Purpose and scope
The purpose of this best practice guideline (BPG) is to foster healthy work environments. The focus in developing this guideline was identifying attributes of interprofessional care that will optimize quality outcomes for patients/ clients, providers, teams, the organization and the system.
This guideline identifies best practices to enable, enhance and sustain teamwork and interprofessional collaboration, and to enhance positive outcomes for patients/clients, systems and organizations. It is based on the best available evidence; where evidence was limited, the recommendations were based on the consensus of expert opinion.
The target audience includes nurses and health-care professionals in all roles and practice settings, including:
• interprofessional team members
• non-nursing administrators at the unit, organizational and system level
• clinical nurses
• students
• educators
• researchers
• policy makers and governments
• professional organizations
• employers
• labour groups
• federal, provincial and territorial standard-setting bodies
Registered Nurses’ Association of Ontario (2013). Developing and Sustaining Interprofessional Health Care: Optimizing patients/clients, organizational, and system outcomes. Toronto, Canada: Registered Nurses’ Association of Ontario.
Recommendations
Do you want to learn about and implement the most- up-to-date evidence-based recommendations on this topic with your colleagues? Download and share the full best practice guideline (BPG), Developing and Sustaining Interprofessional Health Care: Optimizing patient, organizational and system outcomes.
See below for a snapshot of the recommendations from this BPG. We strongly suggest you review the full BPG before implementing the recommendations and good practice statements. The BPG also includes further resources to support implementation and evaluation.
Recommendation 1.1: Leaders of key agencies (governments, academic institutions, regulatory bodies, professional associations, and practice-based organizations) collaborate to make interprofessional care a collective strategic priority.
Recommendation 1.2: Agencies in the health-care system strategically align interprofessional care with their other initiatives for healthy work environments.
Recommendation 1.3: Interprofessional care partnerships across organizations agree on an evidence-based approach to planning, implementation, and evaluation for joint activities.
Recommendation 2.1: Show willingness to acknowledge and share power across organizational boundaries by:
a. Talking about power: be open to constructive and courageous conversations that examine inequities, privilege and power differentials;
b. Building a collaborative inter-organizational environment by recognizing and understanding your power and its influence on others around you;
c. Creating balanced power relationships through sharing leadership, decision making, authority and responsibility;
d. Including diverse voices in collaborative decision making;
e. Sharing knowledge with each other, not withholding or hoarding information; and
f. Creating safe collaborative spaces where everyone feels welcome.
Recommendation 3.1: Academic organizations build interprofessional care knowledge and competencies into their curricula.
Recommendation 3.2: Academic organizations prepare students to work in interprofessional teams by:
a. Instilling values, skills and professional role socialization that will support interprofessional care;
b. Developing, implementing and evaluating education models that foster interprofessional values and skills; and
c. Enhancing educational and clinical opportunities for health professions to study and learn together
Recommendation 4.1: Researchers partner with decision makers to conduct research examining the impact of interprofessional care teams on both patient/client outcomes and on health-care teams.
Recommendation 4.2: Health research granting agencies develop and maintain a focus on Interprofessional care research priority areas.
Recommendation 4.3: Researchers use knowledge translation strategies to encourage action on research findings by funders, government, professional associations and regulatory bodies, as well as by unions, health-care organizations, educational institutions, study participants and other stakeholders.
Recommendation 5.1: Professional associations, regulatory bodies and unions can support interprofessional care by:
a. Including it in legislation and policies for their members;
b. Working together to develop joint competencies and standards for interprofessional care;
c. Working together to add interprofessional care principles to approval standards for education programs; and
d. Including interprofessional care as a competency for licensure.
Recommendation 6.1: Accrediting bodies for organizations and education programs develop standards and performance indicators for interprofessional care.
Recommendation 7.1: Governments can support the culture required for interprofessional care by:
a. Making interprofessional care a priority, and evaluating its impact; and
b. Providing health-care organizations with the fiscal resources required to develop, implement and evaluate interprofessional care
Recommendation 8.1: Organizations must acknowledge the impact of power and hierarchy by: Identifying imbalances of power and making changes to equalize power and build mutually supportive, safe interprofessional workplaces.
Recommendation 8.2: Organizations need to engage and develop leaders at every level, including among their point-of-care health professionals, for successful interprofessional care. Strategies for doing that include:
a. Developing interprofessional care champions/role models in different professions and programs; and
b. Offering leadership courses to introduce the concepts and competencies of interprofessional care and its management.
Recommendation 9.1: Organizations promote interprofessional care by developing a culture that expects collaboration and creates the operational supports it will need to succeed by:
a. Establishing human resources plans that allow dedicated time and coverage for staff to participate in interprofessional activities e.g. team development, a team charter (see Appendix E, H) and effective communication;
b. Designing buildings, spaces, programs and care pathways to accommodate and encourage interprofessional care; and
c. Considering shared spaces for patients/clients and team members to enhance opportunities for communication and innovation.
Recommendation 10.1: Organizations can support interprofessional care through enhanced communication by:
a. Establishing effective communication processes and tools to support collaboration and communication in teams, professions, with patients/clients and across programs and organizations;
b. Standardizing documentation and encouraging information sharing;
c. Adopting strategies to tackle issues such as “turf” protection and disrespectful communication; and
d. Creating a culture that promotes regular formal and informal communication among team members with team rounds and care conferences.
Recommendation 11.1: All health-care professionals, as well as volunteers and students, demonstrate their commitment to the principles of interprofessional care by:
a. Practising and collaborating with colleagues, patients/clients and families in a way that fosters respect, trust and understanding;
b. Understanding their roles and expertise, reflecting on their practice, being confident in their own abilities, and expertise, knowing the standards and boundaries of their practice and recognizing when it’s time to turn to other team members; and
c. Developing communication and conflict-management skills.
Recommendation 12.1: Team members demonstrate their willingness to share power by:
a. Building a collaborative environment through recognizing and understanding power and its influence on everyone involved;
b. Creating balanced power relationships through shared leadership, decision making, authority, and responsibility;
c. Including diverse voices for decision making;
d. Sharing knowledge with each other, openly; and
e. Working collaboratively with patients/clients and their families to plan and deliver care
Recommendation 13.1: Individuals develop skill and competency in precepting, mentoring and facilitating interprofessional learning.
Disclaimer: These guidelines are not binding for nurses, other health providers or the organizations that employ them. The use of these guidelines should be flexible and based on individual needs and local circumstances. They constitute neither a liability nor discharge from liability. While every effort has been made to ensure the accuracy of the contents at the time of publication, neither the authors nor the Registered Nurses’ Association of Ontario (RNAO) gives any guarantee as to the accuracy of the information contained in them or accepts any liability with respect to loss, damage, injury or expense arising from any such errors or omission in the contents of this work.
