Core Competencies for Interprofessional Collaborative

Practice University of Illinois at Chicago

Naomi Twigg, PhD, PHCNS-BC, RN

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Learning Objectives

Explain Barr’s three types of professional competencies. Create a climate of mutual respect and shared values among the

team. Demonstrate high standards of ethics in the delivery of quality care

within an interprofessional team. Communicate your roles and responsibilities to other team members. Explain your colleagues’ roles and responsibilities on the team and

how these various roles and responsibilities attribute to improved care and enhanced team performance.

Describe how team members’ roles complement one another. Practice person-centered care within the context of an

interprofessional team.

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Historical Perspective18

Evolution of medicine and rise of technology = acute care based, technology driven, super specialized health care system

This system is fragmented, competitive, focused on the needs of the system and providers rather than patients and families

Increase in aging population, the insured, and persons living with chronic illness

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Two Major Contributors of Interprofessional Collaborative Practice5, 9, 11, 17, 18,

Institute of Medicine (IOM)

IHI Triple Aim– Improve person’s experience of care

(including satisfaction and quality)– Improve the health of populations– Reduce costs of health care

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Interprofessionality6

The process by which professionals reflect on and develop ways of practicing that provides an integrated and cohesive answer to the needs of the client/family/population… [I]t involves continuous interaction and knowledge sharing between professionals, organized to solve or explore a variety of education and care issues all while seeking to optimize the patient’s participation…Interprofessionality requires a paradigm shift, since interprofessional practice has unique characteristics in terms of values, codes of conduct, and ways of working.

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Interdisciplinarity vs. Interprofessionality6

Response to fragmented health care practices

More cohesive More collaborative Less fragmented Integrated approach to

practice Does not result in the

development of new professions

Response to fragmented knowledge of disciplines

New disciplines emerged based on this fragmentation

Focused on rectifying gaps in knowledge

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Interprofessional Collaborative Practice 1,8,14

When multiple health workers from different professional backgrounds work together with individuals, families, carers, and communities to deliver the highest quality of care. It allows health workers to engage any individual whose skills can help achieve local health goals.

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Interprofessional Collaborative Practice Process6

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Significance of Interprofessional Collaborative Practice12

Improve quality and safety Ensure person-centered care Develop efficient and effective delivery

methods of care Reduce costs to the health care system

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Barr’s Three Types of Professional Competencies14

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Interprofessional Teamwork and IOM Competencies13

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Interprofessional Collaborative Practice4, 14

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Competency 1: Values & Ethics14-16

Development of a uniprofessional identity

Values and ethics are:• Person-centered with a community/population

orientation • Sense of shared person for the common good• Shared commitment to create a safer, more efficient,

and more effective systems of health care Mutual respect and trust are foundational to working in

interprofessional teams

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Collaboration Involves Common Values14

Common values are driven by a shared vision Allows teams to respond in a consistent manner A shift occurs from managing collaboration to addressing

shared values

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Competency 1: Values & Ethics14

General competency: Work with individuals of other professions to maintain a climate of mutual respect and shared values.

Reflection: What barriers have you experienced or observed in maintaining a climate of mutual respect and shared values within an interprofessional team?

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Strategies to Address Values & Ethics2

Develop an interprofessional oath

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Competency 2: Roles & Responsibilities7,15

Be able to define your specific role and your responsibilities

Know and use each other’s expertise Recognize your own limitations Discover how roles complement one another Use the full scope of knowledge, skills, and abilities

of the team (diversity adds to team effectiveness) Use effective communication techniques to clarify

responsibilities Engage in interprofessional development to enhance

team performance

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Reflective Questions

Reflection: Describe your specific role and responsibilities to a team member.

Reflection: Describe another team member’s role and responsibilities.

Safe and effective care demand clearly defined roles.

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Competency 2: Roles & Responsibilities 9, 14-15, 18

General competency: Use the knowledge of one’s own role and those of other professions to appropriately assess and address the healthcare needs of the patients and populations served.

Reflection: What barriers have you experienced or observed related to specific roles and responsibilities within a team?

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Informative Questions

Explore distinctions among your professions. Identify commonalities.

Reflection: What is truly distinct about your profession? What is unique about what you do?

Reflection: What common elements do you share with your team members?

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Strategies to Address Role Clarification9

Develop clear job descriptions Provide ongoing interprofessional

development activities Facilitate a culture built on quality

relationships between providers

Reflection: What other strategies can you think of to address role confusion?

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Listen First3

Finding value in one another and understanding one’s role and responsibilities involves active listening– Provide space for a team member to share their

thoughts, expertise and ideas– Show interest by asking good questions

Promote basic interests of one another:– Feel valued– Be respected– Role recognition

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Reflective Questions

Reflection: Share your reflections working within an interprofessional team.

Reflection: How might you improve your interprofessional relationships?

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Interprofessional Professionalism Vignette10

A team of health professionals consisting of a nurse, social worker, primary care provider, psychiatrist, mental health worker, and care coordinator are collaboratively managing JP’s depression, obesity, diabetes care with secondary complications related to visual and skin integumentary conditions. The team is a shared collaborative in which leadership of and membership within the team are not based on hierarchy or profession, but shift in response to JP’s needs.

Recently, an ethical dilemma has surfaced among the health professionals in relation to the management of JP’s care. Following a health crisis, one of JP’s practitioners became frustrated and communicated to the team that she proposes to disengage JP from receiving supports and services for poor adherence to his treatment. When challenged about this decision, the practitioner argues that she does not have time to deal with ‘‘patients who are not interested in helping themselves.’’ While the team members respect and value each others’ professional autonomy, expertise, and cultures, they identify that a candid dialogue about this ethical concern is warranted.

How would you recommend the team proceed in addressing this issue?

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Conclusion3

Interprofessional collaborative practice offers the richest arena to discover new solutions to new problems.

Series continues next month (May 21st)– Interprofessional Communication Practices– Interprofessional Teamwork & Team-Based

Practice

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References

1. Barton, A.J. (2014). Preparing a collaborative, practice-ready workforce. Journal of Nursing Education, 53(7), 367-368. doi: 10.3928/01484834-20140619-10

2. Brown, S.S., Garber, J.S., Lash, J., & Schnurman-Crook, A. (2014). A proposed interprofessional oath. Journal of Interprofessional Care, 28(5), 471-462. doi: 10.3109/13561820.2014.4.900480

3. Buenza, J. (2013). Conflict resolution techniques applied to interprofessional collaborative practice. Journal of Interprofessional Care, 27, 110-112. doi: 10.3109/13561820.2012.725280

4. Canadian Interprofessional Health Collaborative. (2010, February). A national interprofessional competency framework. Retrieved from http://www.cihc.ca/resources/publications

5. Cox, M., & Naylor, M. (2013). Transforming patient care: Aligning interprofessional education with clinical practice redesign. Josiah Macy Jr. Foundation, 1-191. Retrieved from http://macyfoundation.org/docs/macy_pubs/JMF_TransformingPatientCare_Jan2013-Conference_fin_Web.pdf

6. D’Amour, D., & Oandasan, I. (2005). Interprofessionality as the field of interprofessional practice and interprofessional education: An emerging concept. Journal of Interprofessional Care, 1, 8-20. doi: 10.1080/13561820500081604

7. Edmondson, A. C., & Roloff, K. S. (2009). Overcoming barriers to collaboration: Psychological safety and learning in diverse teams. In Salas, E., Goodwin, G. F., & Burke, C. S. (Eds.) Team effectiveness in complex organizations (pp. 183-208). New York: Psychology Press.

8. Gilbert, J., Yan, J., & Hoffman, S.J. (2010). A WHO report: Framework for action on interprofessional education and collaborative practice. Journal of Allied Health, 39(1), 196-197.

9. Hepp, S.L., Suter, E., Jackson, K., Deutschlander, S., Makwarimba, E., Jennings, J., Birmingham, L. (2015). Using an interprofessional competency framework to examine collaborative practice. Journal of Interprofessional Care, 29(2), 131-137. doi: 10.31109/13561820.2014.955910

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References

10. Holtman, M.C., Frost, J.S., Hammer, D.P., McGuinn, K., Nunez, L.M. (2011). Interprofessional professionalism: Linking professionalism and interprofessional care. Journal of Interprofessional Care, 25, 383-385. doi: 10.3109/13561820.2011.588350

11. Institute for Healthcare Improvement. (2015). The IHI triple aim initiative. Retrieved from http://www.ihi.org/Engage/Initiatives/TripleAim/pages/default.aspx

12. Institute of Medicine. (2001). Crossing the quality chasm. Washington DC: National Academy Press. 13. Institute of Medicine. (2003). Health professions education: A bridge to quality. Washington, DC: The

National Academies. 14. Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional

collaborative practice: Report of an expert panel. Washington, D.C.: Interprofessional Education Collaborative.

15.Khalili, H. (2013). Interprofessional socialization and dual identity development amongst cross-disciplinary students. (PhD Dissertation). Retrieved from ProQuest Dissertations and Theses. (Accession Order No: ETD #3120.

16.Khalili, H., Hall, J., & DeLuca, S. (2014). Historical analysis of professionalism in Western societies: Implications for interprofessional education and collaborative practice. Journal of Interprofessional Care, 28(2), 92-97. doi: 10.3109/13561820.2013.869197

17.Moyers, P.A., & Metzler, C.A. (2014). Health policy perspectives – Interprofessional collaborative practice in care coordination. American Journal of Occupational Therapy, 68, 500-505. doi:10.5014/ajot.2014.685002

18.Speakman, E., & Arenson, C. (2015). Going back to the future: What is all the buzz about interprofessional education and collaborative practice? Nurse Educator, 40(1), 3-4. doi: 10.1097/NNE.0000000000000104

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