During transitions of care, great opportunity exists for miscommunication, poor care coordination, adverse events, medication errors and unnecessary healthcare utilization costing billions of dollars annually. An Interprofessional Transitions of Care (IPTC) clinic was developed utilizing a Family Medicine team that included physicians, nurses, a clinical social worker, and a clinical pharmacist. The purpose of this study was to determine if utilization of an IPTC clinic prevented hospital readmission, and to identify factors that predict most benefit from an interprofessional approach to transitions of care. A retrospective chart review of 1,001 patients was completed. A treatment group (TG) of 501 patients were offered IPTC clinic appointments following hospital discharge. A control group (CG) of 500 patients were hospitalized and received traditional follow-up prior to development of the IPTC clinic. Traditional follow-up typically consisted of an automated appointment reminder and a physician office visit. Outcomes assessed included 30-day hospital readmission of TG versus CG, and whether patient characteristics predisposed specific patient groups to attend IPTC appointments or benefit more from IPTC participation. Compared with CG, patients who completed an IPTC appointment were 48% less likely to be readmitted to the hospital within 30 days. Patients with congestive heart failure and cellulitis particularly benefited from IPTC. Telephone contact within two business days of discharge was the greatest predictor of patients attending an IPTC appointment. These results demonstrate that an interprofessional approach to transitions in care effectively addresses this high risk for error and high cost time in the continuum of care.

This thesis portrays a research study undertaken to explore the unknown concept of electronic interprofessional documentation. Academic literature largely centers on multidisciplinary electronic documentation yet clinicians provide care using an integrated interprofessional model. Current design of electronic health records (EHRs) continue to propagate a deluge of data resulting from disparate siloed documentation. End users report challenges with finding data. Additionally, care planning and decision making are delayed. To bridge the gap between electronic design and interprofessional delivery of care, more understanding of shared documentation is required. The provenance of the design of this study is based on the concept of common ground and the framework for complex diverse data. Common ground is a shared communication space within a team with a shared purpose (Cioffi, Wilkes, Cummings, Warne, & Harrison, 2010). The framework for complex diverse data posits that data must be linked to other interconnected data; linked data enables connection of diverse pieces and insight-sharing within a team. A descriptive qualitative study was designed to answer the research question: What are the common data elements between disciplines? A case scenario of a patient with a fractured hip was created; participants generated clinical notes based on the video and patient record. The clinical notes were coded and results indicated numerous diverse common data elements. These were analyzed and major findings such as categories appropriate for use by all disciplines on admission and design implications for care planning throughout an acute care stay were identified. Further, as disciplines and care team members do have different documentation patterns, it is suggested attendance to differences in the entry of data yet maintaining a common ground in the display of patient information is vital. Finally suggestions such as duplicate checking for documentation through a common care plan that tracks assessments and completed interventions alongside planned interventions are made. Creation of a standardized interprofessional terminology is key in building the road leading to interprofessional electronic documentation. / Graduate

INTRODUCTION: Children’s Oral Health (OH) is a vital part of their general health. Since many OH problems begin during early childhood, prevention of these problems can be achieved through early and routine preventive dental care. The dental community alone cannot adequately address all oral health care needs. The establishment of an interprofessional oral health primary care workforce team can help provide holistic health care services that can improve children’s OH, particularly among under-served populations. OBJECTIVE: The aim of our study was to assess the effect of Interprofessional Education (IPE) on the level of OH knowledge among pediatricians, nurses, speech-language pathologists, nutritionists, and social workers. MATERIALS AND METHODS: Questionnaires assessing participants’ oral-health knowledge were collected from pediatricians, nurses, speech-language pathologists, nutritionists and social workers who are working or studying in Boston, Massachusetts. Pre-test questionnaires were used to evaluate baseline oral-health knowledge and attitude towards IPE. Post-test survey immediately after the IPE training and a follow-up survey after 6-12 months were used to evaluate immediate and long-term retention of knowledge. Pre-, post- and follow-up scores were assigned based on the participants’ responses. Univariate parametric analysis methods such as T-test and non-parametric tests such as Kruskal-Wallis and Wilcoxon rank-sum tests were used to assess retention of knowledge and attitude towards IPE. Fisher’s Exact test was used to evaluate differences in the number of high scores. Multiple linear regression models were used to adjust for potential confounders. Statistical significance was reported when p-value <0.05. RESULTS: Among the 557 participants, the immediate post-test scores showed significant improvement when compared to the baseline knowledge scores across different professions (p<0.01). The long-term follow-up scores was lower than the immediate post-test scores (statistical significance was not detected across all professions), however, still significantly higher when compared to the pre-test scores (p<0.01). Among all the participants, the attitude towards collaboration was high (100%). CONCLUSION: Our results highlight the need for collaboration between dental and non-dental healthcare workforce by incorporating IPE into existing curriculum to enhance the retention of knowledge and increase collaboration after graduation. Continuing education programs can significantly contribute towards long-term retention of knowledge. / 2022-07-29T00:00:00Z

Objective: To explore the role of interprofessional collaboration in the delivery of team-based tobacco dependence treatments within primary care. Methods: A narrative review of the literature was completed to examine FHT team functioning in Ontario, followed by a single, multi-site qualitative exploratory case study. Results: Interprofessional collaboration contributed to changes in tobacco dependence treatment through the initiation of system-wide change, cultivation of collective action, and supporting enhanced quality of smoking cessation care. Conclusion: Interprofessional collaboration can enhance the comprehensive delivery of evidence-based treatments for individuals trying to quit smoking. Supportive public policy, education for patients and providers, and evaluation research is needed to advance FHT functioning.

Class of 2012 Abstract / Specific Aims: To identify areas of commonality between the health profession curriculums on the University of Arizona campus, encompassing nursing, pharmacy, medicine, and public health. Methods: This descriptive, cross sectional study used a set of predetermined interprofessional education (IPE) topics including communication, professional ethics, quality assurance and patient safety, evidence based medicine, and public health to compare the core curricula of the colleges. Syllabi for each class were analyzed to determine which, if any, of the topics mentioned previously were covered, and if needed professors were contacted for clarification purposes on their lectures. Main Results: Each of the health professional colleges covers all 5 of the interprofessional topics studied. Evidence based medicine was the most covered IPE topic with 233.5 hours followed by communication (153.5 hours), public health (133.75 hours), quality assurance and patient safety (106.5 hours), and professional ethics (59 hours). Conclusions: The University of Arizona Health Sciences Campus is capable of developing an interprofessional curriculum based on the shared aims amongst the colleges. Although we were unable to identify a specific time slot that could be used to teach IPE curricula, we are able to recommend that an IPE course be implemented in the first professional year for all the colleges as this was the time in which all the colleges spent the most time teaching IPE topics.

Class of 2010 Abstract / OBJECTIVES: To determine how an interprofessional education (IPE) activity impacts students' attitudes toward interacting with other health professionals. METHODS: Students who are enrolled as first-­‐year students at the University of Arizona College of Pharmacy in the Fall 2009 semester were eligible for this study. Questionnaires administered during regularly scheduled classes collected levels of agreement with statements relating to working with other health professionals and the importance of IPE. Data on gender, years of undergraduate study, current degrees, type of work experience, and years of work experience were also collected. RESULTS: Questionnaires were completed by 93 students before the IPE activity and 66 students after the IPE activity. Overall, attitudes toward interprofessional learning and working with other healthcare professionals, reflected by student questionnaire ratings, were the same or worse after the IPE activity. CONCLUSIONS: Attitudes toward interprofessional learning and working with other healthcare professionals appeared to have no change or changed for the worse after the IPE activity that took place on September 3, 2009.

Background: South Africa is a diverse country in terms of its cultures, languages, socioeconomic variety and community beliefs and this is reflected in our health care setting. Communication is a critical feature of adequate medical care and an understanding of potential barriers to communication is important particularly in understanding under-resourced rural health care settings. The health community is comprised of different professionals who are required to communicate interdependently on a daily basis to ensure the best quality of care for their patients. Little research has been done on the role of interprofessional communication in a rural setting. Purpose: The aim of this research project is to describe and understand the influence of systemic and interpersonal factors on communication processes between health care professionals working in a rural hospital context. Method: The research study used a qualitative design and the application of social interaction theory, specifically Goffman’s framework was used to understand the phenomena studied. The study involved 52 health professionals and included: doctors, nurses, clinical associates, social workers, pharmacists, dieticians, physiotherapists, occupational therapists, speech and language therapists, audiologists and administrative staff. The data in this research were derived from ethnographic observations in the hospital, and focus groups and interviews with participants. Profession-specific vignettes were used during the focus groups to stimulate discussion. A SiSwati speaking research assistant helped with the collection of data and aided in translation and transcriptions. Data from the 52 interviews, 8 detailed xiv observations and 12 focus groups were analysed using thematic analysis. Findings: Numerous systemic and interpersonal themes were derived from the data. The study found that health care professionals felt isolation from both the wider medical community as well as the local community which influenced interprofessional communication. Systemic influences included the impact of the rural setting, changes in health systems (the proposed National Health Insurance scheme) and access to provincial support. Interpersonal themes included management, power, responsibility, handover, recognition of roles, blame, conflict and language issues. One of the most prominent interpersonal themes to emerge was the identity of the health care worker which was interlinked with their professional role, status, power, race, language and community identity. Participants’ thoughts about the way forward for the hospital also emerged. Conclusion & implications: Systemic and interpersonal factors do influence health care workers’ interprofessional communication. Social interaction theory explains some of the complex communication interactions but they do not account for important systemic influences. Goffman’s front and backstage is beneficial in identifying communication in a rural hospital however systemic and interpersonal categories were found to be more useful in this setting. The implications from this study are important for policy, theory and practice such as communication training programmes for rural healthcare teams as well as site specific models of training. Speech and language therapists are communication experts and therefore could be playing a greater role in the development of team communication.

by Chan Siu Shan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1991. / Bibliography: leaves [111-119]. / Chapter Chapter One --- Introduction --- p.1 / Chapter Chapter Two --- Literature Review and Theoretical Discussion --- p.6 / Chapter I. --- The Debate --- p.6 / Chapter II. --- Management-oriented Perspective of Organizational Research --- p.11 / Chapter III. --- The Implicit Model of Actor: Rational or Behavioristic --- p.20 / Chapter IV. --- Reapproaching From Work and Occupation --- p.23 / Chapter V . --- The Incorporat ion of Occupational Image as A Classification Scheme --- p.27 / Chapter VI. --- The Addition of Social Relation Approach --- p.31 / Chapter Chapter Three --- "Objectives, Hypotheses and Conceptualization of Variables" --- p.35 / Chapter Chapter Four --- Research Design --- p.50 / Chapter I. --- General Profile of the Research --- p.50 / Chapter A. --- Population --- p.50 / Chapter B. --- Sampling Method --- p.50 / Chapter C. --- Sample Size --- p.51 / Chapter D. --- Method of Data Collection --- p.51 / Chapter E. --- Response Rate and Representativeness of the Resaerch Result --- p.52 / Chapter F. --- Demographic Profile of Respondents --- p.53 / Chapter II. --- Operationalization of Variables --- p.54 / Chapter Chapter Five --- Findings --- p.66 / Chapter I. --- Regression Analysis I: The Comparison Among the Three Approaches --- p.68 / Chapter II. --- Regression Analysis II： Test of Conditional Hypotheses --- p.72 / Chapter Chapter Six --- "Summry, Theoretical Interpretation and Practical Implication" --- p.86 / Chapter I. --- Assertion of the Occupational Image as a Valid Conditional Variable in the Explanation of Organizational Commitment --- p.86 / Chapter II. --- Further Disscussion on the Implication of Organizational Commitment --- p.92 / Chapter III. --- Limitation and Suggestion for Further Study --- p.102 / Chapter Appendix --- The Chinese Version of Questionnaire / Bibliography / Source of Questionnaire

The need for nurses to be collaborative and practice-ready upon entering the profession has never been more important than it is today. The Institute of Medicine has identified that teamwork and collaboration should be essential parts of the nursing curriculum to prepare nurses to be ready to manage patient care with a team-based approach. The literature supports the idea that by learning out of silos and bringing students together from all different pre-professional programs, the professional working environment can be mirrored and the processes of collaboration and communication within teams can start. Transition into practice has been studied for decades regarding the “burnout” and “reality shock” that result from the experience. However, no literature has been uncovered that has investigated the nurses’ experiences of transitioning into practice after receiving an interprofessional education. The present study used Merleau-Ponty’s phenomenological perspective and vanManen’s phenomenological research method to illuminate the experiences of nurses transitioning into practice after having IPE. Ten practicing nurses who had received IPE were interviewed about their experiences transitioning into practice. Each participant shared stories about her transition period into professional practice. Through the process of reading and rereading transcripts, four essential themes emerged that shed light on the transition into practice after receiving IPE: (a) Understanding Team Dynamics, (b) Competent and Responsive Communicators, (c) Valuing Team Members, and (d) Recognized Self-Readiness. For this study, the lived experience of nurses who transitioned into practice after receiving an education with an IPE curriculum and practice is one of understanding team dynamics as competent and responsive communicators, valuing team members, and recognizing self-readiness. Interprofessional education does not have to occur only with students in nursing, medicine, or other allied health programs. Being creative with multiple programs at any institution can enrich students’ education by developing their communication and collaboration skills and adding quality and scope to their education experiences while preparing them for the real-world environment.

Interprofessional collaboration and collaborative patient and family-centered practice is increasingly advocated as a means of improving patient outcomes and the cost effectiveness of health care. The Canadian Interprofessional Health Collaborative and Registered Nurses Association of Ontario identified best practices and competencies required for interprofessional collaboration and collaborative practice. Despite the widespread dissemination of these competencies and best practice guidelines to health professional schools, there remains a gap in nursing practice regarding nursing knowledge about the core competencies required for interprofessional collaboration. The purpose of this project was the planning of an education program for nurses on interprofessional collaboration and collaborative care. At the project facility, the interprofessional practice team planned an education program for nursing staff to promote interprofessional collaborative practices and thereby improve patient and population health outcomes. The education project was guided by a model of instructional design used previously by the interprofessional practice department. The education program included a handout and a PowerPoint presentation describing the contents of the handout and clinical application of the competencies in nursing practice. The PowerPoint will be retained by the organization to present to nursing staff employed at the organization. Process evaluation included a team member questionnaire assessing leadership, participant involvement and meeting facilitation. Members of the interprofessional practice team agreed on the success of the process and involvement in the overall project. Increasing nursing knowledge about interprofessional collaboration and collaborative practices would represent positive social change to improve nursing practices and as a result, health outcomes for patients and their families.