Interdisciplinary Care and Collaboration: Participate or Perish

By: Travis Baird, MS, NP, RN, CCRN

“Individual commitment to a group effort - that is what makes a team work, a company work, a society work, a civilization work.”

Vince Lombardi

The increasingly complex healthcare environment encourages active and dynamic collaboration among healthcare providers. With changes in the delivery of care and the introduction of the Affordable Care Act, many people will be able to afford insurance; this in turn will create opportunities for quality of care to be provided to millions of Americans who were previously uninsured. With reform, healthcare systems will compete to offer the best patient and family centered services, the most current medical innovations, and positive outcomes found on evidence-based practice. Reimbursement from government and insurance payments will rely on positive outcomes, transparency, and quality of care from healthcare systems. Achieving positive outcomes will depend on the dynamic, coordinated, and interdisciplinary efforts of its healthcare participants.        

Many organizations such as Kaiser Permanente and the Robert Wood Johnson foundation have been looking at ways to improve the communication and coordination of care among healthcare professionals, developing successful models of interdisciplinary collaborations that have gained admiration and support from the Institute of Medicine. Ideally, all healthcare systems should work in synchrony and provide care that is superb and patient centered. However, many healthcare professionals and some institutions continue to operate in virtually separate domains. An atmosphere of isolation and lack of communication continues, and is affecting efficient delivery of care for patients and their families. At the North Shore-LIJ -Heart and Vascular institute, the vision of the future emphasizes teamwork and collaboration in which, interdisciplinary teams work together to ensure that all our patients receive care that is individualized, coordinated, and tailored using the most innovative methods to achieve superior patient care results.

Cardiovascular services embody complex and often dynamic sub specialties designed to improve heart and vascular care and outcomes. The importance of working as a team is directly correlated to patient satisfaction and overall quality of care. Working together towards a common goal enhances better outcomes and increases patient and family satisfaction, and gives the provider, and allied healthcare team members the commitment and joy of performing at their best with each patient they touch.

How Can Nurses Become Full Partners in Interprofessional Collaboration?

Interprofessional collaboration is now considered one of the core competencies of any health profession education and practice. At the heart of the efforts to make the delivery of care collaborative is patient safety and quality of care, taking into consideration the patient’s preferences and their active participation. Nurses are expected to be full partners in this endeavor. The competency domains of interprofessional practice includes values/ethics for interprofessional practice, roles/responsibilities, interprofessional communication, and teams/teamwork (Interprofessional Education Collaborative [IPEC], 2011). It is beyond the scope of this blog to list all the possible roles that nurses can play in interprofessional collaboration but here are a few suggestions for bedside nurses:

·   Be an active participant during interdisciplinary rounds. Don’t just stand there. Share with the team the nursing perspective or the patient’s preferences during discussions.

·   Ask any team members who come to the bedside “what’s the plan for the patient?” This will promote collaboration and improve communication between various providers.

·   Participate in unit practice council or shared governance committees dealing with interprofessional issues. This will allow an active voice from front line staffers in designing and implementing quality improvement projects directed at improving interprofessional collaboration.

·   Explore patients’ preferences with regards to their care trajectories and empower them to be proactive in determining their choices. Refer the patient to the “Ask Me Three” website (https://npsf.site-ym.com/default.asp?page=askme3).

·   Stay up-to-date with your current knowledge of best practices and best evidence depending on your specialty. A knowledgeable nurse is better able to advocate for evidence-based care.

·   Organize an interprofessional event at your respective unit or have an on-going professional development event (e.g., monthly) led by various specialties.

·   Attend interprofessional conferences locally or nationally. This is a good opportunity to learn what others are doing and learn from their experiences.

·   Take on a leadership role in interprofessional committees. This will enhance professional parity of nurses among he various health professions.

These are just a few examples on how nurses can be a valuable team member and leader in making interprofessional collaboration a viable framework of care. The IPEC reminds us that “mutual respect and trust are foundational to effective interprofessional working

relationships for collaborative care delivery across the health professions. At the

same time, collaborative care honors the diversity that is reflected in the individual

expertise each profession brings to care delivery” (IPEC, 2011, p. 18). It is not enough to say we are working together, we must deliberately work interprofessionally.

About the Author: Travis Baird earned his Bachelors of Science in Nursing from Adelphi University and an MSN in Adult Geriatric Nurse Practitioner from Hunter College School of Nursing. He is ANCC certified adult geriatric primary care NP and a CCRN. Currently Travis is a Nurse Practitioner in Cardiology at the Wellness and Diagnostic center at New York Presbyterian Lower Manhattan hospital.