ArticleSpecial issue: Quality and safety educationPromoting interprofessional education
Section snippets
Introduction/overview
Elsewhere in this issue of Nursing Outlook, the quality and safety competencies required by nurses to practice in the current healthcare environment are described.1 One of the key competencies is teamwork and collaboration. The work of the Institute of Medicine (IOM) and others has clearly demonstrated that when healthcare professionals understand each others’ roles and are able to communicate and work together effectively, patients are more likely to receive safe, quality care.2
Evidence
Definition
According to the Cochrane Collaboration:
“An IPE intervention occurs when members of more than one health and/or social care profession learn interactively together, for the explicit purpose of improving interprofessional collaboration and/or the health/well-being of patients/clients. Interactive learning requires active learner participation and active exchange between learners from different professions.”10
Individuals and organizations may use different titles to describe IPE. The Centre for
History of interprofessional education initiatives
Over the past 20 years, there has been growing interest in IPE in the United States. This interest parallels the emergence of research that has suggested that collaborative relationships among health care providers positively affect patient, family, and provider outcomes. Knaus and colleagues15 were among the first to find that the existence of collaborative relationships among nurses and physicians was associated with a decrease in mortality in Intensive Care Unit (ICU) patients. Subsequently,
Evidence of impact of IPE
Collaboration among health care professionals has been associated with delivering high quality safe patient care.27 It is reasonable to conclude that learning together may facilitate collaboration and professionals working together effectively. Carlisle and colleagues6 found that learning collaboration and teamwork as part of professional socialization in formal education programs was more effective than on-the-job skill acquisition.
Zwarenstein and colleagues10 published a Cochrane review “to
Interprofessional education strategies
Numerous approaches to IPE have been described in the literature. Strategies that have been found to be effective include students from ≥ 2 disciplines working together on problem-based learning; case studies that are patient-focused; and jointly learning clinical skills such as physical assessment and the use of electronic health documentation systems.35 An effective approach that facilitates interprofessional learning is a common clinical experience—having common patients, projects, and
Essential features of full engagement in interprofessional education
Although individuals and organizations are becoming increasingly involved in promoting or implementing IPE, it is important to recognize that there is a continuum of engagement in IPE which can range from asking students to read about the roles of other professionals, to a fully integrated, co-created curriculum that embeds and models the philosophy of IPE in everything it does. The authors of this article propose 6 criteria that reflect full engagement by an organization in IPE (Table 1).
Next steps
For nursing faculty interested in learning more about IPE or beginning active engagement, several strategies are suggested for getting started. First, explore if your organization has initiatives currently underway related to IPE, or whether the organization is part of a larger collaborative that promotes IPE. Second, connect with a colleague or colleagues in another health profession to identify exploratory steps that could be undertaken with a small group of committed individuals. One
Research imperatives
As noted earlier, research demonstrating a positive association between IPE and teamwork and collaboration in the work environment is in its early stages. The impact of IPE is not yet fully understood and merits further study. We do know that lack of teamwork and collaboration in the practice setting leads to error and decreased quality of care.27 It stands to reason that learning these skills in formal pre- and post-licensure programs will increase the possibility that graduates will be
Summary
Teamwork and collaboration among professions are vital factors in safe and effective health care. The concept of IPE did not originate among faculty in the health professions. It was formulated by bedside clinicians facing complex patient care situations.38 Despite the fact that patient safety outcomes are increasingly determined by how well teams function under pressure, few health science schools include teamwork training in their curricula.39 To improve patient safety efforts at the bedside
Jane H. Barnsteiner is a Professor of Pediatric Nursing at University of Pennsylvania School of Nursing, and a Director of Nursing Translational Research at Hospital of the University of Pennsylvania, Philadelphia, PA.
References (40)
- et al.
Quality and safety education for nurses
Nurs Out
(2007) - et al.
Operating room teamwork among physicians and nurses: Teamwork in the eye of the beholder
J Am Coll Surg
(2006) - et al.
Interprofessional capability: A developing framework for interprofessional education
Nurse Educ Pract
(2005) Health Professions Education: A bridge to quality
(2003)- et al.
Perceptions of collaborative practice between Navy nurses and physicians in the ICU setting
Am J Crit Care
(1994) Nurse-physician relationships: Impact on nurse satisfaction and retention
Am J Nurs
(2002)- et al.
“Do none of you talk to each other?”The challenges facing the implementation of interprofessional care
Med Teach
(2004) - et al.
Working across the boundaries of health professions disciplines in education, research and service: The University of Washington experience
Acad Med
(2006) - et al.
Hierarchies of evidence and hierarchies of education: Reflections on a multiprofessional education initiative
Learn Health Soc Care
(2004) - et al.
Effective interprofessional education: Argument, assumption & evidence
(2005)
Interprofessional education: effects on professional practice and health care outcomes
Cochrane Database of Systematic Reviews
Interprofessional education in health and social care in the United Kingdom: Report of a CAIPE survey
Interprofessional collaboration and interprofessional education
Br J Gen Pract
An evaluation of outcomes from intensive care in major medical centers
Ann of Int Med
The association between interdisciplinary collaboration and patient outcomes in medical intensive care
Heart Lung
Association between nurse-physician collaboration and patient outcomes in three intensive care units
Crit Care Med
Effect of a collaborative weaning plan on patient outcome in the critical care setting
Crit Care Med
Enhancing collaborative communication of nurse and physician leadership in two intensive care units
J Nurs Adm
Effect of a multidisciplinary intervention on communication and collaboration among physicians and nurses
Am J Crit Care
Cited by (0)
Jane H. Barnsteiner is a Professor of Pediatric Nursing at University of Pennsylvania School of Nursing, and a Director of Nursing Translational Research at Hospital of the University of Pennsylvania, Philadelphia, PA.
Joanne M. Disch is a Professor and Director, Katharine J Densford International Center for Nursing Leadership and a Katherine R and C Walton Lillehei Chair in Nursing Leadership at University of Minnesota School of Nursing, Minneapolis, MN.
Leslie Hall is an Associate Professor of Clinical Internal Medicine at University of Missouri-Columbia.
David Mayer is an Associate Professor of Anesthesiology and Assistant Dean for Curriculum at University of Illinois at Chicago College of Medicine.
Shirley Moore is an Edward J and Louise Mellen Professor of Nursing, Frances Payne Bolton School of Nursing at Case Western Reserve University, Cleveland, OH.