Why is IP important broadly?

As a healthcare system, my concern is that we don’t work efficiently and effectively. We’re not a machine that runs smoothly. One of the solutions to this fragmentation is IPE/IPC.

As a clinician I see this fragmentation within in teams but also at a larger level, I see it at healthcare organizations where there is lack of interprofessional practice.  We continue to see power struggles among professions and I’m still not sure everyone is on the same page about the definitions of IPE/IPC.  This speaks to the challenge of having so many perspectives on one issue around health and the person.  We then have issues of funding and what goes on at the government level, both within provincial ministries and the federal level.  Ministries don’t really talk to each other so you have a lack of collaboration here too. The work we do hits so many different domains. I think we must work collaboratively to address these broad ranging and very complex issues because fundamentally they matter and are important to address.

Why is IP important for you? Personal experiences as a patient and/or practitioner?

During my undergraduate years I was first exposed to IPC (not IPE). I was interested in helping the homeless and the mentally ill so I joined a group addressing the needs of this underserved population. I worked with students from a variety of disciplines (Occupational Therapy, Midwifery, Medicine, and Physiotherapy). We would come together, all focused on the same-shared desire to help this segment of the population.  This really opened my eyes because it was the first time I was with other disciplines, learning what perspectives they had and learning about how they approached these complex health needs.

Even though I’d been fortunate enough to have the experience described here, I didn’t, as noted, have an IPE component to base my thinking on. When I started work as an RN I still had some questions about what other disciplines did and how we fit together as part of a team. I knew I had roles that were delegated to me but I still really didn’t know how we painted the picture together. When I started doing my MScN, as I was working as an RN, I was able to see the educational side as well. I had one foot in theory and one still in practice so I could marry them in my mind.  Added to this was that the hospital I was working at was going through an amalgamation process and I saw that we didn’t have a common team vision or model of practice to base our work. In my student role, I also found myself socializing with people of other disciplines, learning about them as people and learning about their provider perspectives as well.  I think this dual focus really helped to cement my focus on IPC and IPE.

Examples from your life when IP worked (maybe a personal experience as a patient or with a family member)?

In my current job we had a case come up about the use of restraints. There was definite disagreement amongst the team about the use of restraints, what restraint meant and whether or not the patient even required restraint.  One discipline sought out literature on the subject that she brought back to the team, another team member, a nurse, brought to the table their expertise that included a number of safety issues. Yet another team member felt that she was not being heard at all and that we were simply ignoring her perspective.  It was my job to mediate this very difficult and conflict driven situation. I set up a meeting with all team members whereby we could all listen to and hear the other perspective. It was an emotional meeting but ultimately a good one because we were able to voice the benefits and risks of the restraints while at the same time coming up with a creative solution that worked for the patient as well. If I were to use a single word to describe the process it would be synergy. What was also interesting was that in my follow up I went back to a few of the people with whom I felt there was perhaps some residual tension (while the meeting was good it was, as noted, emotional and an emotional situation can very often leave some leftover feelings that should be resolved). In those follow up conversations we were really able to work through anything that was leftover. I now have a fantastic relationship with those involved in this case and I think it’s primarily because of this approach.  The approach solidified teamwork, emphasized creative solutions and respect.  This was a really important experience for me as a clinician.

Examples from your life when you wish you had seen more IP in action?

I think it’s really important to have all members of the team present. I say this as I’m thinking back about an exercise I did some time ago when those of participating were coming up with a model of care. We thought we had the physician group represented but we were wrong.  As I look back on it I realize that we didn’t have all the right stakeholders and those who were there, were not engaged in the right way. We all have a different perspective and a different way of viewing health and that means we learn differently as well. Power Points and discussion don’t always work and you can’t always get folks in the same room at the same time so you have to be creative. In this particular case, we didn’t engage the physician group well enough. When it came time to implement our model of care, they didn’t want to move forward.   I understand now that it was because we didn’t properly engage them using creative methods that were more cognizant of the different ways in which each discipline approaches health.

What song best carries the IP spirit?

The one I’m thinking of is from Sesame Street. It’s their cooperation video, it’s called “Cooperation Makes it Happen”.  In the song they teach about cooperation by demonstrating the teamwork involved to build a street garden, something that can be appreciated by all. To me, this is a metaphor for what we do every day.  Check out the video! http://www.youtube.com/watch?v=anNcJilRNNM

What fictional character is a good IP role model?

Captain Planet whose purpose is to protect planet Earth. I think he’s a good IP role model because he’s not only a leader but he also brings people together.  In fact, this superhero is summoned by the “powers combined” of the entire team (also known as the “Planeteers”). The Planeteers and Captain Planet symbolize that together these individuals are stronger and are more effective than as independent individuals.  His messaging at the end of every show is “The Power is Yours” which to me represents that each of us bring something special to this world and that he alone is not the solution.

 What food best represents IP?

I’d say a lasagne.  There are many essential pieces that go into it. You just can’t have pasta and sauce, otherwise it’s not lasagne. You need the meat and/or veggies and sauce to layer just right to bring it all together into something unique.  I see it as a dish that combines individual pieces and brings the together as something cohesive and wonderful.   The cheese is sort of like the leader, because it binds the whole dish together.

Where would you like CIHC to be in 5 years?

I’d like to see a few things happen.  First, I think the CIHC should take a stronger focus on those on the front lines.  I think the work that’s been done to date is fantastic and builds a great foundation (the research the curriculum work etc), but now I think it’s time now to have an organization that devotes effort and energy into bringing front line staff to conferences to talk through real solutions.   I’ve been to many conferences and I see that it’s not the front line people who are there. Without a more grass-roots level of involvement there is little chance for implementation. I’d love to see the CIHC be a champion of this type of grass-roots movement.  I’d also love to see the CIHC leading focus groups with these same front-liners to really understand what’s required to implement IPC.  I also think it would be great for the CIHC to bridge the gap between the academic and the practice world. It would be a mistake to swing the pendulum too far from the academic, but by the same token there is a gap that exists between those in academia and those in practice. There could be real strength in bridging these relationships and I see that the CIHC could pay a role here too.   I’m focusing here on a more community type approach for the CIHC that goes back to the practice world with academic support.  I also think that we need to get policymakers talking about primary healthcare and prevention and I think we need to focus more on patient groups. We need their voice at these tables. This is the type of work I would love to see the CIHC take on.

This meeting was held as a part of our growing local group of #HCSMCA (Healthcare Social Media Canada) participants.

It should be noted that this meeting happened during game 5 of the Vancouver Canucks vs San Jose Sharks playoff series. The game that Vancouver would eventually win to put themselves into the Stanley Cup final for the first time in 17 years!

But that didn’t deter our core group of health care / social media advocates!

Daniel Hooker presented his thoughts on how important it is for healthcare professionals to be active participants in the digital space. Check out his presentation. It is excellent and thought provoking.

Background:

Introduced at UBC in the 1980’s, the Health Care Team Challenge (HCTC) provides teams of health sciences students (10-12 students in total who may be volunteers but who also may be appointed by faculty members) from different disciplines an opportunity to learn from with and about each other in developing and presenting a patient care management plan. The case is given to the students just a few days prior to the Challenge. As new developments in the case are revealed the two teams will be challenged, individually and as a team, to demonstrate best practices in patient care and the effectiveness of interprofessional collaboration in a clinical setting.  The challenge occurs over a one hour period in front of an open audience of peers, faculty and community members (often totalling over 400 people).

A committee, chaired by Dr. Christie Newton since 2005, meets monthly starting in February or March to develop the challenge for October. The committee is comprised of representatives of each of the disciplines who are brought together under the umbrella of the UBC College of Health Disciplines (a list of disciplines can be found here: http://www.chd.ubc.ca/about/structure#fifteen ).

The primary goal of the challenge is to encourage students to learn about different disciplines and how to work with them as part of the healthcare team for the benefit of patient care. For some students, this is the first time they have worked with other health sciences students. 

2010 HCTC, updates and thoughts from Dr. Christie Newton:

What do you enjoy most about the HCTC?

I have so much fun doing the HCTC. I love it. The students have great energy and every year it’s a new group of people. Over the years I have seen students go on and write IP newsletters, develop CP clubs and one group even established a student run IP clinic.  It’s great to see how these students evolve and so it’s fun to nurture these champions of IP. I absolutely believe that students are the change agents we need. They have the energy, time and totally different perspective than those of us who have been around for a long time.  

How has the HCTC evolved over the years?

Over the past few years we have tried to focus it more on what it is we’re trying to demonstrate by doing the challenge. For example, we’re trying to show students how much the patient can gain by having healthcare professionals work together. We’ve also tried to bring this to the audience by providing materials to them such as the CIHC National Competency Framework.  When the HCTC was first developed the questions were quite clinical (the planning committee still ensures that the content is relevant to students). As it stands now we’re not judging on right or wrong answers to the questions. What we’re looking for is how they work as a team. We also bring in general concepts to care like ethics and cultural competence.  It’s been an evolutionary process and one we think has really helped to focus the HCTC on the big picture.

What recent developments can you share with us?

We’ve just received a Canadian Institutes of Health Research (CIHR) grant of $25,000 to organize an international meeting of all HCTC champions. We’re organizing this with colleagues from Australia, Japan, the US and across Canada.  The goal is to develop a research agenda for all of these HCTC’s to see what the impact of participating is on practice (i.e. does participation impact how students practice). There will also be a national HCTC at the National Health Science Students’ Association (NaHSSA) in March. The goal is to have teams from universities across the country participate.