Interprofessional Working by Health Professionals to Improve Quality of Health - Essay Example

INTERPROFESSIONAL WORKING BY HEALTH PROFESSIONALS TO IMPROVE QUALITY OF HEALTH Introduction Interprofessional work refers to a collaboration of individuals or groups involved in professional work and who aims for a common goal. The primary aim of interprofessional collaboration in health is caring for the patient and upholding his/her rights. The patient or client is at the centre of this working group. (Leathard, 2003, p. 6) This paper is about interprofessional work as a means to improve health care. The first important word mentioned here refers to professional people. Who are these professional people? They are those associated to a particular profession and whose entry required some length of training; accreditation is required that has to be issued by a professional body. When accredited, the professional is recognised as having expertise to the particular field, such as in the medical profession, and is bound by a code of ethics. Set against the backdrop of the twenty-first century, with all the globalisation and information technology (IT) complexities – which can be turned into helpful aids instead of barriers – collaboration is seen as a powerful force by public and private sectors in service delivery especially in the health sector. The health care profession is challenged by various sectors in society to deliver quality care. The NHS Plan requires more interprofessional working as a result of demands from discriminating public and demanding patients. (Leathard, 2003, p. 69) The NHS Plan demands more time or flexibility in working which is to the patient’s interests. Ethical standards have to be explained further since the patient has to have trust to the physician who, because of his/her knowledge in the profession, is at an advantage over the patient who needs to understand his/her health situation. Distrust has developed between the medical profession and the general public, particularly the individuals needing care. Main Body Promoting interprofessional working between government and private agencies requires a whole lot of political will and backing. For example, the government has seen and made it clear that there is a national imperative for an interprofessional knowledge sharing programmes of health and social care providers (Department of Health, 2001 cited in Spence, 2007, p. 121). Along this line of policies should be a series of legislation and activities by the government to promote interprofessional collaboration. The mental health care professions need this political backing but interprofessional working is seen as passing along various barriers. Setting the scene for interprofessional working, education is a necessity. This is known as interprofessional education, defined as: ‘When two or more professions learn with, from and about each other to improve collaboration and the quality of care’ (Barr et al., 2005, p. 2 cited in Spence, 2007, p. 121) Interprofessional education (IPE) functions under multi-professional education where different professionals exchange learning for a common goal. (CAIPE, 1997 cited in Spence, 2007, p. 121) This trend advocates that there is superiority in teams over individuals because of the necessity of skills, judgment and experience in providing health care. This is also needed in staff flexibility (Schofield, 1995 cited in Spence, 2007, p. 122). Benefits for IPE relevant to mental health care include: cost reduction, promotion of collaboration, opposition to ‘elitism, rivalry and inflexibility’, reduction of communication breakdowns, increase in morale and efficiency. IPE provides a wide spectrum for professional learning, way beyond what professionals had learned in formal classroom settings. Professionals learn of each other’s roles in delivering health care, including discipline roles. (Spence, 2007, p. 123) While there are benefits, there are also barriers to joint working which have been categorized into five groups by Hardy et al (1992 cited in Leathard, 2003, p. 7): Structural issues pertaining to health and social services, for example gaps in services; Procedural matters when it comes to joint planning which also touches on budgetary and planning cycles; Financial factors which involve funding and flows of financial resources; Status and legitimacy which refers legitimacy of elected and appointed agencies; Professional issues that may include competitive ideologies and values. There are other barriers encountered by professionals in the course of working together and some of them refer to communication barriers; the problem of working with groups with different languages; distinct training backgrounds; organizational boundaries; loyalties, and so on. Ash and Miller (2011) listed other barriers to interprofessional collaboration as: ‘(1) gender, power, socialization, education, status, and cultural differences between professions (Hall, 2005; Whitehead, 2007); absence of a payment or reward system for interprofessional collaboration; misunderstanding of the concept and scope of the different professions involved in the collaboration; and (4) turf protection (Patterson, Grenny, McMillan, & Switzler, 2002 cited in Ash and Miller, 2011, p. 241). In order to counterbalance barriers with reasonable solutions, interprofessional groups should rationalise by means of coordination and merging of services and resources. Some organisations, utilities, pharmaceutical companies and universities, have used the merger movement or concept in rationalising resources with some successes. Rationalizing resources is the key because this concentrates resources for a common goal. The different agencies are bound by a common objective. By working with others, a professional improves his/her skill. This is one of the requirements of the NMC Code of Conduct with respect to improvement of skill and expertise in the practice of the profession. Managers or owners of health care facilities have a somewhat troubled relationship. Managers are perceived enemies of the medical profession. It is now seen that managers have to work for health care although majority of them have no formal clinical training, to the detriment of the patients’ interests. Ethics can tell that the manager and the clinician have to have a common working platform and must work together to the interests of the patient. If not, the patient suffers and may create more distanced professional work between clinician and manager. The Patient’s Charter 1991 promoted the rights of the patient as promoted by the NHS: the patient is seen as a rights consumer. Health care is also seen as a commodity that a person who needs care possesses and which can be insured. Insurance can provide ‘repair and replacement’ if healthcare is lost (Edgar, 2010, p. 51). Another law worthy of note is the Health Act 1999. The Government launched the primary health care plan to carry on the provisions of The Health Act 1999 which provides principles of community and primary care services for all of the UK. The principle is to ensure partnership and collaboration and assessment between government agencies, service users and independent sectors of society and organisations to provide the necessary services. This new thrust emphasised provision of care nearest the home of the person needing care. The policy reduced the patient or service users’ dependency on long period of in-patient care, rather the patient can choose several options that can be provided by local people. (Sines, 2005, p. 1) The question of quality is posed against interprofessional working groups. How can interprofessional work deliver quality service? Health care systems have been challenged to deliver high quality care with limited resources. Hospitals and health care organisations should develop systems that ensure the best possible patient care. An important quality solution is to develop procedures to improve patient flow, to provide timely and effective treatment and maximum utilization of available resources. Without efficient patient flow, quality treatment may suffer. Quality in health care refers to some areas which have to be addressed in delivering health care to a big population such as the UK. These three areas include cost, quality and access. Poor quality health care is not health care for it won’t deliver what is needed by the populace. Cost should be at minimum, one that is affordable and accessible. The UK has a long tradition of determining diseases to be the basis of epidemiologic analysis. The government uses performance indicators (PIs) in measuring morbidity, mortality, and immunisation rates and in order to find ways to improve health service. (Tulchinsky and Varavikova, 2009, p. 585) Performance indicators were used in the early years of reforms for the health sector in the 1980s. These performance measures were utilized to adjust payments to district health authorities (DHA). Authorities in health care can be penalized for low performance as indicated in the measures. With government decentralization, health systems have to provide quality health care. Quality also includes safety for clients or patients. Support workers and carers must wear appropriate protective clothing when taking care of patient’s body, such as disposable aprons and gloves. The duty of care of private and public care givers goes as far as providing the best care that they should give. Duty of best care should be provided to all needing care without exception. Support workers must exercise ‘reasonable skill and care’ in their relationship with their employers and clients. Quality also recognizes diversity, equality, inclusion and promotes the rights of individuals. (Nolan, 2005, p. 41) Reducing patients’ waiting time in clinics is one of the major health thrusts in the UK. This pertains to the amount of time spent by patients in clinics while waiting for a service provider to attend to their needs. Studies have found that patients would just leave the clinic without being attended to after a certain lapse of time. Steps have been instituted to help patients suffer the fate of waiting in community clinics without out acquiring the necessary medical service they have waited for. A program known as Integrated Child Health Service (ICHS) was established under the NHS Trust in 1997, to address the issue of redundancy or duplication of processes and management in community and hospital services. This combined facilities under a unified management structure for accessibility and in order to provide ‘high quality child and family centred care’. (Clow et al., 2002, p. 122) Community care is provided to anyone in the UK who needs social care and this includes older people, younger adults and children. Care can be provided at home or day centres by the community or carers. This brings to the discussion on the role of family carers and their ability to provide support to people in need of care (Mallik et al., 2009, p. 2). The government has been motivating communities to focus on service users, particularly older people, the disabled and children ‘in need’. (Waine, 2005, p. 8) How to provide adequate care for people needing care is the responsibility of both government and private sectors. The government must provide the tools and the motivation. As patients and clients are regarded as consumers in the new set up, there has to be a good communication process between the various stakeholders. Collaboration between public and private agencies is a must. This is where quality health care is most needed. (Crawford and Brown, 2009, p. 21) Conclusion There is a need for interprofessional working among clinicians and managers and the public and private institutions delivering health care. This has been a thrust by the government in providing quality mental health care to the growing population in the UK. Literature from American, Canadian and UK have many recommendations for interprofessional collaboration in the health care profession because this can improve a lot in improving care (Oandason et al., 2004 cited in Ash and Miller, 2011, p. 241). Interprofessional working produces a collaborative work, a consensus, and a work bounded by a common objective. This should not be ignored or sidestepped and the government should do everything in its power to enforce it for it benefits patients and improve professional work of clinicians and managers. Quality refers to how the person needing health care perceives of the health service and how the system responds to client demands and complaints in an acceptable manner while the client is protected of his/her rights under the law. A public or private health provider has the duty but the client’s rights are not absolute. References Ash, L. and Miller, C., 2011. Interprofessional collaboration for improving patient and population health. In: M. Zaccagnini and K. White, eds. 2011. The doctor of nursing practice essentials: a new model for advanced practice nursing. United States of America; Canada; London, UK: Jones and Bartlett Publishers. Ch. 6. Clow, D., et al., 2002. Reducing waiting times associated with an integrated child health service. The Journal of the Royal Society for the Promotion of Health 2002; 122; 245. DOI: 10.1177/146642400212200412. Crawford, P. and Brown, B., 2009. Communication. In: M. Mallik, C. Hall and D. Howard, eds. 2009. Nursing knowledge and practice: foundations for decision making. Elsevier Limited. pp. 21-43. Edgar, A., 2010. Why do changes in society and institutions matter for professional values? In: S. Pattison, ed. 2010. Emerging values in health care: the challenge of professionals. London, UK: Jessica Kingsley Publishers. Ch. 2. Leathard, A. (ed), 2003. Interprofessional collaboration: from policy to practice in health and social care. USA and Canada: Routledge. Mallik, M. et al., 2009. 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