Interprofessionality: A Pathway to a More Sustainable National Healthcare System

Interprofessionality: A Pathway to a More Sustainable National Healthcare System

Chidiebele Constance Obichi (Indiana University Northwest, USA), April D. Newton (Indiana University, USA) and Ukamaka Marian Oruche (Indiana University, USA)
Copyright: © 2020 |Pages: 20
DOI: 10.4018/978-1-7998-2949-2.ch009

Abstract

Preventable medical errors (PME) is the third leading cause of death in the United States with an incidence range of 210,000 to 400,000 deaths per year and an estimated cost of $19.5 billion to $958 billion per year. Despite advances in patient safety, PME persists across the nation. An unmarked extremity, a soft sponge, medication dose, poor communication, etc. are possible precursors of PME that may lead to death. Preventable medical errors such as wrong-patient or wrong-site surgery, botched transplants, and death from myocardial infarction or septic shock following a discharge from the emergency department are frequently reported. According to the Institute of Medicine, most PME in the healthcare system are caused by poor team collaboration and care coordination, particularly when patient care was provided by independent providers. Therefore, the healthcare workforce must work within interprofessional teams for safe, cost-effective, and quality care delivery significant to sustainable healthcare reform.
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Introduction

The healthcare system is like an orchestra. The orchestra combines instruments from different families which are unified by a set tempo that shapes the sound of the ensemble. These instruments must be in sync to produce the harmonious and satisfying sound that offers the patron an opportunity to experience the power and passion of classical music.

Preventable medical errors (PME) is the third leading cause of death in the United States (US) (Makary & Daniel, 2016; Robertson & Long, 2018) with an incidence range of 210,000 to 400,000 deaths per year (Andel, Davidow, Hollander, & Moreno, 2012; James, 2013; Makary & Daniel, 2016). The cost of PME is estimated at $19.5 billion to $958 billion per year (Patient Safety Movement, n.d). Despite advances in patient safety, PME persists across the nation.

An unmarked extremity, a soft sponge, medication dose, poor communication are possible precursors of PME that lead to patient injuries or death. Preventable medical errors that are frequently reported include: wrong-patient or wrong-site surgery; botched transplants, and death from myocardial infarction or septic shock following a discharge from the emergency department (Wachter & Gupta, 2019). According to a multicenter study led by researchers from Boston Children’s Hospital (Starmer et al., 2014), poor communication and hand-off errors are the most reported PME in hospitals across the US. Starmer et al., (2014) reported a relationship between communication, hand-offs, and PME. Hence PME decreased by 30 percent if improvements were made in verbal and written communication between healthcare providers during patient hand-offs. Similarly, PME decreased in the operating room through the use of ‘time-outs’ - when a procedure can be interrupted to confirm patient identification and surgical site selection (Altpeter et al., 2007).

Preventing PME has become the responsibility of the entire healthcare team. According to the Institute of Medicine (Wakefield, 2000), most PME in the healthcare system are caused by poor team collaboration and care coordination, particularly when patient care was provided by independent providers (Wakefield, 2000). Hence, effective collaborative interprofessional teamwork may serve to avoid and mitigate medical errors (Thomas, Sherwood, & Helmreich, 2003).

The healthcare industry looked toward aviation to determine how teamwork was instilled in the crew members to similarly inform healthcare teams. Following the tragic collision of two 747s on a foggy morning in Tenerife and other similar accidents, aviation began a series of training programs, generally called “crew resource management” or “cockpit resource management” programs, designed to train diverse crews in communication and teamwork (Wachter & Gupta, 2019). Some of the training programs utilized the Situation, Background, Assessment, and Recommendations (SBAR) technique - commonly used in healthcare - for communication strategies and briefing/debriefing techniques (Wachter & Gupta, 2019). The aviation industry acknowledged that these communication and teamwork-based programs were in large part responsible for improving the culture of aviation and the remarkable safety record of commercial airlines over the years (Wachter & Gupta, 2019). The dynamics of the airplane cockpit are similar to those of the operating room. Therefore, operating room services were selected to pilot-test the aviation model of safety training in healthcare (Rivers, Swain, & Nixon, 2003).

Key Terms in this Chapter

Interprofessional and Interdisciplinary Research Collaboration: Occurs when researchers from more than one profession or discipline work together to achieve the common goal of producing new scientific.

Interdisciplinary Research: Research that cuts across the disciplines and fosters the integration of ideas.

Interprofessional Collaborative Practice: Occurs when multiple health workers from different professional backgrounds work together with patients, families, caregivers and communities to deliver the highest quality of care.

Collaborative Research Practice: Occurs when researchers from more than one health-related profession engage in scientific inquiry to jointly create and disseminate new knowledge to clinical and research health professionals in order to provide the highest quality of patient care to improve population health outcomes.

Collaboration: Collaboration implies two or more individuals working together for a desired outcome or goal. For this chapter, that goal is oriented toward improved patient health outcomes through a team-based approach to care.

Chronic Disease/Chronic Condition: A health condition that has one or more of the following characteristics: permanent; leaves lingering disability; non-reversible pathological condition.

Interprofessional Education: Occurs when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes. Once students understand how to work interprofessionally, they are ready to enter the workplace as a member of the collaborative practice team.

Simulation: A pedagogical approach tailored to realistic scenarios in a safe, controlled environment for learners to demonstrate their knowledge and practice the learned skills without consequences of their actions.

Health Professions Students: Health professions students are learners from healthcare disciplines (e.g., dentistry, nursing, nutrition, medicine, pharmacy, physical therapy, radiology, health information management, and social work).

Complex Chronic Disease/Complex Chronic Condition: Refers to a health condition that has one or more chronic diseases and one or more of the following characteristics: permanent; leaves lingering disability; non-reversible pathological condition; co-exists with a psychological illness.

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