INTER-PROFESSIONAL COLLABORATIVE PRACTICE: OPPORTUNITIES AND CHALLENGES

Prof. Achir Yani S. Hamid, MN, DNSc

Professor in Mental Health Psychiatric Nursing at Universitas Indonesia

Steering Board Member of AINEC

“It is no longer enough for health

workers to be professional. In the

current global climate, health workers

also need to be inter-professional“

(WHO, 2010, p.36)

How can they work together if they

don’t learn together?

Complicated Health Challenges Demand

Changing of Health Professions

Move from traditional inward-looking, reactive culture to outward-looking, proactive culture

Shift from profession-centred to patient-centred culture

Blurring professional boundaries

Changes in law re scope of practice/responsibilities

Increased expectations of interprofessional collaboration in education and practice

Focus on evidence-informed practice

Increasing demands for accountability/transparency

Internationalization

4 Foundations Patient Care

PATIENT- CENTRED

CARE

HOSPITAL RISK

MANAGEMENT

• Medical Care • Nursing Care • Nutrition Care • Pharmacy Care

“Safety is a

fundamental

principle of patient

care and a critical

component of

Quality

Management.”

(World Alliance for Patient Safety,

Forward Programme, WHO, 2004)

(PELAYANAN FOKUS PASIEN)

(Nico A Lumenta & Adib A Yahya, 2012)

Patient Care Standard:

Main Mission of Hospital is Patient Service/Care….

EBP VBP

Ethics

Patient’s needs

•Quality •Patient Safety

Inter-Professional Teams

An interprofessional team is made up of members of different professions and positions

Individuals bring to the team the specialised knowledge, skills, methods and attitudes of their disciplines

Members integrate their observations, bodies of expertise and spheres of decision making to coordinate, collaborate, and communicate to optimise client care

Three Types of Professional Competencies

(Barr, 1998)

Common Competencies

Inter-Professional Collaborative

Compatencies

Individual

Professional

Competencies

Inter-professional Collaborative Practice

Competency Domains

Values/

Ethics

Roles/

responsibilities

Inter-professional Communication Teamwork

Collaborative Skills for Teamwork

Cooperation

Assertiveness

Responsibility

Communication

Autonomy

Coordination

Challenges for Inter-Professional

Collaborative Practice

Differences in history and

cultural contextual

Historical interprofessional

and intraprofessional

rivalries

Differences in language and

jargon

Differences in professional

routines

Varying levels of preparation, qualifications

and status

Fears of diluted professional

identity

Opportunities of Collaborative Practice

It Empowers Team Members

It Closes Communication

Gaps

It Enables Comprehensive

Patient Care

It Minimizes Readmission

Rates

It Promotes a Team Mentality/

Moral

It Promotes Patient-

Centered Care

Benefits of Inter-Professional Education and

Collaborative Practice

Improved patient care &

safety

Improved outcome of

chronic patient

Reduced clinical error

Increased patients’

satisfaction

Better compliance to

therapy

Lessons Learned from IPE-CP

Development at Universitas Indonesia

Teamwork and collaboration of healthcare team

Inter-professional Education Module Development

at Universitas Indonesia

Divided into 2 parts: first, at the preclinical stage; second, at the clinical/profession stage

Specific competency: collaboration and teamwork to improve healthcare service through collaborative approach

Module developed by inter-professional team of teachers from 5 faculties in health sciences (Medicine, Nursing, Dentistry, Pharmacy and Public Health)

Interprofesional Education Collaborative (IPEC) Expert Panel (2011). Core

competencies for interprofessional collaborative practice:

Report of an expert panel. Washington, DC. Interprofessional Education

Collaborative. Canadian Interprofessional Health Collaborative. A National

Interprofessional Competency Framework. February 2010.

Universitas Indonesia Canada IPEC

Group dynamic Interprofessional

communication

Inter-professional

communication practices

Concept of collaboration

and healthcare system

Patient/client/fam ily/

communitycentred care

Roles and responsibilities

Conflict management Role clarification Values and ethics

Interprofessional

communication & leadership

Team functioning Inter-professional teamwork

& team based practice

Roles of each profession

Collaborative leadership

Barriers and strategy for

interprofessional

collaboration

Inter-professional conflict

resolution

Shared Competencies by All Professions

at Universitas Indonesia

Basic Biomedical Sciences

Health Research Methodology

Ethics & Law in Health

Health Communication

Disaster Management

Teamwork and collaboration of healthcare

team module (IPE)

Teaching methods

Collaborative learning

Team based learning

Case based learning

Presentation

Group work/project

Assessment system

Self-reflection

Performance (participation)

in group – checklist

Report on the group project

Written examination

(knowledge testing)

The module manages around 800 – 900 students from five schools

Clinical IPE-CP modules at Universitas Indonesia

Implemented since academic year 2015/2016

Community based approach (learning and working in the

community)

Focusing in health promotion and prevention

Students form an inter-professional team

Supervised by faculty members and clinical staff from the

Health District Office

In collaboration with Depok Health District Office and

Jakarta Health District Office

Assessment is conducted through observation, self-

reflection and report (poster)

REFLECTING ON THE IPE-CP EXPERIENCES IN INDONESIA

Lessons learned & actions for improvement

Environmental scan of IPE

implementation in Indonesia

Various models of IPE in different

schools/universities exist

Do we need to have a national

standard of IPE?

How can Indonesia formulate its

own IPE model that fits into local

context?

Establishing IPE core

competencies

REFLECTING ON THE IPE EXPERIENCES IN INDONESIA

Lessons learned & actions for improvement

Differences between professions:

culture, jargon, etc

How can we make it as an

opportunity, not seeing it as barrier?

Introducing IPE as early as possible

to prevent stereotyping

Providing as many opportunities as

possible for different students to

work and learn together (and also

for teachers!)

REFLECTING ON THE IPE EXPERIENCES IN INDONESIA

Lessons learned & actions for improvement

Between IPE and IPC (inter-professional collaboration) in healthcare services, which one is first?

Improving clinical staff awareness on IPE

Establishing a system to support collaboration and teamwork in healthcare (in hospitals and primary care centres)

Role modelling by teachers, clinical staff

REFLECTING ON THE IPE EXPERIENCES IN INDONESIA

Lessons learned & actions for improvement

How to ensure that IPE -CP really has an impact on

behavioural change?

Study the impact of IPE-CP to healthcare

services; how we measure it?

Roadmap of IPE-CP development and research

should be established

Government support: research funding, travel

grants, incentive for collaboration?

Interprofessional practice is reaching

out beyond the team