Representing complexity well: a story about teamwork, with implications for how we teach collaboration

BackgroundIt is pivotal to implement effective collaboration among professionals from different disciplines in the healthcare sector. As the complexity of patients’ health needs grows, so does the importance of developing innovative and efficient models of patient care that rely on interprofessional collaborative teamwork. Interprofessional education (IPE) is a valuable approach that improves communication, collaboration, and ultimately safe patient outcomes in healthcare settings. Students studying medicine and pharmacy are among the healthcare professionals who could potentially benefit from IPE. Despite the existence of newly added undergraduate curricula for interprofessional communication and professionalism, active implementation to achieve the required competencies and skills is not yet widespread, particularly in developing countries. This article presents a successful implementation of simulation-based team-oriented learning sessions among pharmacy and medical students at Delta University for Science and Technology in Egypt. The purpose of the IPE activity was to train students to work collaboratively as members of an interprofessional healthcare team by simulating a real-life situation.ResultsStudent feedback was very positive with most pharmacy and medical students being satisfied with their IPE experience. Moreover, students’ feedback emphasized the significance of IPE and a simulated team-based environment in improving communication skills and collaborative practice.ConclusionThe high level of student satisfaction with the IPE sessions, particularly regarding the clarity of training objectives and the interactive nature of the experience, suggests that simulation-based learning is an effective tool for developing key interprofessional collaboration skills among healthcare students. This highlights the potential of IPE to cultivate future healthcare professionals who excel in interprofessional collaboration, ultimately leading to improved patient care and outcomes. Overcoming barriers to implementing IPE in Egypt needs a multifaceted strategy and a comprehensive long-term follow-up plan is critical for evaluating the lasting effect of IPE on students’ collaborative practices in real-life healthcare settings.

Background Healthcare is provided by a variety of different professionals, including pharmacists who are integral members of the team, and all are expected to work collaboratively to provide quality care. Little is known about the perceptions of pharmacists in Qatar towards interprofessional collaboration. Positive attitudes towards interprofessional education are essential to successful implementation of interprofessional collaboration. Therefore, to develop effective collaboration strategies in practice settings, it was essential to survey the attitudes of practising pharmacists towards collaboration. Objective To explore the awareness, views, attitudes and perceptions of practising pharmacists in Qatar towards interprofessional education and collaborative practice. Setting Community, hospital and primary healthcare settings in Qatar. Methods This was a two-staged sequential explanatory mixed method design. It utilised a quantitative survey (Stage 1), based on a modified version of the Readiness for Interprofessional Learning Scale. This was followed by a qualitative stage, utilising focus groups (Stage 2). Main outcome measures (1) Qatar pharmacists' attitudes towards interprofessional education and collaborative practice; (2) Practising pharmacists' perspectives in relation to enablers, barriers and recommendations regarding interprofessional education and collaborative practice. Results 63% of the practising pharmacists (n = 178) responded to the survey. Three focus groups followed (total n = 14). High scores indicating readiness and positive attitudes towards interprofessional education were reported for pharmacists working in hospital, community and primary healthcare settings. Qualitative analysis identified three overarching themes in relation to the enablers, barriers and recommendations for practising pharmacists working collaboratively. The enabling themes were: professional and patient related benefits, and current positive influences in Qatar; the barriers were patients' negative perceptions; the status of the pharmacy profession and current working practices and processes; the recommendations related to improving patients' perceptions about pharmacists and enhancing the status of pharmacy profession in Qatar. The findings from this study highlighted two major observations: the lack of existence of collaborative practice and hierarchy and power play. Conclusion Pharmacists demonstrated willingness and readiness to develop interprofessional learning and collaborative practice with significant steps already taken towards improving collaborative working practices in different care settings.

To explore the interprofessional collaboration between nursing and social work professionals in their delivery of health services for schoolchildren. Interprofessional education has long been recommended as a way to meet the need for effective collaboration in school health service with a view to improving the quality of health care. No local study in Hong Kong has looked specifically at how nursing and social work professionals carry out school health services through interprofessional education and practice. Therefore, an examination was conducted of collaboration on a community-based school caring project. A qualitative design was employed, using semi-structured interviews, field observation and field debriefing. Seven nursing students and five social work students were recruited and interviewed in 2011. The transcripts were analysed using qualitative content analysis. Three themes were identified: (1) early identification of children's needs through interprofessional collaboration for health promotion, (2) prompt referral for schoolchildren in need, and (3) comprehensive planning and implementation of school health service. The strength of collaborative work between nursing and social work professionals is that it helps to identify and address these complex health needs of children. Healthcare providers are hence able to develop a fuller understanding of children's problems, which in turn enables them to provide appropriate and effective health promotion interventions. The development of interprofessional education for school health services should be envisaged by the local higher educational institute and policy makers to reduce children's risk-taking behaviours and promote their health and well-being. Health educators and health policy makers can better understand how interprofessional education and collaboration can promote children health service for regional and national policy and practice.

The effectiveness of interprofessional classroom-based education in medical curricula: A systematic review

Background and Purpose. The need for developing collaborative practice–ready health care providers, along with new interprofessional education (IPE) accreditation standards, highlights the importance of IPE in physical therapist education curriculum. As we strive to meet the goal of preparing students for collaborative practice and team-based care, the TeamSTEPPS system can be integrated into IPE programs to assist in the provision of quality health care and in the prevention of medical errors. Emory University (Emory), Kansas University Medical Center (KUMC), and the Medical University of South Carolina (MUSC) have integrated TeamSTEPPS into their IP classroom- and practice-based curricula. The purpose of this paper is to describe how these academic health centers have embedded TeamSTEPPS into their IP curricula, with the goal of assisting academic and clinical faculty with the development and implementation of learning activities directed toward the development of IP competency. Method/Model Description and Evaluation, Outcomes. The IPE models used by Emory, KUMC, and MUSC use the TeamSTEPPS framework and are described with select evaluation measures and outcomes. The Emory and KUMC models are primarily classroom based, whereas the MUSC uses a combined classroom- and clinic-based model. Although each institution's model for IP training and assessment is different, all have shown positive results. Discussion and Conclusion. With new IPE accreditation standards for most health professions programs, using TeamSTEPPS is a strategy to assist in meeting the standards for IPE training and a larger goal of improving the quality and safety of patient care.

Background: Healthcare in Qatar is undergoing a period of major reform, driven by a strong economy and vision for a world-class healthcare system. One area identified as a potential contributor to developing a world-class healthcare system is interprofessional education (IPE), with the goal of facilitating collaborative practice among healthcare workers. Several key steps have been taken towards developing IPE in Qatar, such as the formation of the Qatar Interprofessional Health Council (QIHC), the development of an IPE program for undergraduate healthcare students, the development of a set of shared core competencies, the receipt of substantial buy-in from leaders across the healthcare system, and recent approval of funding to develop a post-licensure healthcare IPE program. In order to improve IPE in Qatar, it is important to better understand the facilitators and barriers to interprofessional collaboration in Qatar. This study seeks to do so by qualitatively exploring facilitators and barriers to interprofessional collaboration in Qatar from the perspective of healthcare professionals. This research can assist in improving healthcare in Qatar by increasing understanding about how healthcare workers give meaning to interprofessional education and collaboration. Objectives: The purpose of this paper-presentation is to report on finding from a qualitative study that explored different facilitators and barriers of interprofessional practice in Qatar. Method: 10 healthcare professionals who work in Qatar were interviewed using semi-structured, open-ended interviews organized by the theoretical approach of phenomenology. The interviews focused on exploring barriers, facilitators, and what is working well in terms of interprofessional practice for healthcare professionals in Qatar. Findings and Implications: Different factors associated with interprofessional collaborations will be discussed. In doing so, this research adds to the literature on IPE by shedding light on interprofessional collaboration and education in the Middle East. Furthermore, this study identifies barriers for healthcare workers to work collaboratively in healthcare settings in Qatar. Addressing such barriers, and building on what is working well, will facilitate Qatar in reaching one of the Qatar National Vision 2030 goals of improving Qatar's health and wellness.

Introduction: The number of complex healthcare problems is increasing, the workforce is diminishing, and healthcare costs are rising. Interprofessional Education and Collaborative Practice is a promising solution, necessitating the cultivation of skills and competencies among health and social care professionals. The central question guiding this study revolves around the possibility of merging interprofessional collaboration, lifelong learning, the International Classification of Functioning, Disability and Health (ICF), and the Rehabilitation Competency Framework (RCF) into a unified competency framework that can be used in both education and in the work field. Method: In total, five modified Delphi rounds were executed during three phases specifically comprising the design, relevance, and report stages. The first contains a literature search, the second includes 11 pilots with surveys, and the last finalized the INPRO Competency Framework (INPRO CF). Results: The primary result is the INPRO CF that is readable, accurate, applicable, and accepted. It contains five domains, 17 competencies, and 200 learning outcomes or behaviors. It exists in four languages (Dutch, Finnish, English, German). Discussion: The INPRO CF is a relevant interprofessional competency framework designed to alleviate deficiencies between education and practice so it is suitable for a lifelong learning process. It demonstrates adaptability across various contexts. Implications for Practice The INPRO Competency Framework provides a structured overview of the learning journey in becoming an experienced interprofessional collaborator and is applicable in both practice and educational settings. The INPRO Competency Framework provides a comprehensive understanding of goals that an individual in a team can work on and structures those that it would like to achieve. The INPRO Competency Framework has the potential to positively impact person centered care by promoting collaboration among health and social care professionals. It simultaneously can contributes to transforming education by shaping curricula and preparing students for interprofessional teamwork in their future careers.

The case for interprofessional learning and collaborative practice in graduate medical education.

IntroductionEnhancing clinical outcomes and patient satisfaction can be achieved through interprofessional collaboration between physicians and nurses. Conversely, a lack of nurse-physician interprofessional collaboration compromises patient safety, care, and improvement, and creates moral discomfort for healthcare professionals. Studies indicate that failures in interprofessional collaboration between nurses and physicians lead to adverse medical events, including hospital-acquired infections, medication administration errors, and unnecessary health-related costs.ObjectiveThis systematic review and meta-analysis aimed to investigate the pooled proportions of the interprofessional collaborations towards patient care and associated factors among nurses and physicians in Ethiopia, 2024.MethodsA comprehensive search was conducted to find articles on interprofessional collaboration towards patient care and associated factors among nurses and physicians in Ethiopia. The study included cross-sectional studies conducted in Ethiopia and published in English from inception up to August 20, 2024. Excluded were conference proceedings, qualitative research, commentaries, editorial letters, case reports, case series, and monthly and annual police reports. The search encompassed full-text publications written in English and databases such as PubMed/MEDLINE, African Journals Online (AJOL), Semantic Scholar, Google Scholar, and Google. A checklist from the Joanna Briggs Institute (JBI) was used to evaluate the quality of the studies. Two independent reviewers performed data extraction, critical appraisal, and article screening. Statistical analysis was performed using STATA-17 software. A random-effects model was employed to estimate pooled proportions, and effect sizes with 95% confidence intervals were used to analyze determinants of interprofessional collaboration in patient care among nurses and physicians. Funnel plots and Egger’s test were used to examine the possibility of publication bias (p-value < 0.10), and the trim-and-fill method by Duval and Tweedie was applied to adjust for publication bias.ResultsFive studies with a total of 1686 study participants that are conducted in three Ethiopian regions and meet the inclusion criteria were reviewed and pooled for this evaluation. The pooled proportions of the interprofessional collaboration towards patient care in Ethiopia is 52.73% (95% CI = 44.66, 60.79%, I2 = 91.5%). Factors such as attitude (favorable attitude towards collaboration) (OR = 1.13, 95% CI: 0.13, 9.89, I2 = 97.7%) and organizational support (satisfaction towards organizational support) (OR = 0.38, 95% CI: 0.07, 2.10, I2 = 97.5%) were not significantly associated with interprofessional collaboration towards patient care.ConclusionIn summary, this systematic review and meta-analysis reveal that interprofessional collaboration between nurses and physicians in Ethiopia is moderately common, with a pooled proportion of 52.73%. This finding underscores the need for ongoing efforts to enhance collaborative practices to further improve patient care outcomes. Additionally, the review identified two potential contributors to interprofessional collaboration: satisfaction with organizational support and favorable attitudes towards collaboration. However, the pooled effects of these factors did not show a significant association with interprofessional collaboration. This highlights the necessity for further primary research to identify additional factors that may influence interprofessional collaboration and enhance patient care outcomes. Notable limitations of this study include significant variation among studies, a small number of studies, a focus solely on public hospitals, restriction to English-language publications, only observational studies, and limited access to databases such as EMBASE, CINAHL, and Web of Science.RegistrationThis systematic review and meta-analysis was registered in Prospero with the registration ID and link as follows: CRD42024579370; https://www.crd.york.ac.uk/prospero/#recordDetails.

Introduction: At present progress in the health, the sector requires health workers to provide professional services. The patient's problem is also increasingly complex. Health workers are required to work in an integrated manner, therefore good collaboration and collaboration between healthcare professionals is needed in realizing patient satisfaction. Health services in hospitals are carried out by various health professionals. Effective interprofessional collaboration practices are key to providing health services. The management of the patient's health and all actions must be patient-focused. The model of providing care with interprofessional collaboration is very important so that all services are coordinated and there is good communication between caregivers. This study aims to find out about the effect of implementing interprofessional collaboration on patients. Methods: This research is a literature review. The research source was taken from several databases, with the keywords "Interprofessional collaboration, patient safety, health services". The Google Scholar database was found in 15,455 journals, EBSCO found 32, NCBI found 98, MEDLINE 23, and ProQuest 61. From the total database, only 11 met the inclusion criteria. Results: This meta-analysis shows that interprofessional collaboration has a positive impact. There are several benefits obtained from the application of interprofessional collaboration, namely affecting patient safety, patient quality of life, reducing the risk of falls, preventing medication errors, increasing the patient's functional status. elderly patients. Conclusion: Interprofessional collaboration or Interprofessional Collaboration (IPC) is collaboration between people with different professional backgrounds and working together to solve patient health problems and realize professional health services that focus on patients.Keywords: health services, interprofessional collaboration (ipc), patient safety

This study examines how patient care is developed in meetings between students of occupational therapy, physiotherapy, nursing and medicine who are allowed to shape their own interprofessional collaboration. We conduct a thematic interpretative analysis of audio recordings and observations from the meetings and informal talks with the students. The analysis draws on traditions in sociocultural learning theory that deal with interaction on something in common between actors with different knowledge bases and the consequences of this interaction. The analysis showed that the students developed collaboration in patient care by sharing, assessing and determining professional knowledge of patients’ health conditions collectively. In conclusion, we argue that the students learned to use a multiprofessional knowledge base in the design of patient treatment when they were given responsibility to create the collaboration themselves. This demonstrates that students can be encouraged to independently develop professional collaboration in patient care within interprofessional education. Corrected and republished 22.12.2019.

It is expected that, by 2050, there will be 83.7 million adults aged 65 and older in the United States1 and 1.6 billion world-wide.2 Already there exists an unrecognized crisis in dementia and mental health care for this rapidly growing population.3 Further, the workforce with expertise in aging, dementia, and mental health/substance use (MH/SU) continues to decline, contributing to health disparities.3 As noted by both the Institute of Medicine (IOM)4 and the World Health Organization (WHO),5 interprofessional teams can play an important role in the improvement of population health outcomes for older adults. Interprofessional teams are not new to geriatrics and gerontology.6 Over the past decade, emerging strategies and models of care for interprofessional education and collaboration have built on foundations laid by several organizations.4 For example, the WHO generated the widely accepted definition and framework for interprofessional education and collaboration.5 For over 50 years, the IOM4,7–8 has supported interprofessional education and collaboration and raised awareness of workforce needs for older adults with MH/SU.3 The National Center for Interprofessional Practice and Education9 has partnered with the Robert Wood Johnson Foundation,10 the Josiah Macy Jr. Foundation,9 the John A. Hartford Foundation,9,11 and the Gordon and Betty Moore Foundation,9 to further the work of the Geriatric Interdisciplinary Team Training and Geriatric Interdisciplinary Teams in Practice programs.6,9,11 The Partnership for Health and Aging (PHA)12 developed competencies for geriatrics and gerontology. Finally, the PHA and the American Geriatrics Society13 published a position statement to support team training. Yet, despite longstanding and broad support for interprofessional education and collaboration in the care of older adults, physical and mental health disparities persist. In this supplement, Farrell et al.14 recommend a unified effort to integrate geriatric and gerontology competencies, content and principles into interprofessional curricula that are aligned with objectives for health systems science.15 Those objectives aim to transform curricula to improve population health, team-based care, high-value care, leadership, quality improvement, patient safety and health policy.15 Farrell et al.14 posit that an intentional, systematic approach by health science educators, health care systems leaders and clinicians is essential to advancing innovation for positive outcomes around aging, dementia and MH/SU. Guided by the Interprofessional Learning Continuum (IPLC) model4 (see Farrell et al.,14 Figure 1), this Commentary reinforces and extends the Farrell et al.14 recommendations by highlighting national and international innovations in interprofessional geriatrics and gerontology, especially related to dementia and mental health. The comprehensive IPLC model grew out of recognition in the IOM’s “Measuring the Impact of Interprofessional Education on Collaborative Practice and Patient Outcomes”4 that curriculum reform and collaborative practice redesign are prerequisite to improving health and system outcomes.16 In that context, this Commentary provides a discussion of curriculum reform, collaborative practice redesign and their linkages to health and systems outcomes15,16 and concludes with a brief global perspective17 on interprofessional education and practice as they relate to aging, dementia and MH/SU in older adults. Innovation exemplars in interprofessional education aim to challenge and stimulate leadership in interprofessional geriatrics and gerontology.

This paper is a report of a study to examine nursing emotion work and interprofessional collaboration in order to understand and improve collaborative nursing practice. Nursing standards identify collaborative practice as necessary for quality patient care yet many nurses are often reluctant to participate in interprofessional teams. Strategies intended to improve participation often fail which suggests that the factors underpinning nurses' disinclination towards interprofessional collaboration have yet to be understood. The concept of emotion work has not been applied to nursing interprofessionalism, and holds the potential to improve collaborative practice. Nursing emotion work is defined as the management of the emotions of self and others in order to improve patient care. Qualitative data were collected in 2006 using non-participant observation, shadowing and semi-structured interviews with nursing, medical and allied professionals in the general internal medicine wards of three hospitals in urban Canada. Nurses' collaborations with other professionals are influenced by emotion work considerations. The establishment and maintenance of a nursing esprit de corps, corridor conflicts with physicians, and the failure of the interdisciplinary team to acknowledge the importance of nursing's core caring values are important factors underpinning nurses' interprofessional disengagement. Longstanding emotion work issues must be addressed before nurses will engage collaboratively. We suggest improving nursing collaboration through the refining of holistic nursing information, and reflections on practice by all interprofessional team members.

Background: Inter-professional collaboration (IPC) among the health care team in critical care units is essential for delivering high-quality and safe care for patients and getting the desired health care outcome for patients. In Critical Care Units (ICU and CCU), an IPC approach comprises cooperation, coordination, and partnership among healthcare specialists from different disciplines to deliver thorough and patient-centred care to critically ill patients. Objective: Determining the level of IPC among health care team members in ICUs and CCUs. Methods: A descriptive cross-sectional design that targeted (n = 364) nurses, physicians, and clinical pharmacists in ICUs and CCUs, The Assessment of Interprofessional Team Collaboration Scale II (AITCS-II), was employed in this study. Results: The IPC level among health care team members in ICUs and CCUs was substandard. The partnership domain was weak with a mean score (MS) of 2.31, cooperation was moderate with a MS of 2.51, and coordination was weak with a MS of 2.17. The overall ICP was poor with a MS of 2.33. Conclusion: As hypothesised, the overall IPC covering all three main domains (partnership, cooperation, and coordination) among health care team members in critical care units is substandard. It is imperative for Iraqi nursing colleges to prioritise educating their students on inter-professional collaboration and its significance in delivering quality patient care. Instilling a clear understanding of their roles in healthcare among students is vital to cultivating a culture of teamwork and its advantageous outcomes for both patients and healthcare teams. Nurses should engage in specialised workshops that focus on professional collaboration within healthcare settings to reinforce and build upon their academic knowledge of their crucial role(s). This may help in improving their inter-professional teamwork, leading to better patient care.

Interprofessional Collaboration in the Perianesthesia Setting