Interprofessional, Interdisciplinary, or Multidisciplinary?

As a longtime researcher in interprofessional collaborative care and deputy editor-in-chief of the Journal of Interprofessional Care, I was dismayed by the imprecise use of language in the article by Colbenson et al.1 The title says “interprofessional,” the first sentence of the abstract says “interdisciplinary,” and the abstract also uses the word “multidisciplinary.” These words have different meanings and are not interchangeable. The first implies collaborative interactions, the second is often used by physicians to imply physicians with different specialties interacting (eg, oncologist and pathologist), and the third simply means that persons from different professions are in the same space per- haps working in parallel, perhaps sequentially. Another term the authors use, “ICU [intensive care unit] teams,” may or may not actually be working as teams, but the terms are not defined. The theme “interdisciplinary dynamics” is really about multidisciplinary interactions and is minimally described. If nurses feel devalued and not involved in decision-making, the dynamics are not interprofessional or even interdisciplinary.

Evaluation of an Interprofessional Academic-Practice Partnership in End of Life Care

Introduction: The purpose of this mixed-methods study was to evaluate an interprofessional academic-practice partnership in end of life care by examining patient medication outcomes, the contributions of student pharmacists and a pharmacy preceptor to care teams, and student learning experiences. Methods: Retrospective chart review assessed polypharmacy differences in hospice patients with a primary terminal diagnosis of non-Alzheimer’s dementia between two patient groups; Group 1 managed on interprofessional care teams within the pharmacy partnership, and Group 2, managed on teams without a pharmacist. Team members who interacted with student pharmacists and the pharmacy preceptor participated in semi-structured key informant interviews to document perceptions of pharmacy contributions to care teams and the organization. At the end of their APPE, students completed reflective writings regarding their learning. Results: Patients in Group 1 were on statistically significant fewer medications than Group 2 at both week 4 and weeks 7-12 following admission. Five conceptual themes emerged from interviews: pharmacists as team medication experts, improved patient outcomes, interprofessional collaboration, patient/caregiver trust in medication regimens, and desire for sustainability. Student reflections included the following learning themes: teamwork, respect, value, and patient-centered care. Conclusions: The addition of a pharmacist on interprofessional care teams decreased the average number of medications in the non-Alzheimer’s end of life patient population. Team members identified value-added contributions of student pharmacists and the pharmacy preceptor that enhanced team efficiency and patient care. Student pharmacists recognized these contributions and the experience served as an exemplar of interprofessional practice.

Learning to swallow together: Medical and speech and language therapy student interprofessional learning about dysphagia

BACKGROUND: Interprofessional education (IPE) is considered to be a necessary step in preparing the healthcare workforce for collaborative patient care. Dysphagia, a complex health condition, requires collaboration between disciplines such as medicine (MED) and speech and language therapy (SLT). Therefore, both disciplines must have a shared understanding of dysphagia management within the context of interprofessional care. OBJECTIVE: This study investigated MED and SLT students’ shared learning about dysphagia management following an IPE workshop. The student experience of IPE was also explored. METHODS: Fifty students participated in one 3-hour classroom-based IPE dysphagia workshop which was appraised through a questionnaire completed immediately before and following the workshop. Within- and Between-Group analysis evaluated change in knowledge about dysphagia management. Comments related to student learning experiences were examined using a qualitative description approach. RESULTS: 98%of students (24 MED; 25 SLT) completed pre- and post-workshop questionnaires. Wilcoxon Signed-Rank tests indicated statistically significant post-workshop growth in knowledge of symptoms (p < 0.001) and medical conditions (p < 0.001) related to dysphagia. Students reported increased confidence in their ability to identify dysphagia (p < 0.001). Greater understanding of interprofessional roles was observed post-workshop, notably nursing (p < 0.05), pharmacy (p < 0.05), occupational therapy (p < 0.05) and physiotherapy (p < 0.001). While recognised as beneficial to shared learning and appreciation of different discipline perspectives, both cohorts found IPE challenging. CONCLUSIONS: Classroom-based IPE is an appropriate approach for shared learning about complex health conditions which require interprofessional care. Including patient-facing activities would further enhance student learning. While students found IPE challenging, they identified several benefits related to their professional development.

Digital health needs for implementing high-quality primary care: recommendations from the National Academies of Sciences, Engineering, and Medicine

A National Academies of Sciences, Engineering, and Medicine committee developed a plan to implement high-quality primary care. One of the 5 key objectives was designing information technology that serves the patient, family, and interprofessional care team. The committee defined high-quality primary care as the provision of whole person, integrated, accessible, and equitable healthcare by interprofessional teams who are accountable for addressing most of an individual’s health across settings and through sustained relationships. The committee recommended 2 essential actions for digital health. The first action is developing the next phase of digital health certification standards that support relationship-based, continuous, person-centered care; simplify user experience; ensure equitable access; and hold vendors accountable. Second, the committee recommended adopting a comprehensive aggregate patient data system usable by any certified digital health tool. This article reviews primary care’s digital health needs and describes successful digital health for primary care.

Patients’ Experiences of Interprofessional Care: A Narrative Inquiry

Interprofessional care (IPC) has been discussed in the literature as having the ability to lower health care expenditures, decrease wait times, enhance patient health outcomes and increase healthcare provider satisfaction with care-delivery. To date, limited research has been conducted to develop an in depth understanding of patients’ experiences receiving IPC. Using Connelly and Clandinin’s Narrative Inquiry qualitative research approach, three participants were interviewed and asked to engage in a metaphor selection drawing exercise. Participants were invited to describe how they experienced IPC and whether or not they believe person-centered care was delivered to them. Collected stories were analyzed as per Narrative Inquiry approach of three dimensional space: temporality, sociality and place. The National Canadian Interprofessional Competency Framework provided the theoretical lens through which the stories were examined. Along with giving voice to patients, three narrative threads emerged within this study: communication, patient within interprofessional team and interprofessional team members.

Patients’ Experiences of Interprofessional Care: A Narrative Inquiry

Interprofessional care (IPC) has been discussed in the literature as having the ability to lower health care expenditures, decrease wait times, enhance patient health outcomes and increase healthcare provider satisfaction with care-delivery. To date, limited research has been conducted to develop an in depth understanding of patients’ experiences receiving IPC. Using Connelly and Clandinin’s Narrative Inquiry qualitative research approach, three participants were interviewed and asked to engage in a metaphor selection drawing exercise. Participants were invited to describe how they experienced IPC and whether or not they believe person-centered care was delivered to them. Collected stories were analyzed as per Narrative Inquiry approach of three dimensional space: temporality, sociality and place. The National Canadian Interprofessional Competency Framework provided the theoretical lens through which the stories were examined. Along with giving voice to patients, three narrative threads emerged within this study: communication, patient within interprofessional team and interprofessional team members.