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“Communication” & “Collaboration”: Just a couple of 13 letter words?

(With apologies to Bob Dylan)

John H.V. Gilbert, Ph.D., FCAHSProject Lead and Chair, Canadian Interprofessional Collaborative

Principal & Professor Emeritus, College of Health Disciplines, UBC

Canadian Partnerships for Progress in Health Human Resources

Ottawa October 9 2009

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Four MessagesWhy Collaboration is Tough

I. Communicating the “interprofesssional” wordII. Being interprofessional is being collaborative III. Impediments to IP collaboration for HHR changeIV. Collaboration IS communication: walking the walk,

talking the talk

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I. Communicating the “interprofesssional” word

It’s a definition not a sound bite• Learning With, From and About• For the purposes of collaboration.• To improve the quality of care

– Structure– Process – Outcome -> impact

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II. Being Interprofessional is Being CollaborativeA way of learning, practicing and caring

• Not the same old same old – me in my small corner and you in yours.

• Not 1:30 on alternate Fridays when it’s raining• About understanding the richness of interactions.

– Is your sentence the same as my sentence? – I suspect your tone of voice, – You’re moving body parts – I don’t believe you

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'You might very well think that; I couldn't possibly comment'.

Used by Francis Urquhart (Conservative Chief Whip) whenever he could not be seen to agree with a question, with the emphasis on either the 'I’, or the 'possibly’, depending on the situation.

(From the 1990 BBC series “House of Cards”)

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III. Impediments to IP collaboration for HHR change

• The unreality of ratios vs. the reality of population health• The confusion between health vs. education policies• The iron hand of accreditation• The ring-fence of Legislation and Regulation• The problem of too many languages.

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“You Just Don't Understand: Women and Men in Conversation”

(Deborah Tannen, 1990)

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Caught in a Web of WordsJones D, Mitchell A (2006). Lean thinking for the NHS. London: NHS Confederation.

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"I hear you, but I do not listen.”(Wim Duisenberg, President European Central Bank 1998-2003)

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IV. Collaboration IS communication: Walking the walk, talking the talk

For the things we have to learn before we can do them, we learn by doing them.

(Aristotle: Nicomachean Ethics)

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Collaboration in Practice & Collaborative Practice:A Testable Description

An interprofessional process for:

• communication and decision making that:• enables the separate and shared knowledge and skills

of different care providers to: • synergistically influence the care provided through

changed attitudes and behaviours.

(after Daniel Way, Linda Jones & Nick Busing, (May 18, 2000) “Family Doctors & Nurse Practitioners Delivering Shared Care” written for the Ontario College of Family Physicians)

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Collaborative Learning Environments“How They Brought the Good News from Ghent to Aix”

• Service organizations are learning organizations• The existing disciplinary protocols for practice learning• The tools that have been developed• The existing collaborative environments

– Mental health– Primary health care– Chronic disease clinics– Acute

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Collaborative Learning EnvironmentsJust don’t confuse the snake

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“Communication”? & “Collaboration”? 26 essential letters for HHR evolution

“Mr. Godot won’t come this evening, but surely tomorrow” “Waiting for GodotSamuel Beckett)