Building Capacity for Interprofessional Collaborative Practice: The Interprofessional Collaborative Learning Series

Christie Newton; Victoria Wood; and Louise Nasmith

Overview

Drivers for change

Development of an IP-PD program: the IP-CLS

Pilot Implementation and Evaluation

Moving Forward

Esther Winckler

In March 2000 Esther Winckler entered Chilliwack General Hospital for an elective hip surgery. A 77 year old grandmother in good health except for osteoarthritis of the hip. She was on no medications and was considered an excellent surgical candidate. She died three days post operatively. The inquiry identified medical error through a failure of communication as the cause of untimely death.

Why Learning to Collaborate Matters?

“In health care a report of 2,000 critical incidents showed that 70% to 80% of medical errors are due

to interpersonal interaction issues” 

Williamson et al 1993

Drivers for Change

Our healthcare system, rooted in a uni-disciplinary approach to practice, no longer meets the needs of our patients.

The patients and the system have become too complex for ‘old’ practice patterns to be effective.

Interprofessional collaborative patient centred practice offers a practical framework within which the numerous health professions can interact with each other in order to provide the optimal quality of care.

Why Learning to Collaborate Matters?

IP-CLS Development

IP-CLS

Stakeholder

involvement

Institute for Health Improvement Model

for Improvement

Needs assessment findings

BC Competency Framework for

Interprofessional Collaboration

IP-CLS Goal

Advance participants’ understanding and ability to lead fellow colleagues in the art and science of working collaboratively for patient-

centred care

The IP-CLS Model

Train-the-Trainer

Strengths of the Model

Context Relevant

Facilitates Change

Patient-Centred

Train-the-Trainer Approach

Pilot and Evaluation of the Model

Southlake Regional Health Centre, Newmarket, Ontario (April 2009-May 2010)

Pilot Evaluation

35 clinical educators and practice leaders

Professions: medicine, nursing, physical therapy, occupational therapy, dietetics, pharmacy, audiology, speech language pathology, laboratory medicine, interventional radiology, and human kinetics

Retrospective pre- and post-participation self-assessment Asked to rate how often they felt they demonstrated the knowledge, skills and

behaviours described in the BC competency framework using a 5-point Likert Scale

Focus group explored: What they found beneficial about the IP-CLS; Suggestions for improvement; Changes in themselves, their practices and within the organization that resulted

from the learning series; and The future of interprofessional collaborative practice across the organization.

Overall Findings

The frequency with which participants felt they demonstrated each competency increased after their participation in the learning series.

Influenced by how often they felt they demonstrated each competencyprior to participation

Specific Findings

Prior to participation in the learning series, most participants felt they ‘almost always’ or ‘always’ demonstrated competencies related to general collaboration, which are also relevant to uni-disciplinary practice

Specific Findings

Only 50% of participants felt they demonstrated competencies more specific to interprofessional collaboration ‘almost always’ or ‘always’ prior to participation

After taking part in the learning series, 90% of participants felt they ‘almost always’ or always demonstrated these more specific competencies

Specific Findings

Skill based interprofessional competencies (role negotiation, conflict management, team facilitation,…) improved in the post-test.

However, not as much as the collaborative practice knowledge based competencies (role definitions, scopes of practice, patient-centred care).

Program Findings

Elements of the series that people particularly liked were:

The learning tools provided, which they subsequently used with their colleagues and students;

The use of role plays and case scenarios to drive the learning; and

The session on shared decision-making.

Conclusion

Has the potential to build capacity for interprofessional collaborative practice

Promotes interprofessional competencies allowing participants to incorporate elements of interprofessional collaboration into practice

Creates leaders for interprofessional collaborative practice that are able to model it to colleagues and students on placement and thereby serve as change agents within the practice context

Moving Forward

IP-CLS content is being implemented in the health authorities across British Columbia, and there is ongoing evaluation.

Challenges with the logistics of 7 sessions have resulted in modifying the delivery IPC on the Run

www.chd.ubc.ca