Reflection on Promoting Collaboration in Nursing

Collaboration

Collaboration is stepping stone for the success of any team or organization, especially in health care. Collaboration is achieved among the group through sharing, trusting each other, having respect to each other in a group, having a common goal, working towards the common goal, through the exchange of knowledge, skills, and ideas (Campaign for Action, 2015). In health care collaboration is essential to achieve a common goal of providing safe, adequate, quality care to the patient promptly to prevent unavoidable damage to the patient and to increase productivity to the organization.

Multidisciplinary collaboration effects on clinical decision making

Working together, teamwork, coordination and collaboration are essential for clinical decision making and for providing safe effective care, for reduction of errors in medical field, to improve health outcomes, to reduce length of stay in hospitals, for reducing costs, to enhance patient satisfaction, to provide a safe and excellent care (Babiker et al. 2014). All these goals are as a result of a team effort, it is not possible by a person, so collaboration and coordination of team are important (Morley, Cashell, 2017). Collaboration helps to improve team satisfaction such satisfaction among health care personnel such as doctors, nurses, office staff etc., Studies have shown that results of interdisciplinary collaboration are positive and so it is vital to have multidisciplinary collaboration among the team (Mahdizadeh, Heydari, and Moonaghi, 2015). The factors that can contribute to multidisciplinary collaboration are the structure of an organization such as roles of personnel, environment, the influence of environment, social factors and culture, communication. So, it is important to consider these factors when planning for the establishment of clinical institutes. Multidisciplinary teams help to share evidenced-based practices among professionals, increases the decision making and help in the innovation of practices. Multidisciplinary collaboration promotes efficiency, responsiveness and involves family, and community along with patient which in turn leads to improved care. Multidisciplinary partnership helps to provide more education to the patient and participation in their care, in turn, can lead to safe, effective care. Where there are a collaborative culture and safety, there staff satisfaction and retention more, staff are more involved in what they do, and absenteeism can be less and turnover for the organization is more, in turn, can benefit the patient as well as an organization (Morley, Cashell, 2017). For example, an interdisciplinary team plays an essential role in the patient discharge process and brings a good outcome.

The ways of collaboration that can lead to improved patient outcomes

Collaboration helps to improve patient outcomes by removing barriers to miscommunication, by resolving conflicts and by improving coordination among health care personnel to coordinate care (Vega & Bernard, 2016). For example, Medical errors that are caused by lack of communication and coordination among health care professionals removed by collaboration. Collaboration helps to improve efficiency and quality of providing patient care. Medical errors and adverse events can be minimized or avoided by collaboration which in turn leads to safe and improved patient outcomes. For example, nurse communication about patient fall risk in end of shift report helps to prevent falls. Communication through medication reconciliation on discharge helps to avoid errors and helps for continuity of care at different levels. Collaboration helps to improve patient outcomes and lead to new successful innovations (Campaign for Action, 2015). As nurses spend more time with the patient, communication of patient needs to providers help to meet patient needs sooner and improved outcomes. For example, Provider prescribes therapy and nurse administer and monitor it, and if the nurse does not communicate with a physician if any adverse events because of treatment, then no modifications are done in treatment, then it can delay the outcome or length of stay.

The lack of collaboration can lead to poor patient outcomes

Lack of communication can lead to poor patient outcomes, and it is dangerous to patient health, leads to unavoidable injury, length of stay in hospitals, increased financial costs, dissatisfaction in the patient and family, negative perception of hospital stays and loss of life etc. (Herm-Barabasz, 2015). For example, lack of collaboration can lead to a lack of connection in care and inadequate care. To avoid these poor outcomes interprofessional and intra-professional communication is vital in healthcare.

The barriers to professional collaboration among healthcare professionals and patients

The obstacles to professional cooperation between healthcare professionals and patients are reimbursement issues, lack of communication among specialists and patients to coordinate care and culture of healthcare, lack of shared decision making, lack of common goal or lack of action towards common goal, lack of coordination, lack of respect at each other, lack of cooperation,  lack of trust, lack of autonomy, assertiveness, and lack of motivation etc., (Vega and Bernard, 2016; Herm-Barabasz, 2015; Campaign for Action, 2015; and Morley and Cashell, 2017). Some of the examples are lack of communication between nurses, physical therapist, physicians, case managers etc., and unable to identify professionals each other. Reimbursement issues such as unable to build the time spent on the collaboration of care.

The five best ways to promote professional collaboration in pediatric primary care

The means to foster professional collaboration in pediatric primary care according to the American Academy of Pediatrics (2018) and Babiker et al. (2014), are as follows:

Clearly defined roles and responsibilities of personnel in a pediatric primary care setting

Providing a culture of trust among caregivers and patients and parents, family members and community

Respectful and empathetic open communication among professionals as well as with patient

Establishing clear, realistic and specific procedures and policies for referrals and follow up the process for patients

The common goal towards safe, effective, and quality care delivery among health care professional and patient

Strong leadership, appreciation of diversity, and harmonious decision making

Problem-focused solution solving and ongoing evaluation towards goal achievement and additional care management support if needed

The ways the nurse practitioner encourage and support collaboration among the patient, family, caregivers and healthcare professionals

The nurse practitioner helps and promotes collaboration among the patient, family, caregivers and healthcare professionals by following ways:

As nurse practitioners emerged from nursing background, they know communication, coordination, formulation of common goal, working to towards that goal, involving all healthcare personnel including patient in their care is essential to provide safe, exceptional care, to prevent medical errors, to ensure the best satisfaction, to reduce length of stay and to meet the patient goals. Nurse Practitioners know what works for the patient and what does not work, so by communicating that information to other members of the health care team, they can encourage and support collaboration among the group (Campaign for Action, 2015). In Patient-centered care, collaboration is essential for success (Vega and Bernard, 2016).  By doing bedside rounding nurse practitioners can involve other team members as well as patient in formulating goals, can sharing plan of care and encourage them to participate in delivering extraordinary care to the patient (Herm-Barabasz, 2015). Bedside rounds also improve patient satisfaction and safety and as a result improved outcome. By participating and promoting the interprofessional and intraprofessional communication nurse practitioner can encourage and support collaboration. The nurse practitioner can act as the liaison between physicians and other health care team, can guide the patient in self-care to be independent and self-sufficient in various stages of a recovery period. Collaboration is essential to promote care across different health care settings. By having effective communication and good teamwork, knowledge and skills, by educating patients and other members of the health care team, by being as a role model in doing all the activities nurse practitioner can encourage and support collaboration among the patient, family, caregivers, and health care professionals.

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As a future Nurse Practitioner, I believe it is vital for me to know what the collaboration, importance, barriers, benefits, advantages and disadvantages are and how to promote collaboration, my role in collaboration and how patient, health team members and organization get benefitted by collaboration.

References

• American Academy of Pediatrics. (2018). Team based care in primary care pediatric office. Retrieved from https://www.aap.org/en-us/professional-resources/practice-transformation/implementation-Guide/pages/Team-Based-Care.aspx
• Babiker, A., Husseini, M., Nemri, A. A., Frayh, A.A., Juryyan, N. A., Faki, M.O … Zamil, F.A. (2014). Health care professional development: Working as a team to improve patient care. Sudanese Journal of Pediatrics, 14(2): 9-16. Retrieved from https://www.ncbi.nlm.nih.gov/pmc4949805/
• Campaign for Action. (2015). Fostering interprofessional collaboration in health care. Retrieved from https://campaignforaction.org/fostering-interprofessional-collaboration-healthcare/
• Herm-Barabasz, R. M. (2015). Intraprofessional nursing communication and collaboration: APN-RN-Patient bedside rounding. Retrieved from https://digitalscholarship.unlv.edu/cgi/viewcontent.cgi?referer=&httpsredir= 1&article=3364&context=thesesdissertations
• Mahdizadeh, M., Heydari, A., Moonaghi, H. K. (2015). Clinical Interdisciplinary collaboration models and frameworks from similarities to differences: A systematic review. Global Journal of Health Science, 7(6): 170-180. Doi: 10. 5539.gjhs. v7n6p170. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4803863/
• Morley, L., Cashell, A. (2017). Collaboration in healthcare. Journal of Medical Imaging and Radiation Sciences, 48: 207-216.  Retrieved from https://www.jmirs.org/article/s1939-8654(16)30117-5/pdf
• Vega, C.P., Bernard, A. (2016). Interpersonal collaboration to improve health care: An introduction. Retrieved from https://www.medscape.org/viewarticle/857823