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
Patient Care Standard: Main Mission of Hospital is Patient Service/Care. HOSPITAL RISK MANAGEMENT PATIENT- CENTRED CARE (PELAYANAN FOKUS PASIEN) 4 Foundations Patient Care Medical Care Nursing Care Nutrition Care Pharmacy Care Patient s needs Ethics EBP VBP Quality Patient Safety (Nico A Lumenta & Adib A Yahya, 2012) Safety is a fundamental principle of patient care and a critical component of Quality Management. (World Alliance for Patient Safety, Forward Programme, WHO, 2004)
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 Individual Professional Competencies Inter- Professional Collaborative Compatencies
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 Concept of collaboration and healthcare system Interprofessional communication Patient/client/fam ily/ communitycentred care Inter-professional communication practices 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 Barriers and strategy for interprofessional collaboration Collaborative leadership 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, selfreflection 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
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