Interprofessional Collaboration in Healthcare: Examples

 Interprofessional frameworks often emphasize individual competencies and adopt a broad scope to remain versatile across diverse settings. Yet, this generalized approach can be inadequate for navigating the complexities unique to hospital settings. A systematic review of 22 studies suggests that interprofessional collaboration (IPC) “may affect Patient-Reported Outcomes positively across all outcomes” such as quality of life, coping, functional ability, pain, satisfaction, and therapeutic relationship. In this blog, we will be discussing the main themes behind successful IPC in healthcare settings and provide examples of common mistakes made by hospital staff when collaborating. 

Core Competencies and Behaviors for Effective Interprofessional Collaboration

In order to leverage the expertise of all team members and to create a work environment that fosters collaboration. The framework for interprofessional team collaboration in a hospital setting is defined by 5 core competences. 

1. Communication

• Achieving common understanding through active information sharing and seeking, using clear language. Associated behaviors include developing processes for timely information exchange, considering who needs specific information, and avoiding jargon. Be as specific as possible when communicating with other teams, describing exactly what you need from them and why.

CASE EXAMPLE

(Cardiology Interconsultation for Suspected Heart Attack Patient)

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>I am requesting an urgent consultation for a 47-year old male patient (who) with suspected acute acute myocardial infarction (AMI) with multi-branch involvement (what) who we would like evaluated for a coronary angiography (why). He presented to the emergency department with acute onset chest pain and ECG manifestations of ST-segment elevation ≥ 2 mm in V2 and V4 (justification). He was initially managed with nitroglycerin and is currently on IV heparin. His blood pressure has remained within normal range during hospitalization, his platelet count is 180,000 and he has no previous history of stroke, renal disease. (relevant details for requested procedure). 

2. Interprofessional Conflict Resolution

• Responding to conflicts promptly and collaboratively to find solutions. Behaviors include proactively addressing conflicts, listening openly to diverse opinions, and reaching mutually agreed-upon solutions. Creating a climate of transparency, openness, and valuing every team member’s perspective. Behaviors include speaking positively about other roles, creating a safe environment for advocacy, and considering organizational and individual ethics.

CASE EXAMPLE

3. Shared Decision-Making

Collaboratively deciding on care plans, reflecting patient and family needs, and defining accountability. Behaviors include creating interprofessional care plans centered on patient needs and collaboratively deciding on learning goals. We will dive into this in the next section. 

4. Reflection

Learning from past experiences to optimize team interactions and impact on patient care. Behaviors include dedicating time for team reflection, utilizing tools, like Videolab and Attendance Radar, for this process, and identifying areas for improvement. Regular reflection fosters a culture where learning and continuous improvement are valued and integrated into the team’s routine.

CASE EXAMPLE

(Management of Heart Attack Patient in the Emergency Department)

• • Poorly Handled Situation

• • • A patient experiencing symptoms of a heart attack arrived at the emergency department. However, due to a communication breakdown, the patient’s condition was not immediately assessed, and there was a delay in administering necessary medications like aspirin and nitroglycerin. The patient felt neglected and anxious as they waited for treatment. Once treated, the patient was discharged without clear instructions on post-heart attack care, leading to confusion about medication management and lifestyle changes. 

• • • REFLECTION: The delay in assessment and treatment was exacerbated by poor communication among healthcare staff, which compromised timely care. Moreover, failing to provide clear discharge instructions left the patient uncertain about how to manage their condition post-discharge. The healthcare team also missed the chance to educate the patient on crucial lifestyle changes and medication adherence, which are vital for preventing future heart attacks.

• • Ideally Handled Situation

• • • A patient arrived at the emergency department with heart attack symptoms. The healthcare team quickly assessed the patient’s condition and administered appropriate medications, such as aspirin and nitroglycerin, while also ensuring the patient received emotional support. After stabilization, the patient was enrolled in a cardiac rehabilitation program, which included personalized diet and exercise plans, stress management counseling, and regular follow-ups to monitor progress and address any concerns.

• • • REFLECTION: Timely assessment and treatment minimized heart damage and improved outcomes. By involving the patient in their care plan and providing ongoing support, the healthcare team fostered a sense of control and confidence, enhancing the patient’s overall experience and adherence to treatment recommendations.

5. Role Clarification

Ensuring team members understand each other’s roles, scopes, and expertise, optimizing interdependencies and avoiding redundancies. Behaviors include articulating one’s own role, actively seeking understanding of others’ roles, and recognizing limitations.

Patient-Centered Care as a Foundation for Interprofessional Collaboration

Healthcare professionals should strive to place patients at the forefront of care planning. This includes listening respectfully to their needs, sharing information appropriately and striving for their participation every step of the way. Both patients and their families should be considered a part of the interprofessional team. In order to see lasting results, medical staff should understand the role these play in continuity of care. 

• • Healthcare professionals should represent themselves clearly by name, title, and their role in the patient’s care. They should outline the initial management plan and inform of any collaboration with other healthcare professionals such as nutritionists or physical therapists. 
  • Collective leadership, where responsibility is distributed throughout the group, can enhance patient engagement and help answer any questions that may emerge. For example, the nurse can better explain the process of how, when and where medication can be administered while the physical therapist can answer questions regarding reincorporating to their usual exercise regimen. 
  • Patient-centered care fosters shared decision-making in order to develop a realistic, shared plan of care. Care plans should  adapt to each patient’s reality, adjusting for their line of work, the flexibility of their schedule, food preferences and socioeconomic background. This ensures that care plans align with what matters most to the patient.

CASE EXAMPLE (Heart Attack Patient Recommendations)

• The physician might prescribe medications depending on the unique case such as aspirin (to prevent blood clots), beta-blockers (to reduce heart workload), ACE inhibitors (to lower blood pressure), and statins (to manage cholesterol). They may also refer the patient to a cardiac rehabilitation program and schedule a follow-up visit to monitor heart function with an echocardiogram, stress test or blood tests for cardiac markers. 

• The nutritionist will work with the patient to limit salt intake and increase foods high in omega-3 and fiber, to help control blood pressure and lower LDL levels. They will recommend a reduced intake of saturated fats (found in red meat and full-fat dairy) and trans fats (found in processed foods). Likewise, they will mentor about portion control and the importance of hydration. 

• Nursing staff will educate the patient about warning signs of complications like swelling in extremities and provide instructions on when to seek emergency care. They will also help patients understand how and when to take prescribed medications (i.e. morning vs. evening doses) and provide strategies for remembering them (i.e. pill organizers, notes on the fridge). 

• The physical therapist might recommend starting with low-impact activities such as walking for 5-10 minutes daily and gradually increase duration and intensity over the coming weeks. They will teach the patient how to monitor their heart rate during physical activity within a safe range (typically 50-70% of their maximum heart rate during the early recovery phase). Likewise, they may recommend balance exercises like standing on one leg or heel to toe walking to improve coordination and prevent falls. 

Lessons from Competitive Sports

Just as in competitive sports where teamwork is paramount to achieving victory, the principles of effective collaboration learned from the sports arena can offer valuable insights for healthcare teams. The dynamics observed in successful sports teams, ranging from clear understanding of roles to navigating challenges collectively, hold significant relevance for how healthcare professionals interact and coordinate patient care. 

Role Clarity

• Just as athletes in a sports team have specific positions that contribute to the team’s success, healthcare teams rely on professionals like diagnosticians, prescribers, pharmacists, and nurses to bring their specialized skills together for patient care. However, flexibility in stepping outside traditional roles when necessary is equally important for optimal outcomes. Interprofessional collaboration thrives when team members understand each other’s responsibilities and areas of expertise—a principle emphasized by the Sunnybrook framework. Similarly, we must highlight the need for registrants to comprehend both their own role and those of other health professionals to build strong collaborative practices. Understanding what your colleague does helps put into perspective the things that they are looking for when collaborating. 

Trust and Confidence

• Trust is a cornerstone of effective teamwork, growing gradually through shared experiences and personal connections. Healthcare environments often face obstacles like rotating staff that complicate trust-building efforts. Still, working closely across disciplines fosters mutual respect and understanding of each other’s roles, which enhances interprofessional collaboration. Confidence in one’s abilities further boosts team confidence as a whole. According to the Sunnybrook framework, fostering trust involves upholding “interprofessional values and ethics,” such as transparency, openness, and a collaborative spirit. Respecting and trusting team members is key to successful interprofessional partnerships.

The Ability to Overcome Adversity

• Every team encounters difficulties, whether on the field or in healthcare settings, like handling intricate patient cases or addressing staffing issues. During such times, teamwork becomes even more crucial, and the collective commitment to patient care must remain steadfast. Shifting focus away from blame and toward collaboration is essential for navigating challenges successfully.

The Ability to Overcome Personal Differences

• While conflicts may arise among team members, the ability to overcome personal differences and focus on shared goals is vital. Diversity within a team should be seen as an asset, offering unique perspectives that drive innovation. In healthcare, the collective mission revolves around putting the patient first.

Collective Leadership

• Rather than relying on a single individual, this philosophy spreads leadership responsibilities throughout the group. This inclusive approach enhances team members’ involvement and sense of ownership. Recognized as a critical competency in interprofessional education, collaborative leadership draws on the collective strengths of the team. It emphasizes the importance of multiple voices in decision-making. Likewise, the rotation of leadership roles among team members based on their expertise and situational needs greatly benefits patient care.

Interprofessional collaboration has proven to be a crucial strategy in addressing evolving healthcare challenges. The integrated collaboration of all members of the healthcare system became essential in managing patient care and ensuring the safety of both patients and providers during staffing shortages. IPC creates a more positive and satisfying work environment for healthcare professionals. This positive atmosphere leads to increased job satisfaction and lower burnout rates among healthcare workers. As healthcare delivery becomes increasingly complex and interconnected, the flexibility and comprehensive approach offered by interprofessional collaboration will be vital in navigating future challenges in the healthcare landscape.