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The health care community is turning to interprofessional care teams to deliver the highest quality of care and increase quality outcomes. Through this model, a well-rounded team of clinical experts work from the same evidence-based playbook to collaborate on an effective treatment plan—caring for the patient in holistic way. A team of health care professionals from EBSCO Information Services (EBSCO), based in Ipswich, MA, explore this rising model and why it’s taking the health care community by storm.
Is there clear evidence that demonstrates how interprofessional health care collaboration leads to better outcomes?
Earlier this year the National Academies of Practice, an interprofessional organization dedicated to fostering collaboration and advocating policies in the best interest of individuals and communities, published a white paper examining the state of interprofessional collaborative practice. The paper included a review of the literature on the relationship between interprofessional practice and outcomes. More than 20 studies are summarized in the report. Overall, interprofessional collaborative practice involving different teams of health care professionals in a variety of settings and patient populations was associated with improved outcomes, including decreased length of stay and admission rates.
Describe how interprofessional health care supports the Quadruple Aim.
Outcome improvement has been a priority focus in all clinical professions for decades. National and international quality groups have taken leadership roles in support of health care improvement. The Institute for Healthcare Improvement (IHI) introduced the Triple Aim Framework in 2007 with the goal of improving the lives of patients.The Quadruple Aim, which is geared towards the well-being of clinicians, evolved from the Triple Aim, which is focused on patients.
No single clinical discipline working independently can meet the expectations of the Quadruple Aim. An interprofessional team, working in collaboration across the care continuum, provides the best hope in achieving the improvement outcomes associated with the Quadruple Aim components listed below.
Patient Experience of Care
Clinicians have a keen awareness of health system challenges and the reality of sometimes “missing the mark” in attempts to provide an exceptional patient experience. An interprofessional team, working to uncover the patient’s unique situation and health status, can effectively facilitate a shared plan focused on the patient’s individualized needs, thus enhancing the care experience.
Reducing Per Capita Costs
Health care spending continues to rise, especially in the United States, and there is consensus that the current level of spending is unsustainable, according to a recent JAMA study on health care spending. With the shift to value-based care, reimbursement models are now risk-based, causing hospitals and health systems to re-evaluate care models and associated costs for defined populations. Interprofessional strategies are also effective in value analysis, collaborating to evaluate research findings and make recommendations for supply utilization, pharmaceuticals, and other costs associated with care variation.
Population health challenges the health care system to base strategic decisions on an understanding of population needs and then structure services and care teams to serve those needs. Patients within the defined population deal with social determinants of health such as poverty, access to health care, educational level, and other environmental and personal factors impacting outcomes, according to a study in the American Journal of Public Health. Population health strategies require team-based care, community collaboration and integrated practice expertise in the provision of health services, chronic disease management, and culturally competent care.
Care team satisfaction is a predictor of patient satisfaction and clinician well-being is essential for safe, high-quality patient care. However, every discipline across all specialties and care settings are experiencing alarming rates of burnout and associated conditions such as depression, emotional exhaustion, and suicide rates that are two times higher than the general population. In 2017, the National Academy of Medicine launched the Action Collaborative on Clinician Well-Being and Resilience, a network of organizations committed to reversing trends in clinician burnout.
The Collaborative has three goals:
- Improve baseline understanding of challenges to clinician well-being
- Raise the visibility of clinician stress and burnout
- Elevate evidence-based, multidisciplinary solutions that will improve patient care by caring for the caregiver
By fostering a healthy culture of interprofessional teamwork, supporting joy in work, and decreasing burnout for all disciplines, organizations can improve the quality of care provided to patients.
What are some of the national interprofessional initiatives that support this model?
In addition to the National Academies of Practice, there are other national organizations focused on advancing interprofessional health care.
- The National Center for Interprofessional Practice and Education (IPE) was established in 2012 at the University of Minnesota. Funded by the Department of Health and Human Services, along with private foundations, the National Center serves as a coordinating body for the advancement of IPE and practice.
- The American Interprofessional Health Collaborative advocates for and advances the alignment of interprofessional educational programs, the importance of interprofessional health care delivery, and research programs that facilitate examining these education-practice linkages towards better outcomes for health and health care.
- The National Collaborative for Improving the Clinical Learning Environment (NCICLE) provides a forum for organizations committed to improving the educational experience and patient care outcomes within clinical learning environments, with an emphasis on learning in interprofessional teams.
What are the implications of interprofessional health care for nurses and nurse leaders?
Those engaged in the profession of nursing are in a unique position to assume a leadership role in advancing interprofessional education and practice. Nurses work in diverse positions of influence within health care systems, academic organizations, government agencies, and industry. Because of this broad influence, nurses have many avenues to get involved and have an impact including:
- Stay informed on recent interprofessional initiatives and advances
- Seek to understand interprofessional colleagues’ unique scope of practice to improve clarity, collaboration, and coordination of patient care
- Join interprofessional national/international groups and participate in initiatives
- Share interprofessional best practices with others through education, publication, and presentation
- Advocate for and implement interprofessional approaches through committee work, research, or policy/standards development
- Influence policymakers, businesses, and health system boards, advocating for the advancement of interprofessional education and practice
Most clinicians say they chose health care as a career to make a difference and give back to humanity. If nurses can individually commit to action, the profession can collectively make a significant contribution in advancing interprofessional education and practice.
Michelle Troseth is the Clinical Effectiveness Officer for EBSCO Health at EBSCO Information Services. In her various leadership roles in health systems and industry, Michelle has made significant contributions of applying evidence-based practice at the point of care by leveraging health information technology. She is a strong advocate for interprofessional care delivery that is inclusive of patients and families.
Eileen Yoshida is the Deputy Editor of Medication and Clinical Informatics for EBSCO Health at EBSCO Information Services. Eileen has extensive experience in clinical informatics, EHR implementation, health care consulting, and clinical pharmacy and is a published author and speaker on clinical decision support.
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