inter-professional collaborative practice: …
TRANSCRIPT
INTER-PROFESSIONAL COLLABORATIVE PRACTICE: OPPORTUNITIES AND CHALLENGES
Prof. Achir Yani S. Hamid, MN, DNSc
Professor in Mental Health Psychiatric Nursing at Universitas Indonesia
Steering Board Member of AINEC
“It is no longer enough for health
workers to be professional. In the
current global climate, health workers
also need to be inter-professional“
(WHO, 2010, p.36)
How can they work together if they
don’t learn together?
Complicated Health Challenges Demand
Changing of Health Professions
Move from traditional inward-looking, reactive culture to outward-looking, proactive culture
Shift from profession-centred to patient-centred culture
Blurring professional boundaries
Changes in law re scope of practice/responsibilities
Increased expectations of interprofessional collaboration in education and practice
Focus on evidence-informed practice
Increasing demands for accountability/transparency
Internationalization
4 Foundations Patient Care
PATIENT- CENTRED
CARE
HOSPITAL RISK
MANAGEMENT
• Medical Care • Nursing Care • Nutrition Care • Pharmacy Care
“Safety is a
fundamental
principle of patient
care and a critical
component of
Quality
Management.”
(World Alliance for Patient Safety,
Forward Programme, WHO, 2004)
(PELAYANAN FOKUS PASIEN)
(Nico A Lumenta & Adib A Yahya, 2012)
Patient Care Standard:
Main Mission of Hospital is Patient Service/Care….
EBP VBP
Ethics
Patient’s needs
•Quality •Patient Safety
Inter-Professional Teams
An interprofessional team is made up of members of different professions and positions
Individuals bring to the team the specialised knowledge, skills, methods and attitudes of their disciplines
Members integrate their observations, bodies of expertise and spheres of decision making to coordinate, collaborate, and communicate to optimise client care
Three Types of Professional Competencies
(Barr, 1998)
Common Competencies
Inter-Professional Collaborative
Compatencies
Individual
Professional
Competencies
Inter-professional Collaborative Practice
Competency Domains
Values/
Ethics
Roles/
responsibilities
Inter-professional Communication Teamwork
Collaborative Skills for Teamwork
Cooperation
Assertiveness
Responsibility
Communication
Autonomy
Coordination
Challenges for Inter-Professional
Collaborative Practice
Differences in history and
cultural contextual
Historical interprofessional
and intraprofessional
rivalries
Differences in language and
jargon
Differences in professional
routines
Varying levels of preparation, qualifications
and status
Fears of diluted professional
identity
Opportunities of Collaborative Practice
It Empowers Team Members
It Closes Communication
Gaps
It Enables Comprehensive
Patient Care
It Minimizes Readmission
Rates
It Promotes a Team Mentality/
Moral
It Promotes Patient-
Centered Care
Benefits of Inter-Professional Education and
Collaborative Practice
Improved patient care &
safety
Improved outcome of
chronic patient
Reduced clinical error
Increased patients’
satisfaction
Better compliance to
therapy
Lessons Learned from IPE-CP
Development at Universitas Indonesia
Teamwork and collaboration of healthcare team
Inter-professional Education Module Development
at Universitas Indonesia
Divided into 2 parts: first, at the preclinical stage; second, at the clinical/profession stage
Specific competency: collaboration and teamwork to improve healthcare service through collaborative approach
Module developed by inter-professional team of teachers from 5 faculties in health sciences (Medicine, Nursing, Dentistry, Pharmacy and Public Health)
Interprofesional Education Collaborative (IPEC) Expert Panel (2011). Core
competencies for interprofessional collaborative practice:
Report of an expert panel. Washington, DC. Interprofessional Education
Collaborative. Canadian Interprofessional Health Collaborative. A National
Interprofessional Competency Framework. February 2010.
Universitas Indonesia Canada IPEC
Group dynamic Interprofessional
communication
Inter-professional
communication practices
Concept of collaboration
and healthcare system
Patient/client/fam ily/
communitycentred care
Roles and responsibilities
Conflict management Role clarification Values and ethics
Interprofessional
communication & leadership
Team functioning Inter-professional teamwork
& team based practice
Roles of each profession
Collaborative leadership
Barriers and strategy for
interprofessional
collaboration
Inter-professional conflict
resolution
Shared Competencies by All Professions
at Universitas Indonesia
Basic Biomedical Sciences
Health Research Methodology
Ethics & Law in Health
Health Communication
Disaster Management
Teamwork and collaboration of healthcare
team module (IPE)
Teaching methods
Collaborative learning
Team based learning
Case based learning
Presentation
Group work/project
Assessment system
Self-reflection
Performance (participation)
in group – checklist
Report on the group project
Written examination
(knowledge testing)
The module manages around 800 – 900 students from five schools
Clinical IPE-CP modules at Universitas Indonesia
Implemented since academic year 2015/2016
Community based approach (learning and working in the
community)
Focusing in health promotion and prevention
Students form an inter-professional team
Supervised by faculty members and clinical staff from the
Health District Office
In collaboration with Depok Health District Office and
Jakarta Health District Office
Assessment is conducted through observation, self-
reflection and report (poster)
REFLECTING ON THE IPE-CP EXPERIENCES IN INDONESIA
Lessons learned & actions for improvement
Environmental scan of IPE
implementation in Indonesia
Various models of IPE in different
schools/universities exist
Do we need to have a national
standard of IPE?
How can Indonesia formulate its
own IPE model that fits into local
context?
Establishing IPE core
competencies
REFLECTING ON THE IPE EXPERIENCES IN INDONESIA
Lessons learned & actions for improvement
Differences between professions:
culture, jargon, etc
How can we make it as an
opportunity, not seeing it as barrier?
Introducing IPE as early as possible
to prevent stereotyping
Providing as many opportunities as
possible for different students to
work and learn together (and also
for teachers!)
REFLECTING ON THE IPE EXPERIENCES IN INDONESIA
Lessons learned & actions for improvement
Between IPE and IPC (inter-professional collaboration) in healthcare services, which one is first?
Improving clinical staff awareness on IPE
Establishing a system to support collaboration and teamwork in healthcare (in hospitals and primary care centres)
Role modelling by teachers, clinical staff
REFLECTING ON THE IPE EXPERIENCES IN INDONESIA
Lessons learned & actions for improvement
How to ensure that IPE -CP really has an impact on
behavioural change?
Study the impact of IPE-CP to healthcare
services; how we measure it?
Roadmap of IPE-CP development and research
should be established
Government support: research funding, travel
grants, incentive for collaboration?
Interprofessional practice is reaching
out beyond the team