Academic journal article Nursing and Health Care Perspectives

Building Community: Developing Skills for Interprofessional Health Professions Education and Relationship-Centered Care

Academic journal article Nursing and Health Care Perspectives

Building Community: Developing Skills for Interprofessional Health Professions Education and Relationship-Centered Care

Article excerpt

The restructuring of the health care system has raised numerous questions about the nursing work force: Are we preparing too many nurses? Are nurses being prepared to work in a market-driven, managed care health delivery system? Should some schools be closed? Should enrollments be reduced? Should new kinds of programs be offered? As the 1993-1995 National League for Nursing Board of Governors struggled with policy decisions surrounding the preparation of the nursing work force for a restructured health care system and education. Specific questions about nursing education and the nursing work force could then be answered in terms of opportunities within that future. [sections] Because of the complexity of nursing work force issues, the Board endorsed the creation of a President's Commission to address them. The Commission on a Workforce for a Restructured Health Care System was chaired by Richard Lamm, health reform advocate and the former Governor of Colorado. The final report of the Commission is available in its entirety on the NLN website ( Only the conclusions and recommendations are published here, starting on page 91. [sections] In 1995, the NLN commissioned an Interdisciplinary Health Educational Panel to examine issues related to interdisciplinary education and make recommendations for future implementation. The Panel's work spanned 1995 through 1996. The final report of the panel is presented here and available on the NLN website.

Health professionals from many disciplines need to work in concert to address the complex health needs of our diverse and changing populations. Although each discipline has its own focus, "all health care disciplines share a common and primary commitment to serving the patient and working toward the ideal of health for all" (1). Therefore, society and health care would be better served if students in the health professions "have opportunities to experience working together ... in valid models of cooperative health care delivery" (2).

Consistent with its Vision and Mission Statement, which presents as a guiding principle "strengthening ties with the community and expanding interdisciplinary activities" (3), the National League for Nursing established a presidential panel on interdisciplinary/transdisciplinary education and practice for the health professions. (These and similar terms are frequently used interchangeably. They are explained, with references from the literature, on page 89 under "Definitions of Terms.")

An interdisciplinary team of health professionals was convened to examine such issues as professional boundaries, clinical practice competencies, processes for education in primary care, collaborating partnerships for community-based health care delivery, and program accreditation. The expected outcome was to target reform agendas and identify quality benchmark indicators for interdisciplinary health professions education.

A Brief History of Interprofessional Team Care Interprofessional teams to provide health services to communities were used by missionaries in India in the early 1900s. Before World War 1, Richard Cabot and others in Boston called for "teamwork" of health professionals in the interest of "clinical efficiency." After World War II, Martin Cherkasky and H. K. Silver initiated efforts to employ interprofessional teams to meet the multiple needs of chronically ill patients and families in the community (4).

In the 1960s, the federal government encouraged the use of interdisciplinary teams at their funded neighborhood health centers. In the 1970s, a number of schools began a major effort at interdisciplinary team training for health professions students. In the 1980s, the Veterans Administration funded a nationwide effort to train teams of health professionals in the care of aging veterans.

During the past decade, under pressures for greater efficiency and fiscal accountability from the government and managed care organizations, there has been a revival of interest regarding the use of interprofessional teams in health care. …

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