Interprofessional relationship
A cultural shift in healthcare away from hierarchy and communication silos to a collaborative client centered model of interprofessional relationships
What is the goal of interprofessional collaboration?
improved health outcomes
Interprofessional collaboration
- is a process that occurs when professionals from different areas of expertise combine elements of respect, understanding and shared decision making to develop working relationships to maximize health-care delivery.
- collaboration begins with communicating - being aware of knowledge and skills of interprofessional team members.
- elements: respect, trust and shared decision making in order to promote safety and quality care.
National Interprofessional Competency Framework.
- integrative approach to describing the competencies required for effective interprofessional collaboration.
- six competency domains: knowledge, skills, attitudes and values that shape judgements.
- allows students and practitioners to learn and apply the competencies, no matter their level of skill or the type of practice.
- Role Clarification:
- understand your role and the roles of others.
- Important aspect of safe care
- Team functioning:
understand team dynamics and team work processes.
- interprofessional conflict resolution:
- engage with others in constructively addressing conflict/agreement.
- Recognize conflict is positive when handled appropriately.
- Collaborative leadership:
Shared decision making and shared leadership or shared collaboration on the most appropriate role to lead
- Pt/client/family/community centered care:
- the client is part of the inter-professional team.
- seek out and include the client as a valued member.
- interprofessional communication:
- established teamwork communication principles.
- actively listen to other team members
- communicate w/ all team members and ensure everyone has the same understanding
- develop trusting relationships
- use communication technology appropriately.
Barriers to team communication:
lack of info among members, hierarchy, differences, conflict, incivility, lack of respect.
I-SBAR-R
- a standard method for communicating critical and concise assessment information that requires attention and action. (Nurse report, shift change report).
- identity: who is calling and who are you calling about?
- situation: briefly state the problem, severity, and when occurred.
- Background: what is the clinical background or context?
- Assessment: what is the assessment? latest vital signs?
- Recommendation - what needs to be done? Repeat back any orders.
- Repeat back - repeat back any orders, clarify any questions.
Electronically Mediated Communication (EMC):
Communication between and among people through the medium of electronic devices and media. (e-mail, chat rooms, bulletin boards, cellphones, texting).
EMC vs. FtF
EMC:
- synchronous or asynchronous (time to compose a message; feedback is delayed.
- anonymity
- More open to misinterpretation and the potential for deception.
- non-verbal cues are different, rely heavily on words
- easier for more direct disclosure
- permanent, not private
- risk of confidentiality
FtF:
- obtain info from how people behave, react, and how they look.
- feedback is immediate
- non-verbal cues make up about 40% of FtF
- may be awkward to communicate honestly.
- more transparent nad accurate
Combining EMC and FtF
- EMC helps to escalate or maintain FtF relationships
- people use e-mail, messaging and cellphones to maintain contact w close friends.
- increases amount of communication you have w others
- social networks and support systems
- research has mixed results on whether EMC is positive or negative in relationships.
Online Conflict:
- dont hit send too quickly
- watch your online non-verbal behaviours
- disinhibition effect
- move to a different medium
- reread message and avoid assumptions
- avoid humor - may escalate
- paraphrase your understanding of the message
Communication considerations with the public:
- confidentiality and privacy (HIPPA)
- pt understanding of ehealth
- pt digital literacy
- cost for technology
- employment
The digital divide
- internet and email is not uniform across the population; digital divide speaks to socio-economic differences.
- other factors such as age, ethnicity and educational level have an influence on the uptake of e communication.
Hyperpersonal relationship:
EMC relationships that form and become more personal in less time than they would through FtF relationships.
Digital literacy:
- read the full story
- what are the sources - go to the original source
- who is the author?
who benefits? - helps a nurse support a pt by understanding this concept.
The business email
- subject line
- salutation
- body
- closing
- signature
