Interprofessional Practice: Healthcare - Essay Example

Inter-professional Practice - Heath care PART - I Compare practice in different disciplines and the concept of promotion and implementation of inter-professional working. Introduction Contemporary technology has been employed to enhance the quality of healthcare at the NHS, and lower its costs simultaneously. Geographical backdrop, clientele information as well as monetary aspects have fashioned the direction of health services. Proof of change emerges from the burgeoning functions of nurses and from the report about the Commission on Nursing, which incorporates a scheme on health changes, and these demand nurses as well as other healthcare experts to investigate modern channels in allocating elevated care for the sick, (Crossan, M., Lane, H.W., Hildebrand, T. 1993). The hypothesis of collaboration, in interdepartmental and multidisciplinary teamwork is pivotal to elevation in healthcare. To make sure that there is interdepartmental multi-disciplinary integration and evolution in medical care, the adoption of personal outcomes has been embraced in a bid to make certain that services are aligned to make an impact when it comes to meeting the needs of the patients. In this paper, we delve deep into the exposition of the progressive evolution within the healthcare framework. Contemporary reviews in addition to the varying legal structure have been highlighted. The importance of inter-agency as well as inter-departmental collaboration and their impact is also discussed (Crossan, M., Lane, H.W., Hildebrand, T. 1993). The Concept of Collaboration Many scholars have asserted that one of the central features of nurse leadership is integration of nursing with other healthcare facilities in the dissemination of patient care. Porter (1991), Henneman et al. (1995) and Blue and Fitzgerald (2002) agree that integration is an imperative hypothesis in nursing since it has been a solution to many intricacies inherent within the clinical domain. Porter (1991), Henneman et al. (1995), Henneman (1995), Opie (1997), Lindeke and Block (1998), Miers (1999), Davies (2000) and Blue and Fitzgerald (2002) concur on this point and highlight that collaboration is an important concept in nursing as it can provide a solution to many of the problems arising from rigid hierarchical traditions. This is because traditional management discourses and hierarchies within a workplace could prevent an employee from being part of the collaboration process regarding the care of a particular patient, (Freidson, E. 1988). This is how collaboration is central to the functional development of healthcare. Health initiatives like Rush et al.'s (2002) Documentary on Nursing Competencies and account on National taskforce of healthcare employees, have been championing the adoption of an integrated line of service for the dissemination of health care in the prospective future. In reference to the structures found in healthcare, nurses have been encouraged to integrate their respective disciplines to enhance association. Teamwork has been viewed as an important element in health care services. Instead of being mere objects of the system, the nursing fraternity is required to take advantage to strive to become subjects with reflective awareness by employing their novel assertiveness, knowledge and competence to engage in healthcare changes (Crossan, M., Lane, H.W., Hildebrand, T. 1993). Inter-departmental and multi-departmental integration have focused on the diverse backgrounds from which the practitioners have emerged. There exists a disparity between the two; Multi-departmental collaboration is a form of collaboration that defines affiliates of diverse departments who share patient statistics and also support private reviews. Inter-departmental collaboration is a deeper aspect of teamwork where associates of diverse departments take part in planning and prioritizing patient care by means of collective action, by pooling jointly their specialized information and expertise. Hall and Weaver (2001) observed that in the event of 1990s, in an attempt to curtail healthcare costs in Canada, structural alterations have pushed health care expertise to investigate their practices, (Nelson, R.E. 1989). Intricacies witnessed in patient care have prompted the demand for effective interdisciplinary collaboration, which could help minimize expenses by eliminating service replication and also by reducing redundant interceptions. Barr (1997) accounts that within a needs-led service the most significant procedure in determining the achievements of interdisciplinary collaboration is witnessing of enhanced patient results. Reviews carried out by Baggs et.al (1999) and Higgins (2000) have stressed the association of poor integration in intensive care units and subsequent inadequate results (Reese, D.J., Sontag, M.A. 2001). Leadership and Integration Healthcare environments have gone through several changes and one of these is the focus on inter-professional practice. Inter-professional teamwork is not a new phenomenon in the NHS domain and healthcare services. Indeed the Primary Care agenda has long been eulogized as a very important part of the work culture, despite being considered as under-resourced. It has been argued that this prospective models of care fall far short of the perimeters of inter-professional practice that is envisaged within the NHS framework. The NHS guidelines are inclined to encourage care planning allocation and management that advances sustainability of care in partnership with Local Authority Social Service Departments, (Milligan, R.A., Gilroy, J., Katz, K.S., Rodan, M.F., Subramanian, K.N. 1999). Multidisciplinary Teamwork Multi-departmental teamwork is illustrated as a two-way process. The administration of shared efforts by the members connects the leadership capabilities across departments. Whyte, L., Brooker, C. (2001), contend that sharing of information by team members have various dimensions. It could - a) connect disciplines; b) overlap the roles of personal associates; c) show disparate attributes of members; d) highlight the divergent methodological standpoints of personal associates; e) suggest divergent conceptions of occupational esteem; f) focus on the disparate methodological standpoints of individual associates; g). reveal divergent perceptions of work-related regard; and, h) show workload perceptions. According to Mintzberg et al. (1996) organisational connectedness could be implemented with optimal efforts of persons who share accountability of work procedures as well as outcomes, Whyte, L., Brooker, C. (2001). Research also established the importance of managing communication within any department. In addition to that, the need to avert disintegration amongst teams is also crucial. Subsequently, the prospects for struggles over autonomy, raising the associated issues of trust as well as ambivalence as discussed by Lewicki et al. (1998) could be highlighted. Milligan et.al (2000) have illustrated the tension in nursing and medicine on matters related to control, sovereignty and influence. Dominance of power has also been identified as a hindrance in collaboration. More so it was further established that divergent opinions of teamwork and divergent skills acquisitions for one's use as a team member can slow down multi-departmental integration. Whereas there's an abundance of research illustrating the demands for collaboration and some research defining hindrances for working in groups, little is known about precisely how multi-departmental groups can proficiently function. To define the variables influencing the capacity of cross-utility outcomes, the need for innovation and balance are keys to proficient functioning of such a system. Other features include functional assortment; social unity; and superordinate uniqueness, (Schoenecker, T.S., Daellenbach, U.S., McCarthy, A.M. 1995). Multiplicity and Functionality Serviceable multiplicity is illustrated as connoting the number of functional constituencies represented by the team whose members are fully connected in an assignment. Burgeoning practical multiplicity has been conceived as an aspect that creates an understanding of attitudes as well as perceptions; even though there is a warning about the in sequence surplus and failure of resolve disparities. Eagleson et al. (2003) hint that in case of management groups, the perimeters of multiplicity is operational in the context of a group's function and is not something that is, or should be necessarily managed. Operational multiplicity when joined with demographic diversity is requisite for the success of multi-departmental group functionalities. In healthcare, operational multiplicity is closely associated with professional identities. Nevertheless, functions are becoming more specific and there is a requirement for greater interdependence in any profession. (Whyte, L., Brooker, C. 2001). The importance of the cross-functional group lie in the fact that through cross functionality, the access to diverse information, expertise as well as opinion positioned in the functional spheres and presented through team associates are multiplied. Nevertheless, if a cross operational team member maintains a profoundly different functional identity then integration could be difficult. Cross-functional group associates should evolve with a collective identity so that there is access to knowledge, information and opinion of the team as a collective unit. In the framework of health, operational distinctiveness of medical doctors could be the result of surgical specialty. For instance, a cardiac operating group now comprises of specialized analgesic nursing team, a technical group as well as other expert assistant staff. Equity between multiplicity panoramas and social unity is necessary for a team to reach its prospects; team members will have to be innovative to gain knowledge from each other. Subsequent to these variables, group acquaintances need a sense of involvement and loyalty to the team. Research shows that group associates follow decision making traditions and construct part of the decision making configuration, (Eisenhard, K.M., Kahwajy, J.L., Bourgeosis, L.J. 1997). Decision making in Multidisciplinary Frameworks Faulkner, Schofield and Amodeo (1999) have indicated that decision-making process is present innately within the precincts of a diverse healthcare group. Most scholars have accorded collective opinion execution in line with scheduling, as well as answerability, a function in actualizing the prospects of multidisciplinary groups and note that, in the healthcare backdrop the patients and the caregivers take part in a mutual participatory system. Indeed, innovative ideas are often at the nexus of inter-unit links. To foster innovation, information and knowledge should be deliberately distributed. A network of inter-unit links provides channels for distributing information and knowledge in such a way as to stimulate and support innovative activities. Proximal associations between team members and patients and staff remain crucial for proper functioning. Multiplicity of functions of administrators of departments and a diverse continuum of professionals assist in achieving this. Nonetheless, as formerly confirmed, the functional scope is a backdrop where equality between discrete functions, social consistency and superordinate images can be anomalous. In such environments the transfer of new knowledge as associated learning or innovation is reliant upon absorptive ability of all group affiliates, Kippist, L., Fitzgerald, J.A. (2006). Access to Information Tasi (2001, p. 998) illustrates absorptive ability as an organisational unit capability to associate new disparate information achieved from external sources and suggests that the illustration also comprises of the departments' aptitude to employ expertise opportunistically. Cohen and Levinthal (1990), debating and penning on absorptive ability as well as its association to scholarship and novelty, affirms that admittance to external data is decisive to the improvement procedure. Cohen and Levinthal (1990) illustrate absorptive competence as fundamental to an organization's functions of revitalization and decisive to the application of this. Absorptive capacity (Cohen and Levinthal, 1990, pp. 128, 133) involves analyzing and capitalizing on external information, the capacity to acknowledge of who knows what, who can assist with what anomaly, or who can exploit new information. Adding on that, research indicates that diverse groups constitute a functional as well as geographical multiplicity that is time-honored by the framework. A fundamental element of these multiplicities, captioned by various scholars (Reese and Sontag, 2001; Coopman, 2001; Whyte and Brooker, 2001), is knowledge. Cohen and Levinthal (1990) have argued that a wide ranging backdrop of knowledge is adequate in constructing new connections and associations that most scholars call originality. Research also establishes that original linkages and similarities is an integral reason for creating a cross- operational group. Conclusion: The concept of inter professional working whether within management organizations, healthcare or any other public or private sector organizations will be associated with understand not just the concept of team working and collaboration but also the nuances of decision making, leadership and the relationship between functionalities in multi-departmental or inter-professional scenarios. Along with a sense of involvement, trust and sharing of information there has to be a motivation to move beyond hierarchies to enhance absorptive competencies as access and absorption of knowledge is facilitated by a supportive group strategy. The sprit of partnership is primary although the diversity of roles and distinct functional scopes could easily highlight structural disparities as well. The challenge would be to overcome such individual disparities to focus on collective identities although at the same time it would be necessary to understand individual strengths as essential to any collaborative framework. The key as discussed earlier is to strike a balance. PART - II Critical Evaluation of Health and Social care Practice within the Context of Inter-Agency and Inter-Professional working and Reflection on the process of inter-professional and inter-agency experiences. Methodology The NHS plan (DoH, 2000) is a plan of both investment and reform within the healthcare practice. The plan outlines the vision of a health service that is patient centered and also highlights changes in the delivery system for the NHS and between health and social services as well new directions for NHS doctors, nurses, midwives, therapists and other NHS staff focusing on collaboration and teamwork. The evaluation of collaborative teamwork in healthcare and inter agency practice is best understood with the help of examples from published research findings on multi-disciplinary and inter-professional working within healthcare contexts. This is further bolstered by reflective practices on the first hand experiences of working as a health care professional. An analytical methodology could be employed to analyze inter-reliance with reference to the healthcare teamwork. This is embedded within the framework of participant observation. The reflective approach has been widely employed in health management reviews. It is viewed as a way of accessing beliefs and traditions enhancing these to be conceived in the context in which they occur. In one example, the opinion polls were conducted for a period of 6 months with 30 interviews involving doctors as well as nurses who were group participants in hospital sections; this included functional rooms, intensive care units as well as ward areas in a hospital. Those that were interviewed consisted of surgeons, anesthetists, nurse overseers, and foster clinicians, (Jassawalla, A.R., Sashittal, H.C. 1999). In the above case, each interview was audiotaped and transcribed verbatim. Remarks were noted in the structure of keywords and minutes. Vigilant distinctions were made in the event of observations and interviews were used to calculate the team traits. Scientific advances were adopted to help in detailed coding and evaluation of the collected review material, enhancing the interpretation process, (Illich, I. 1990). Sophisticated software QSR N-Vivo was employed for that reason. In the evaluation phase of the project, the review material was established to revolve around various central topics. Statistics were collectively themed and coded by means of a progressive relative evaluation and expression. Evolutionary yet relative evaluation is constantly employed in analyzing statistics to expand provisional codes and to develop theories, clusters of relationships, commonalities and disparities within the profession establishment (Fitzgerald, 2002). Evidence and methodical thinking surrounding connections and interconnections is employed to define and comprehend underlying conventions that control circumstances in which medical professionals as well as nurses find themselves, (Hansen, M.T. 1999) . In the context of health care teams, task specialization synergy is only a part of team performance outcomes. Although in an operating theatre, task specialization is vital, team member interactions to achieve their goals in confluence is an important competence for operating team performance. This requires managing fragmentations between and within professional and occupational groups; managing autonomy; and, balancing functional diversity (skills), social cohesion between occupational cultures and identities, (Fitzgerald, J.A. 2002). Another study by Priest et al (2008) explored inter-professional attitudes arising from shared learning in mental health. Inter-professional working in healthcare is considered essential for improving team-work and communication. In the study, mental health nursing students and trainees participated in an inter-professional education and working scenario. The experiences and outcomes were evaluated with a tool to determine the implications for inter-professional working. The results indicated that there was an increase in clarity among professionals regarding roles, approaches and resources, and how to collaborate in inter-professional practice (Priest et al 2008). Challenges were also identified, in accordance with one's academic level, previous experiences, expectations, assessment, motivation and efforts which are all factors that tend to affect the collaborative process. Yet collaboration with all its challenges and adversities remain the foundation for effective team-working. Mental health professionals have to work effectively in multidisciplinary teams just as managers facilitate collaborative relationships within an organization. Management principles are effectively utilized in inter- professional practice within the clinical and even mental health care settings. Managing fragmentations Disparities between group members in functional aspects can bring about diverse specialized traits. These traits can consist of influence as well as self magnitude illustrated by proficiency control and ability and conceived answerability for the accomplished tasks. For instance, it has been observed that most doctors have separated themselves from the rest, intentionally or not, by displaying traits that sets them apart, normally above the rest, by exhibiting superiority of status. In the operating theatre this demonstration of features demarcates the medical line of work from others, Fitzgerald, J.A., Lum, M. (2006). For instance, various doctors in the operating theatre remarked that their position was higher than that of anyone else in the health domain and that this was reinforced by associates within the expertise, (Faulkner Schofield, R., Amodeo, M. 1999). Analysis With the ever changing world characterized by massive intercontinental networks ingenious contemplation is required, especially in the healthcare domain. Healthcare in the US and UK and the rest of the world is an integral function of the social well being of any civilization. Yet in swiftly varying backdrops, teams are commonly employed as conduits for health care dissemination variations, (Simons, T., Pelled, L.H., Smith, K.A. 1999). These groups unfold in multi-departmental huddles, where particular disciplines present a disconnected unit of care or check.-up. Speculatively this channel is a resourceful as well as an efficient theory of concern and service rescue. Pragmatically to embrace groups with a diverse professional backdrop needs team members to enhance and sustain elevated heights of interdependency to enable communication and engender and distribute acquaintance. Consequently, group's associates must not only be expert nurses from their disciplines, they need to be experienced medical providers as group members; a diverse cluster of expertise collectively, (Bernthal, P.R., Insko, C.A. 1993). Whereas members of multi-disciplinary groups have evolved and applied separate clusters of discipline centered know-how that are pertinent to their occupation, they have at the same time urbanized and employed different sets of skills associated to their needs as panel members from certain backgrounds. In the example above, the team comprised of professionals with diverse backgrounds; doctors and nurses collectively shared responsibilities for the combined health care of patients, (Coopman, S.J. 2001). Much as collective responsibility utility has been common within the healthcare profession, doctors have had an elevated command over the work processes in which nurses' work and inconsistency between specialized clusters occur. In any case professionals have exhibited longstanding traditions with well enhanced expertise limitations and have encouraged on collaborative value of their work. It has been debated that much effort is needed to acclimatize group membership expertise in adapting technical or faculty centered skills to various occupational specialisms. Reflective Practice The focus for any team approach could still be founded and based on personal experiences and personal experiences of healthcare professionals highlight the individual dimensions of health care nursing. The close association between individual experience and collective working is understood through the process of reflection and reflective analysis that highlight the first hand experiences of the nursing professional when working within a team or faced with a challenging perspective. As a nursing and social work professional within the health care setting and specifically within the acute/critical environment in which personal experiences are based, this researcher have faced several advantageous and disadvantageous situations within the framework of the professional environment. The acute/critical care plan would require emergency and intensive relief to patients in many cases. The advantages of team work and collaborative inter professional working could be expansion of knowledge and learning and an ability to share information across a wide range of disciplines. This helps in taking a holistic perspective of the patient's problems and in treating the patient not just clinically but from all dimensions giving a comprehensive health care plan. This clearly enhances nursing and surgical procedures and provides superior healthcare facilities to the patient. This is especially significant in case of long term patient care or care of patients suffering from long term, fatal or terminal illness. Elderly individuals with end of life care support and patients suffering from cancer and other life threatening diseases require holistic care as they suffer from myriad problems in terms of social, emotional and physical, psychological health. There are disadvantages related to inter-professional working as expressed through manifestations of prejudice and ingrained perceptions of hierarchies and too much focus on specific temporary need based approach rather than holistic approach. Need based approach and emergency care is especially required in acute and critical care nursing yet yet within a team the needs could be reflected through various dimensions as a psychologist would note different needs of a patient when compared with a surgeon. What is thus necessary is to pool the information available from all dimensions and understand the patients as individuals who could be given quality care only when all the comprehensive aspects of his illness are identified and take care of. Reflective practice is also corrective education and learning as it is about identifying one's flaws and weaknesses when handling emergency or sensitive patient conditions. In case of inter-professional collaborative environments, one's personal knowledge and discipline is especially important as it would become difficult for other team members to work with incompetent coworkers. As discussed earlier, knowledge and motivation of a team member affects the collaborative achievement so in any individual reflective practice the significance of being a team member has to be understood for professional growth. Conclusion The ever varying healthcare backdrop needs nursing and other healthcare experts to venture into modern ways of delivering improvements in healthcare that will be advantageous to patients. Individual results have been integrated by organizations that endeavor to meet the real needs as well as expectations of the persons they attend to. In this respect, the need to launch review in this region is of cardinal significance as the latter would be vital in investigating meaningful quality results in services claiming adherence to individual outcomes, (Atwal, A., Caldwell, K. 2006). If not, such progress in healthcare may be illustrated as mere window dressing. Ratification in configuration, monetary and legal framework is also imperative, as these are elementary components to the success of personal results. In spite of the crisis, scholars have argued that an advantageous budget to healthcare could bring about better results although healthcare management systems would have to be more teamwork focused and follow inter-professional practice as a fundamental management principle in healthcare settings. The proposed NHS health reforms aimed at providing a more streamlined health service with less officialdom (Kelly, 2003) can also lend support to the argument for personal outcomes. In addition, organisations implementing person-centred approaches cannot forget about their most valuable asset of all, their people and patients (Cohen, W.M., Levinthal, D.A. (1990). The value placed on them, and the collaborative process engaged in, will ultimately determine the success of personal outcomes. The core of the achievement of individual results is in engaging collaborative traditions through nurturing interdepartmental as well as multi-departmental team working. Corporate expertise as well as interpersonal experiences has been investigated in this paper, although more research of the effect on patient results of collaboration is required. According to the literature review and findings, transformational leadership, a central hypothesis of the advanced nurse practitioner, is perhaps the most valuable means to confront the uncertainties that shared team work presents. 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