According to Barnsteiner (2007), “ The work of the Institute of Medicine (IOM) and others has clearly demonstrated that when healthcare professionals understand each others’ roles and are able to communicate and work together effectively, patients are more likely to receive safe, quality care” (p. 144). There are many good practices to consider when evaluating the roles and responsibilities of an interprofessional team member.
This paper will look at four interdependent strategies; team member roles must be clearly defined and articulated, there must be an understanding and respect for each other’s roles, there must be an appreciation of each other’s scope of practice, and a willingness to learn about and how other members’ roles compliment your own. Although these strategies can be used for all types of interprofessional teams their use in the healthcare setting will be highlighted.
Interprofessional team work allows various professionals to learn from one another, share skills and knowledge, and develop an appreciation for each other’s expertise in a collaborative environment. In healthcare this can improve communication, improve quality of care and ultimately result in a more effective and efficient delivery of patient care.
Nandiwada (2010) quoted Dr. Kyu Rhee, Health and Human Resources – Chief Public Health Officer A health care team is like a sports team, except for instead of points we are dealing with people’s lives. Like any great team, it is essential to know the roles and responsibilities of each of the players and to have trust in one another. It is vital to have that team learn together, and practice together so that when the game truly matters they can each play their best with trust and understanding leading to more positive outcomes. (p. 26)
The focus of this paper will be to examine the roles and responsibilities of interprofessional team roles using four strategies; clearly defined and articulated roles, understanding and respecting individual roles, appreciation for scope of practice, and a willingness to learn about and how other members’ roles compliment your own. This paper will show evidence these are four good practices when participating in an interprofessional team. Examples will be provided for use of these strategies within an interprofessional healthcare environment.
Headrick (1998) study indicated the following: Improved health outcomes usually lie outside the scope or control of any single practitioner. Real improvements are likely to occur if the range of professionals responsible for providing a particular service are brought together to share their different knowledge and experiences, agree what improvements they would like to see, test these in practice, and jointly learn from their results. (p. 772) Upon formation of an interprofessional team, clearly defined roles and responsibilities need to be established.
These roles and their responsibilities must be understood by all team members. Teams are generally made up of a team leader &/or facilitator, recorder, timer (optional) and individual team members. The team leader will be the person with an in depth knowledge of the teams focus and/or goal. Some team leaders choose to assign a group member to facilitate or moderate the meeting process, others may choose to lead the meetings themselves. As the team leader it is their role to coach, provide constructive feedback, value the groups’ ideas and decisions yet not withdraw when conflict arises.
Banutu-Gomez (2011) stated, “ The most important of all is having a leader who does not separate him or herself from the group but participates and influence people to be great followers by empowering them every chance he or she gets” (p. 57). The recorders responsibility is to take and keep accurate meeting notes. Some groups may want to assign a timekeeper, although this role is not essential. Team members should be chosen for their knowledge, skill and abilities.
Each member must commit to working within the team’s plans, timelines and priorities, be willing to work collaboratively on problem-solving and accept change as part of process improvement. Team members must also be respectful of one another, welcome diversity, and establish both trust and accountability within the team. All team members must be willing to decide how they will work together by jointly developing a code of conduct, ground rules, or team principles. These should support the team mission and drive the team toward accomplishing its goal.
Banutu-Gomez (2011) indicated, “ Also, all the members of an effective group need to be committed to the group’s ideas, goals, and decisions or the team will be unable to get any work done” (p. 60). Interprofessional healthcare teams are no different, members should be chosen from a variety of disciplines who share common values and interest in the project goal and outcomes. Interprofessional healthcare teams are often made up of physicians, nurses, occupational therapists, physiotherapists and social workers.
Which healthcare professional assumes which role varies the choice very much dependent on the teams goal or outcome. If the teams outcome is to reevaluate the role of the nurse within an outpatient ambulatory care setting you may want the nurse to team lead as he/she will have the best knowledge and skill set to help the team reach its goal. O’Daniel (2008) stated the following: Collaboration in health care is defined as health care professionals assuming complementary roles and cooperatively working together, sharing responsibility for problem-solving and making decisions to formulate and carry out plans for patient care.
Collaboration between physicians, nurses, and other health care professionals increases team members’ awareness of each others’ type of knowledge and skills, leading to continued improvement in decision making. (p. 2) Understanding the influence of professional roles on collaboration and interaction with others is critical. Bronstein (2003) found “ Sometimes, the diverse cultures, norms, and language of each profession make the process of interdisciplinary collaboration resemble the bringing together of inhabitants from foreign lands” (p. 302).
A prerequisite for understanding the professional role and its expectations within a group is to have a clear understanding of the individual professionals’ skills, attitudes, and abilities. MacDonald et al (2010) acknowledged: The willingness of a professional to learn about other professional roles leads to a broadening and an enrichment of the knowledge required to collaborate with other team members in providing effective healthcare. Interprofessional teamwork allows healthcare professionals to identify unique differences in, and to understand, the roles and contributions of other team members.
As members of an interprofessional healthcare team it is imperative that the basis of our different knowledge and skill set be acknowledged and understood. As healthcare professionals we must understand what other health professionals do, how to access their services, and understand the teams’ goals and needs from their perspective. As collaborative partners working to achieve quality care we must find ways for healthcare professionals to become good collaborators and competent team members.
According to MacDonald et al (2010) qualitative discussions “ It’s really important for everybody to understand what the other person is bringing to the table because if you’ve never worked closely with a pharmacist, a dietician, a nurse, you don’t really know what they learn and what they’re supposed to do and what they can do to make your job easier” (p. 239). As nurses working on an interprofessional team it is vitally important to understand other members’ professional roles. Nurse navigators will find this particularly important as they define their position within the interprofessional team.
Often the role of the social worker and nurse can appear to parallel. This is where understanding and respecting of each others’ practice will help define your position and influence your decisions made within the team. All professionals function with a scope of practice. This scope encompasses the activities its members are educated and authorized to perform. While the scope of practice outlined by a professional body sets the broad limits, the actual scope of practice is influenced by the settings in which individuals practice, the requirements of the employer and the needs of their clients.
When discussing healthcare professionals MacDonald (2010) clarified, “ to be effective, team members must accept the responsibility to act in accordance with the standards of practice and within the role obligations defined by their professional scope of practice, and communicate this scope of practice to others” (p. 240). Most healthcare professionals abide by and report to a professional body; The College of Physicians and Surgeons, the College of Nurses of Ontario and National Association of Social Workers to name a few.
Each of these professional bodies promotes, guides, and directs professional practice through the application of professional standards. These standards outline expectations, self-assessment, duties, and existing policies while providing a basis for the development of new policies within a principled framework. As a nurse within an interprofessional team it is important for both the nurse as well as other team members to clearly understand the competencies and contributions of a registered nurse. To know in what situations a nurse is most appropriate and where the limitations of that practice lie.
For example, on a team that has been created to evaluate and implement medical directives understanding the nurses’ scope of practice is vital to its successful development and implementation. Effective team members look beyond the confines of their own discipline to bridge the differences for better navigation of complex issues. In their article discussing healthcare professional education Barnsteiner and associates (2007) stated, “ There are very few opportunities to bring faculty and students from multiple disciplines together for the purpose of learning and understanding each others’ roles, and practicing collaboration and teamwork” (p. 145).
Effective healthcare teams need an improved ability to better navigate the complexity of the current healthcare environment. This will lead to a solution that includes integrated interprofessional learning about teamwork, collaboration, problem-solving, and decision-making. MacDonald et al (2010) discussed the need to openly seek out the contributions of other team members by stating: In order to provide the most comprehensive and effective client care, team members must develop and maintain a willingness to utilize the knowledge and skills of the interprofessional team members.
All team members must have an understanding of the knowledge and skills that each team member can contribute in a given situation. (p. 240) Nurses are often a casualty of the silo thinking that we often see in the healthcare setting. Often forgotten or pushed aside is the unique input that nurses as the hands on care givers can provide. Nurses are able to contribute an intimate perspective which effectively enhances a positive patient and family experience. Nurses are invaluable in decisions regarding maintaining cost effective yet high quality patient care.
High quality interprofessional collaboration and teamwork includes membership with shared objectives and direction, clear roles and tasks, respect and understanding. Through the use of these four interdependent strategies all types of interprofessional teams yet most importantly interprofessional healthcare teams can become more effective. In their (2008) article O’Daniel quoted Deming, one of the greatest proponents of teamwork, “ Teamwork, he believes, is endemic to a system in which all employees are working for the good of a goal, who have a common aim, and who work together to achieve that aim” (p. 2).
