Episode #5: Interprofessional Education and Interprofessional Collaborative Practice: Why isn’t it sustainable?

Interprofessional Education and Interprofessional Collaborative Practice: Why isn’t it sustainable?

Introduction to Episode

Both of us have spent a good portion of our careers developing and helping organizations implement tools, processes and infrastructures that support interprofessional education and collaborative practice.  As you might guess this is a topic that is near and dear to our hearts. 

The Institute of Medicine (IOM) reports, To Err is Human:  Building a Safer Health System (1999); Crossing the Quality Chasm: A New Health System for the 21st Century (2001) and Health Professions Education:  A Bridge to Quality (2003), served to heighten the awareness of concerns about safe, quality, cost-effective care within the United States healthcare system.  These reports also reinforced the need for interprofessional education (IPE) and interprofessional collaborative practice (ICP).  IPE and ICP represent an interdependent pair.  Both are necessary to prepare the future and the current workforce to work collaboratively.

More recent reports indicate the traditional cultures and practices in healthcare settings do not support ICP (Brandt, Kitto, & Cervero, in press) and those who have experienced IPE go into practice settings that do not support what they have learned.

Achieving the national goals of safe, quality, efficient, effective care will require a healthcare workforce prepared and supported to work collaboratively.  Managing the IPE and ICP polarity is key in achieving sustainable outcomes.  Leveraging strong partnering relationships between practice and education leaders may be one way to manage the IPE/ICP polarity and support current and future workforce preparation.  

Episode Summary Points:

·        Practice settings are not supporting sustainability of IPE

·        Gordian Knot as representation of interprofessional education and collaborative practice (IPECP) as

an intractable problem

·        Infinity loop is a representation of the ongoing tension between IPE and ICP

·        Positive outcomes from focusing on IPE and ICP

·        Negative consequences from over emphasizing IPE to the neglect of ICP

·        Negative consequences from over emphasizing ICP to the neglect of IPE

·        Interdependent relationship between IPE and ICP

·        IPE and ICP partnering relationships

·        Simultaneous action steps to strengthen IPE and ICP outcomes

·        IPE and ICP early warning signs of negative consequences

·        Greater purpose and deepest fear for leveraging the tension between IPE and ICP

·        Equal importance of IPE and ICP

·        Tension between IPE and ICP cannot be eliminated, it must be managed

·        Education and practice partnerships as essential to establishing shared responsibility 

Recommended Resources:

Brandt, B., Kitto, S., & Cervero, R. M.  Untying the Interprofessional Gordian Knot: The National Collaborative on Improving the Clinical Learning Environment 1-12. DOI: 10.1097/ACM.0000000000002313

 Brandt, B. (2015, March). Interprofessional education and collaborative practice:  Welcome to the "new" forty-year-old field.  The Advisor. Retrieved from https://nexusipe.org/resource-exchange/interprofessional-education-and-collaborative-practice-welcome-new-forty-year-old

Golom, F. D. & Schreck, J. S. (2018).  The journey to interprofessional collaborative practice.  Are we there yet?  Pediatric Clinical North America Journal, 65: 1–12 https://doi.org/10.1016/j.pcl.2017.08.017

Health Professions Accreditors Collaborative. (2019). Guidance on developing quality interprofessional education for the health professions. Chicago, IL: Health Professions Accreditors Collaborative.

Institute of Medicine (U.S.), Committee on Quality of Health Care in America (1999).  To err is human: Building a safer health system.  Washington, DC:  National Academy Press.

Institute of Medicine (U.S.), Committee on Quality of Health Care in America (2001). Crossing the quality chasm: A new health system for the 21st century.  Washington, DC:  National Academy Press.

Institute of Medicine (U.S.). Greiner, A. & Knebel, E. (2003). Health professions education:  A bridge to quality. Washington, DC: National Academy Press.

National Academies of Sciences, Engineering, and Medicine 2019. Strengthening the Connection Between Health Professions Education and Practice: Proceedings of a Joint Workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/25407.

Hendricks, S., LaMothe, V. J., Halstead, J. A., Taylor, J., Ofner, S., Chase, L.,  Dunscomb, J., Chael, A., & Priest, C. (2018). Fostering interprofessional collaborative practice in acute care through an academic-practice partnership, Journal of Interprofessional Care, 32(5):, 613-620, DOI: 10.1080/13561820.2018.1470498

To link to this article: https://doi.org/10.1080/13561820.2018.1470498

Weiss,  K. B., Passiment, M., Riordan, L., & Wagner, R. for the National Collaborative for Improving the Clinical Learning Environment IP-CLE Report Work Group. Achieving the Optimal Interprofessional Clinical Learning Environment: Proceedings from an NCICLE Symposium. http://ncicle.org. Published January 18, 2019. doi:10.33385/NCICLE.0002

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Tracy Christopherson