Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Building Positive Relationships in Healthcare: Evaluation of the Teams of Interprofessional Staff Interprofessional Education Program

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Building Positive Relationships in Healthcare: Evaluation of the Teams of Interprofessional Staff Interprofessional Education Program

Article excerpt

Healthcare professionals are increasingly aware that interprofessional collaboration and effective team communication are essential for improved patient care and safety. Nursing has embraced interprofessional care as critical to enhanced practice and client outcomes (Canadian Nurses Association [CNA], 2006; Doran, 2005; Tremblay et al., 2010). Successful interprofessional practice (IPP) is based on collaboration, communication and teamwork (Oandasan et al., 2006; Registered Nurses' Association of Ontario [RNAO], 2006). IPP integrates the knowledge and expertise of members from different healthcare professions to accomplish common goals. Each member of the team works within their area of expertise, while integrating the expertise of other health professionals, to achieve the patient goals using a collaborative team approach (Casimiro, 2009; CNA, 2006). Effectively working together as part of an interprofessional team is now included in the expectations for most healthcare providers (Cann, 2000; Casimiro, 2009; College of Nurses of Ontario [CNO], 2002; Liaskos et al., 2009; Nahrwold, 2005). Empirical evidence shows that collaboration and teamwork lead to improved patient care, reduced healthcare costs, and improved job satisfaction (Baggs & Schmitt, 1997; Baker & Norton, 2004; Barrett, Curran, Glynn, & Godwin, 2007; Hendel, Fish, & Berger, 2007; Zwarenstein, Reeves, & Perrier, 2005).

Teamwork involves a complex process that can either help or hinder its success (Oandasan et al., 2006). Zwarenstein and Reeves (2006) cite that possible explanations for poor collaboration and communication stem from lack of clear role definitions among healthcare staff, lack of time for team building, and the effects of healthcare professionals' socialization. Examples include the impact on clinical decision-making of power differentials between different professions, and the vertical hierarchies created within professions. Nurses identify with this particular barrier to IPP, as they have historically been seen as having less power than physicians, often their closest coworkers (Ceci, 2004; Cox, 1991; Tosh, 2007). Reeves, Freeth, McCrorie, and Perry (2002) state that 'by many accounts collaboration remains problematic, with difficulties being continually encountered concerning interprofessional coordination and communication' (p. 337). Way, Jones, and Busing (2000) note that while physicians support interprofessional collaboration, they are concerned about the impact of the ensuing 'shared-care' on funding and liability issues, and question the relevance of a fixed or unified view of collaborative practice.

Given the growing empirical evidence that poor interprofessional relationships can have an adverse effect on healthcare outcomes (Barrett et al., 2007; Etchells, O'Neil, & Bernstein, 2003; Hall, 2005; Lingard et al., 2004), it is imperative that the culture in healthcare institutions begins to support, promote and expect collaboration, teamwork, and communication among all healthcare professionals (RNAO, 2006). Horak, Hicks, Pellicciotti, and Duncan (2006) purport that institutions not only need to change the prevailing culture but also implement shared governance for improved morale, patient care and trust among all staffand management to create a strong functional unit.

In order for IPP to be adopted across all healthcare settings, current healthcare professionals need support to consistently adopt a team approach to clinical care (Health Force Ontario [HFO], 2007). The Teams of Interprofessional Staff(TIPS) Project provided interprofessional education (IPE) for practicing professionals in order to both enable and motivate the adoption of IPP. The TIPS Project itself, and the curriculum design met the requirements for effective IPE as outlined by Liaskos et al. (2009). More specifically, the sessions were team taught, the objectives were quantifiable and measureable, the subject matter was within the competence and scope of each team member, teams reinforced their need for enhanced team knowledge and skills for quality care, and there is evidence that such team development knowledge and skill can be transferred (RNAO, 2006). …

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