Development and Testing of a

Conceptual Framework for

Interprofessional Collaborative Practice

Brenda J. Stutsky RN, MScN, EdS, PhD

University of Manitoba brenda.stutsky@med.umanitoba.ca

Heather K Spence Laschinger RN, PhD, FAAN, FCAHS

University of Western Ontario hkl@uwo.ca

Objectives

Describe a conceptual framework for interprofessional collaborative practice.

1

2

3

Describe the preliminary empirical testing of the framework.

Determine potential application for the framework.

Literature Review

• Problem– Interprofessional literature: Atheoretical– Terms are poorly conceptualized– Consistent framework for research is missing

(Reeves et al., 2011)

ConsequencesInterprofessional

Collaborative

Practice

Conceptual Framework

Antecedents

ANTECEDENTS

Personal Factors• Beliefs in IPC• Flexibility• Trust• Cooperation• Communication Skills

Situational Factors• Leadership• Empowerment• Support Structures

Interprofessional

Collaborative

Practice

• Collective Ownership of Goals

• Understanding of Roles

• Interdependence• Knowledge Exchange

CONSEQUENCES

Work Behaviours & Attitudes

Personal• Work Satisfaction• Intent to Stay

Team• Perceived Team

Effectiveness• Conflict

Organizational Outcomes• Patient Safety• Quality of Patient Care

Patient Outcomes• Patient Biopsychosocial

Outcomes• Patient Satisfaction• Patient Empowerment• Length of Stay

Method

• Descriptive correlational design• Regulated healthcare providers in Northern Health

Authority in Manitoba, Canada• 3 hospitals, 3 long-term care facilities, 4 primary

healthcare centres• Interprofessional Collaborative Practice Survey

– Constructed from existing standardized measures– 55 items with 9 demographic items– Reliability was adequate (.67 to .88) and .78 for overall ICP

scale– Construct validity confirmed via exploratory factor analysis

(Stutsky & Laschinger, 2012)

Results

Demographics• Response rate 32% (N=117)• 95 females, 21 males, 1 not indicated• 23-68 yrs. of age (M=43.30, SD=11.77)• 0.5-40 yrs. of experience (M=15.51, SD=12.45)• 75% nurses, 17% allied health, 8% physicians• 59% acute care, 34% community care, 7% long-term care• 72% full-time, 24% part-time, 4% casual• 78% direct patient care

Results

MeansOverall mean for ICP was moderate (M=3.76, SD=.43)

ICP dimensions were moderate to moderately high:• Understanding of Roles (M=3.15, SD=.75)• Interdependence (M=4.24, SD=.47)• Knowledge Exchange (M=3.98, SD=.50)• Collective Ownership of Goals (M=3.43, SD=.69)

Results

Correlations• Correlations between ICP and its antecedents and consequences• All factors were significantly correlated with overall ICP (r=.33-.65, p<.01) except for flexibility

Path AnalysisReasonably adequate fit for a newly developed framework:• Comparative Fit Index (CFI) .81• Normed Fit Index (NFI) .77• Root Mean Square Error of Approximation Index (RMSEA) .14

Results

Discussion

• Encouraging preliminary empirical support for the conceptual framework

• Results were consistent with findings in the literature including the importance of relationship-centered collaborative care

• Limitations include small sample size and response rate• Psychometric properties of the ICPS are promising but

continual refinement and validation is needed • Patient outcomes need to be captured in future studies

Discussion

• Use of the framework– Healthcare leaders: Guide for facilitating ICP to enhance patient

safety and quality of care– Educators: Strengthen IPE curricula– Healthcare professionals: Share the framework with their

colleagues to promote ICP and remind all those involved in caring for patients of the importance of individual attitudes and behaviours and interprofessional interactions to improving patient safety and quality

– Further research to validate the framework

References

• Atwal, A., & Caldwell, K. (2002). Do multidisciplinary integrated care pathways improve interprofessional collaboration? Scandinavian Journal of Caring Sciences, 16(4), 360-367.

• Blewett, L. A., Johnson, K., McCarthy, T., Lackner, T., & Brandt, B. (2010). Improving geriatric transitional care through inter-professional care teams. Journal of Evaluation in Clinical Practice, 16(1), 57-63.

• Bronstein, L. R. (2003). A model for interdisciplinary collaboration. Social Work, 48(3), 297-306. • Canadian Health Services Research Foundation (2006). Teamwork in healthcare: Promoting effective teamwork in

healthcare in Canada - Policy synthesis and recommendations. Retrieved from http://www.chsrf.ca/Migrated/PDF/teamwork-synthesis-report_e.pdf

• Canadian Interprofessional Health Collaborative. (2010). A national interprofessional competency framework. Retrieved from http://www.cihc.ca/files/CIHC_IPCompetencies_Feb1210.pdf

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References

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