semi-structured interviews were conducted with 23 participants involved in multidisiplinary research work at two San Antonio, Texas, institutions. Interview materials were tape-recorded, transcribed, and content analyzed using qualitative methods.Themes that emerged from the content analysis were used to develop and refine strategies to enhance the work of MDRTs. The findings showed that MDRTs operate through multiple cycles of: 1) team formation, 2) team collaboration, 3) sustainable collaborative activities, and 4) team maturity. Content analysis identified four interrelated basic elements within the MDRT tract that facilitate team cycles: 1) shared interest/vision among agreeable team leader and members, 2) viable means of communication, 3) available resources, and 4) perceived gain/benefit of teamwork.Conclusions: Our findings highlighted several opportunities and challenges in the formation, dynamics, and growth of MDRTs. Effective strategies to enhance teamwork should levearge these opportunities and address challenges, taking into consideration the interdependent aspects of the basic elements within the MDRTs tract
A Multidisciplinary Team of a Physician and Clinical Pharmacists Managing Hypertension
No full textBackground: Providing effective pharmaceutical care to ambulatory care patientswith chronic diseases presents an enormous challenge. Medication therapy management (MTM) is defined as the direct, responsible provision of medicationrelated care for the purpose of achieving definite outcomes that improve a patient’s quality of life. MTM is a patient-centred service, typically provided by clinical pharmacists in collaboration with physicians and other healthcare providers, that seeks to improve the quality of medication use and intended results among patients who are at high risk of having adverse reactions from medications.Methods and Findings: We tested the hypothesis that MTM provides both improved outcomes and cost reduction as determined by differences in the measurable outcomes (lipid levels, tobacco consumption, weight, prescription cost, and average blood pressure values). Patients were given, at random, the opportunity to participate in MTM in a 5-month period. We found there was a significant reduction in blood pressure, glucose, LDL, triglycerides, cholesterol, and cost for patients participating in MTM.Conclusions: MTM may improve pharmacotherapy outcomes and reduce medication costs