Running head: INTERPROFESSIONAL COLLABORATION 1

Interprofessional Collaboration: A Social Worker’s Point of View

Stephany Villacres

SUNY Delhi

NURS 604 CRN11465

Dr. Digger

September 2018
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Abstract

Effective interprofessional collaboration is the responsibility of all disciplines in order to achieve

good patient outcomes. The Interprofessional Education Collaborative (IPEC) designated four

competencies that when integrated within interdisciplinary teams would improve

interprofessional collaboration. The four competencies are values/ethics, roles/responsibilities,

interprofessional communication, and team/teamwork. The attitudes and viewpoints of a social

worker as it relates to the IPEC competencies are explored. The aim of this paper is to convey

the importance of interprofessional collaboration in improving practice.

Contact Information: Pamela Andrews Email: pandrews@a-b-c.org

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Interprofessional Collaboration: A Social Worker’s Point of View

Interprofessional collaboration in the healthcare field is essential to providing safe and

quality patient care. Patients rely on healthcare professionals to work together to achieve their

best possible outcomes when ill. Unfortunately, interprofessional collaboration does not come

without its obstacles. In 2009 an Interprofessional Education Collaborative (IPEC) was formed

to support and prepare healthcare professionals in learning more and engaging in team-

based care to improve patient outcomes. The IPEC developed four competencies and several sub

competencies to guide individuals through their journey in interprofessional collaboration with

other specialties. The goal is to provide our patients with seamless care that will not only

improve their patient experience but will also improve their outcomes. It is imperative that all

disciplines involved in improving an individual's health be aware of these competencies and help

introduce them into practice.

Social work is one of the many disciplines involved in a patients’ care both inpatient and

outpatient. It is an extensive profession that reaches all levels of healthcare. Social workers are

an essential part of the healthcare team, an advocate for the patient and family, and a resource to

everyone involved in the patients care outside of the healthcare team. As Pamela

Andrews stated, “A social workers goal is to improve the lives of those they advocate for and we

can do this in so many ways.”

Pamela Andrews, LMSW, MPH

Pamela Andrews is a licensed clinical social worker who holds a master's degree in social

work and public health. Most of her work has been grounded on improving the health outcomes

and opportunities for underprivileged children in New York City. Pamela works in both inpatient
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and outpatient settings with children and families struggling to find the resources that they need

to get ahead. Currently she works as a therapist at Association to Benefit Children where she

consults with psychiatrists, nurse practitioners, medical doctors, and ACS workers to improve

the well-being of a child in an at-risk home. Pamela also works inpatient per-diem at New York

Presbyterian hospital as a social worker for one of the behavioral health units. Pamela’s role both

inpatient and in the community is to find adequate mental health services for her clients along

with programs that will increase their productivity in society.

Values/Ethics for Interprofessional Practice

In an individual's professional practice, it’s important to have clearly delineated values

and ethics to be able to achieve optimal patient outcomes. The expectation is that these values

and beliefs will then transcend into the individual's interactions with other disciplines. These are

Pamela’s thoughts on how professionals in the healthcare field should operate with other

professionals; unfortunately this is not always the case. All healthcare professions are taught

differing values in school and this can cause frustration in the workplace because disciplines find

it difficult to create mutual values by which to work by.

As a professional/expert in your own field of practice there must be some values that you

have that other professions do not share. How do you overcome such barriers?

Pamela speaks about the struggles there are among interdisciplinary teams finding

common values and respecting differing perspectives. She states that often she finds herself

competing for attention because her role is not seen as important as others. As she reflects on her

past experiences Pamela states that unfortunately social workers are not as valued as other

disciplines and therefore not able to contribute as much as she would like.
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One of her biggest struggles is conveying with the healthcare team the importance of

communication between the patient, healthcare team, and family. Pamela strongly believes that

including the family in the patients' care is essential to a safe and speedy recovery. She maintains

that family or close friends are a support system that any individual who is living with a chronic

illness or temporarily debilitating disease needs. Unfortunately, other disciplines do not share

that specific value, and dismiss the importance of patient-family centered care. Chong, Aslani, &

Chen (2013), discussed that one of the biggest difficulties for social workers was finding

adequate support systems to help transition the patient from inpatient to outpatient safely.

Resistance is often met by other disciplines that do not believe the family is an adequate support

system, and prefer to try a different approach that only leads to the patient coming back into the

hospital shortly after discharge. In the mental health care community education about the

patients’ illness and treatment is imperative to improving their outcomes. Unfortunately, the lack

of communication among the interdisciplinary teams and patients often leads to a negative

patient outcome.

When family is not being included in the decision making process it falls on Pamela to

try and include the family, but it becomes difficult doing it on her own. She says that the only

way to overcome such a barrier is to educate the patient on the benefits of patient-family

centered care. Pamela educates the patient and then the patient can speak for him or herself and

ask for the family to be included. Pamela explains that the most important aspect of a healthy and

trusting relationship between healthcare providers and patients is education. For

many patients the healthcare field is a wide area of unknown and it is up to the professionals to

continuously educate the patient about his care, resources, and what to expect.

Roles & Responsibilities

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With so many distinct disciplines involved in a patient’s care it’s easy to confuse the

roles and responsibilities of each individual member. However, it is up to each professional to

learn more about their team members individual and collaborative roles. A team will not work

effectively if everyone is not fully knowledgeable or willing to learn about their other team

members scope of practice. Ambrose-Miller & Ashcroft (2016), discussed the challenges that

social workers faces with role clarification within a healthcare team. The role of the social

worker has continued to expand, and it is imperative that professions are made aware of the

competencies that these professionals have. Unfortunately, due to already existing structures and

healthcare models within hospitals, the role of the social worker can be challenged by other

disciplines. It is left up to the social worker to speak up and challenge other disciplines who

might not be aware of the social workers scope of practice (Ambrose-Miller & Ashcroft, 2016).

Do your professional responsibilities at times become blurred due to the lack of knowledge

of other disciplines?

When working with adults on the behavioral health unit many times Pamela has seen the

confusion on her team members face when she attends a meeting. She states that more than once

she has been told, “this person has no difficulty with child services” or “she already has a doctor

and doesn’t need an appointment.” Comments such as these shed light on the lack of knowledge

other professions have about her scope of practice. Pamela understands that a big part of her

work lies in finding appropriate resources for her patients once they leave the hospital.

However, she can also offer other services such as individual and/or family counseling,

insurance information, and medical benefits.

At her other job, the Association to Benefit Children, the contrary occurs. Her team

members are aware of what she can do but her job description pertains more to helping the
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family connect with community resources as opposed to providing therapeutic counseling.

Unfortunately, when a therapist is out she is called in to conduct a last-minute session with a

family and this can be a bit of hassle because she has other responsibilities to manage. Pamela

spoke about the importance of knowing your role where you work and educating others about it.

Professions can carry the same titles in different work places, but this does not mean that

responsibilities and roles are the same.

Every profession has limits to what he/she can do. Does your team offer you the support

and resources you may need to accomplish the goals you have for your patients?

Knowing your team members role alone is not enough to providing effective

interprofessional care. Communicating with them about what their needs are, how you can help,

and vice versa is what allows for interprofessional collaboration. Many times, Pamela states that

she is given tasks to do from the doctor without a proper discussion taking place beforehand.

Pamela finds it difficult to work with professionals who do not understand or are unable to see

the entirety of her role within the team. She finds that she must explain herself multiple times

and clearly state what she needs to fulfill her responsibilities. For example, the doctor will ask

her to find the patient placement for rehab but has not filled out the pertaining paperwork. Or

sometimes elderly patients need physical therapy services at home but have not had an inpatient

evaluation. These missing components make it impossible for Pamela to submit the adequate

paperwork to find her patients the services they need. Communication is what often time lacks

between disciplines often resulting in disruptions in care.

Interprofessional Communication

There is a lot of different technological tools that facilitate communication between

individuals that you would think communication would not be a problem. However, it is
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sometimes these very tools that allow for miscommunication to happen more often than we

would like. Pamela uses three different tools her work cell phone, work e-mail, and

an iPhone that uses a messaging app to communicate with disciplines that do not have a work

cell phone. Keeping track of all the messages and e-mails that occur throughout the day along

with her digital calendar can be overwhelming. Pamela says the best form of communication,

speaking, has been almost completely obliterated and this makes her job more difficult.

What do you believe is your biggest barrier to communication with other members from

different interdisciplinary teams?

Pamela talks about how solely relying on e-mail to get real time information to a

professional can causes mishaps to happen often. Changes in care plans are happening constantly

and to keep all disciplines in the loop can be difficult. A mass e-mail can be sent but then

perhaps someone is not copied on the e-mail and the vicious cycle of miscommunication begins.

Pamela believes that the best way for everyone to be up to date is to hold an interdisciplinary

meeting in the morning and brief meeting at the end of the day with updates. This system not

only follows a schedule, but all disciplines are encouraged to attend, in the case someone is not

able to make it then updates can be given to a team member to inform the team on their behalf.

Teams & Teamwork

Teamwork can only be achieved if everyone involved is mindful that the goal is to

provide excellent patient care and that can only be done as a team. If disciplines decided to

operate independently of each other than the patient can be subjected to erroneous information,

repetitive exams, and receive inconsistent care. Teamwork is essential in healthcare because it

allows for continuous, integrated, systematic care.

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What strategies do you use to work effectively and collaboratively with other disciplines to

achieve good patient outcomes?

Pamela believes that developing a plan at the beginning of a patient's care is essential. A

plan acts as a guide for all members of the interdisciplinary team to follow. It provides structure

and a template. Pamela insists that the plan must not only be developed at the beginning of the

patients care but consistently updated as the patient transitions from one level of care to another.

Pamela finds that when a plan is developed and changed it is more likely to be followed and

allows for all team members to be on the same page.

How do you and your team manage disagreements and handle accountability related to

poor patient outcomes?

In healthcare accountability is an important topic because it allows us as professionals to

own the work that we do and improve in areas that we might be at fault. Patient success stories

do not occur all the time and sometimes there is a break in communication and a patient's care is

less than optimal. When this happens it’s important to be able to speak about the frustrations and

causes behind a poor patient outcome. Pamela states that ironically it is when a substandard

patient outcome occurs that the team is most cohesive and willing to work together to remedy the

situation or prevent it from happening again. Pamela discussed more discussions, policies, plans,

and procedures being put into place after a negative patient experience that truly prevents it from

happening again.

What Did I Learn?

There are a lot of moving parts to interprofessional collaboration. It's not as simple

as gathering all the disciplines in one room and making sure everyone is speaking; it’s beyond

that. It’s knowing more about each profession, and how you can help each other out. It's about
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consistently communicating and updating everyone on decisions that are being made. It’s about

keeping the patient and family at the center of all decisions and acknowledging that our

responsibility is to them. Perhaps most important, is that I learned that interprofessional

collaboration is learning that each discipline is significant and that there is no one discipline that

is superior to any other. Every discipline contributes significant and relevant care to the patient

and their overall wellbeing. Rishel & Hartnett (2017), explored how to better prepare social

workers for interprofessional collaboration within the health care team. Their focus was on

including healthcare models with a focus on interprofessional collaboration within their

coursework prior to graduation. In this way individuals that were going into the field were well

aware of the other disciplines role and responsibilities. I believe that if we include more

coursework and practicum experience in each disciplines formal education it will help improve

interprofessional practice.

Application of IPEC Competencies in my Practice

As a nurse it is imperative that I keep the IPEC competencies at the forefront of my

practice because it will help improve my patient outcomes. Looking through all the competencies

I’m able to reflect on areas in which I need to improve. This interview and paper have helped me

realize that the competency which I need to improve the most is knowing about other disciplines

roles/responsibilities. Unfortunately, I know the basic there is to know about other disciplines,

and rarely find the time to attend interdisciplinary rounds. I simply send a quick message to the

head doctor or physician assistant and ask for updates and this is not enough. Talking with

Pamela made me realize that I’m missing the bigger picture and being a part of the team can not

only help me understand my patients progress through the hospital from admission to discharge

but can also help me know what will be expected and when.
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References

Ambrose-Miller, W., & Ashcroft, R. (2016). Challenges Faced by Social Workers as Members

of Interprofessional Collaborative Health Care Teams. Health & Social Work, 41(2),

101–109. https://doi.org/10.1093/hsw/hlw006

Chong, W. W., Aslani, P., & Chen, T. F. (2013). Shared decision-making and interprofessional

collaboration in mental healthcare: A qualitative study exploring perceptions of barriers

and facilitators. Journal of Interprofessional Care, 27(5), 373–379.

https://doi.org/10.3109/13561820.2013.785503

Rishel, C. W., & Hartnett, H. P. (2017). Meeting the Challenge of Preparing Social Workers for

Integrated Health Practice: Evidence From Two MSW Cohorts. Journal of Social Work

Education, 53, S27–S39. https://doi.org/10.1080/10437797.2017.1288593