Interprofessional Collaboration

Interprofessional education and collaboration are essential to promoting health care utilization that results in safe, effective, quality and equitable care in an evolving health care arena in the United States. The purpose of this essay is to evaluate the evolution of interprofessional education (IPE) and collaboration, and characteristics of interprofessional collaboration (IPC). Additionally, an analysis of how IPC can impact patient safety and quality of care, along with implementation facilitators, barriers and sustainability will be discussed. Finally, opportunities for utilization of IPE and IPC in an organization with DNP-prepared APRNs will be explored.
The evolution of IPE and IPC originated with the first conference of the Institute

of Medicine (IOM) where there were discussions of how multiple disciplines in health care could improve interprofessional education (Interprofessional Education Collaborative Expert Panel [IPEC Report], 2011). The first report was published in 1972, stating the need for interprofessional education however; the second report was not published until 2003 (McNeal, 2013). In 2009, the American Association of Colleges of Nursing, American Association of Colleges of Osteopathic Medicine, American Association of Colleges of Pharmacy, American Association of Medical Colleges, American Dental Education Association and the Association of Schools of Public Health began to collaborate and formed the Interprofessional Educational Collaborative (IPEC) (McNeal, 2013, p. 69). The 2003 key processes of communication, cooperation, coordination and collaboration in teamwork were enhanced in 2011 with four competency domains including: values/ethics for interprofessional practice, roles/responsibilities, interprofessional communication, and teams and teamwork (IPEC Report, 2011, p. 16). These domains provide the framework for educational institutions to implement interprofessional collaboration coursework into the curricula. While the idea of IPE is around forty-five years old, some may conclude that the practice and implementation of IPE is still in its infancy. According to a Cochrane Review of IPE and the effects on professional practice, IPE would benefit with increased standardization to effectively evaluate healthcare outcomes (Reeves, Perrier, Goldman, Freeth, & Zwarenstein, 2016). However, IPE is the foundation for IPC implementation in the workforce.
IPC has specific characteristics that can be utilized by DNP prepared APRNs.

These characteristics consist of clinical competence, interpersonal competence and communication skills, social awareness, trust, mutual respect, and humor (Chism, 2016, p. 51-52). These characteristics can be implemented strategically to ensure desired outcomes are achieved. Clinical competence in nursing would promote intraprofessional cohesion that results in a unified professional approach to health care. Professional scope of practice must be maintained to build trust within a profession and between professions. Interpersonal competence and communication skills are essential characteristics to ensure professionalism when implementing policy changes, incorporating evidence-based practice and ensuring equitable use of health care resources. Social awareness, trust, mutual respect and humor are building blocks of effective communication skills. Being mindful of the differences between professions through social awareness builds mutual respect for professions that can result in increased trust between professions. Humor is an effective tool to decrease tension and stress, as well as build a bridge to achieve collective goals (Chism, 2016, p.

51-52).
IPC is essential to promote patient safety and quality of care to ensure that obstacles in health care can be navigated efficiently to increase access to care and decrease health care disparities (Chism, 2016, p. 40). A DNP graduate must be proficient in IPC to actively participate and incorporate “practice models, peer review, practice guidelines, health policy, standards of care, and/or other scholarly products, lead interprofessional teams in the analysis of complex practice and organizational issues and employ consultative leadership skills with intraprofessional and interprofessional teams to create change in health care and complex healthcare delivery systems” (American Association of Colleges of Nursing [AACN], 2006b, p. 15). Effective communication within the nursing profession is the first step in ensuring patient safety. Intraprofessional relationships support the nursing profession by individuals being responsible for understanding and implementing skill sets in each role of nursing – from a nursing assistant to a DNP prepared practitioner. Building credibility in a profession promotes IPC by increasing mutual respect with other professionals (Chism, 2016). Mutual respect functions to encourage honest, open, non-punitive communication between professionals that results in increased patient safety and satisfaction. Effective implementation of evidence-based practice results in increased patient safety by evaluating and implementing practices that have shown to promote good outcomes. Policy changes in practice, especially in scope of practice for APRNs, would increase access to health care and decrease mortality and morbidity in the US (Lathrop & Hodnicki, 2014). Effective communication within a health care facility, especially during transition of care between professionals, is required to ensure patient safety and quality care.
IPC in the facility where treatment of patients with substance use disorder (SUD) hinges upon effective, confidential communication. The implementation of electronic health record (EHR) facilitates IPC within the author’s practice and organizational system. One record allows access to specific parts to ensure patient confidentiality, while allowing access to crucial information that has been obtained from medical assistants, APRNs, counselors, and physicians. Each patient record has information that is shared to appropriate providers to ensure patient safety and compliance is enhanced. When issues arise regarding dosages, for example, IPC is utilized to have a conference with patient, counselor, APRN and/or physician. This model is patient-centered to enhance patient compliance with treatment regimen. Facilitators to IPC in this setting focus around providers ensuring patient involvement, assessing personal bias, providing non-judgmental care and ensuring safety and privacy.
Barriers to implementing and sustaining IPC include physician perspectives of nursing professionals. The nursing profession has generally recognized and respected the medical profession, however, some studies have revealed that some physicians do not recognize or have mutual respect for the role of nursing professionals (Matziou et al., 2014). Mutual respect is a requirement to promote and implement IPC in every health care setting. This is particularly important in the treatment of SUD, as patient safety and compliance. Another barrier to IPE and IPC includes a limited amount of data that can objectively evaluate the effectiveness of these practices (Reeves et al., 2011). Removal of barriers for IPE and IPC by creating standardized criteria in educational and research institutions would enhance the implementation of IPE and IPC in the health care field.
IPE and IPC opportunities in the current setting of treating SUD include assessing knowledge base of health care providers, evaluating current best practice through evidence-based practice, implementing policy to promote utilization of APRNs to the fullest capacity and prepare for potential changes in scope of practice.

Leadership skills developed in a DNP program equips APRNs to be a role model through articulating goals of IPE and IPC to promote patient safety, increased quality of care and decrease stigma associated with the disease of addiction (Chism, 2016). Recognizing educational deficits and facilitating increased awareness of addiction through the use of concise, fact based information tools can promote understanding of the disease of addiction, treatment modalities and risks associated with overdose after receiving treatment. The nursing profession is especially equipped to promote IPE and IPC through leadership by example because nurses have historically had increased exposure to direct patient care that leads to development of trust between health care provider and patients. These skills can be enhanced to promote IPE and IPC with other professionals by promoting policy changes to recognize the full capacity and recognition of the nursing profession within the terminal degree of a

DNP.