INTERPROFESSIONAL COLLABORATIVE

HEALTH PRACTICE
UGM EXPERIENCES

SIMULATED HOSPITAL THE REAL HOSPITAL

Sunartini Hapsara

LECTURE S2 PSIK FK UGM , SEPTEMBER 2016

ABS.30-08-2004
 ABS022005

CURRICULUM VITAE
Name : Dr. Sunartini-Hapsara, PhD
Position : Professor in Pediatrics,
Senior Advisor of School of Nursing
and School of Midwifery UGM,
Coordinator IPE / IPCP UGM Hospital
Director of Children House Griya Lare Utami
Education : Medical Doctor, UGM, Jogjakarta
Pediatrician, UGM, Jogjakarta
PhD, Kobe University, Japan
3
Component of Multidisciplinary Teamwork

4
 IMPLEMENTATION OF IPCHP (1)

Content :

1.Operational Definition
IPE and IPCHP or Inter professional
Teamwork
2. Aims of IPCHP for Medical, Nurses and
other Human Health Resources Education
 Definition of Multiprofessional,
Interprofessional and
Transprofessional Education (1):
Multi professional education:
Occasions when two or more professions learn
side by side for whatever reason.
Multi professional teamwork :
Several medical and health professional provide
various aspects of management and care, but
separatedly in their services without any
coordination one to other profession
NIN 11
 Definition of Multiprofessional,
Interprofessional and
Transprofessional Education (2):
Inter professional education:
Occasions when two or more professions learn
from and about each other to improve
collaboration and the quality of care.
Inter professional teamwork:
Patients cared by several teams from different
medical and other health professionals but stay
in one coordination and collaboration among the
professionals. Provider must has same aim,
same responsibilty and same resources.
 Definition of Multiprofessional,
Interprofessional and Transprofessional
Education (3) :
Transprofessional education
Occasions when two or more professions learn from
and about each other, harmonize and respect to their
culture to improve collaboration and the quality of
care.
Transprofessional team work:
Relationship among medical and other health
professionals provider very close, harmonize and
respect to their culture impressed no a professionals
limits among them To analysis the patient's
problem solving using a collaborative approach in
NIN 11
making a decision
 THE DIFFERENT OF INTERPROFESIONAL,
MULTIPROFESIONAL &TRANSPROFESIONAL
COLLABORATIVE HEALTH PRACTICE (3)

MONO DISCIPLINE MULTI INTER DISCIPLINE TRANS DISCIPLINE

INTRA DISCIPLINE INTER TRANS
PROFESSIONAL MULTI PROFESSIONAL PROFESSIONAL
PROFESSIONALS
 IMPLEMENTATION OF IPCHP (2)
Content :

3. Implementation of IPCHP in Hospital.

UGM Experiences
a) The trial in Pediatric Wards Dr. Sardjito
Hospital
b) Collaboration with JICA
Mobile Rehabilitation after earth quacke
c) IPE Clinical problem solving and decision
making
d) From Simulated to the Real Hospital
 IMPLEMENTATION OF IPCHP

Content :

4. Integrated Health Services :

UGM Academic Hospital
a) Mater Plan
b) Cluster Model Hospital
c) Health Care Services Base on Cluster.
Evidence and Value (Integrated Health
System)
5. Constraint and Hope for Implementing IPE
and IPCHP in every Teaching Hospital
 EXPECTED COMPETENCY FROM IPE
Knowledge: understand the autonomy of each
profession and their respective roles in the
collaboration
Skills : professionalism is maintained, not to
scramble nor contrary but to synergize,
complementary and integrated in holistical
services, humane, ethical and quality. Good
communication skill, give a priority client/patient
safety
Attitude : professional, respect to each other,
sincerity cooperated in allignment, has mutual trust
to other professions, openess, dicipline and
responsible
 WHY IPE IS IMPORTANT IN
MEDICAL TEACHING? : (2)
Aim of IPE : in order to student will
1.Ready to collaborate (in knowledge, skills,
behaviour, and in perception of professional
collaboration)
2.To improve team work by learning together,
working together, and to observe and review
patient together
3.To increase quality of service
4.To understand about priority of patient
safety
It has been suggested that "each team
member's abilities, skills experience,
attitudes, values, role perceptions and
personality all the things that make a
person unique determine what they are
willing and able to contribute, their level of
motivation, methods of interaction with other
group members and degree of acceptance of
group norms and the organization's goals"
Teamwork is essential in the provision of
healthcare. The division of labor among medical,
nursing and allied health practitioners means
that no single professional can deliver a
complete episode of healthcare
Formal training in teamwork skill development in
undergraduate or postgraduate health
professional education programs teamwork
skills are largely learned 'on-the-job .

In healthcare, where patient outcomes are

dependent on effective interdisciplinary
teamwork, there is need for better preparation of
health professionals in teamwork.
The vision developed for the integrated
services initiative was:
Integrated community-based health and social
services provide efficient, effective and holistic
services that are person/family focused and
seamless and that recognize the principles of
population, social services reform and primary
health care.
 Facilitators
Community leadership
Programmatic leadership
Organizational support
Co-location of workers

Three motives received the highest ranking of

all the skills, knowledge, traits and motives;
commitment to working collaboratively (64.1%),
commitment to a quality outcome (69.2%) and
commitment to organization (64.6%).
 Tabel 1. Areas of conflict between
the professional and TQM

Professional (Indibidual) IP Collaborative

Individual responsibilities Collective responsibilities
Professional leadership Managerial leadership
Autonomy Accountability

Professional authority Professional Participation

Goal expectations
Rigid Individual Planning
Restrospective
performance appraisal
Performance & process
expectations
Team collaborative planning
Concurent performance
appraisal / Audit
Quality improvement and
 Definition of Multiprofessional,
Education and Teamwork (1):

Multi Professional Education:

Occasions when two or more professions learn
side by side for whatever reason.
Multi Professional Teamwork :
Several medical and health professional provide
various aspects of management and care, but
separately in their services without any
coordination one to other profession

NIN 11
 Definition of Inter professional
Education qnd team work (2):

Inter Professional Education:

Occasions when two or more professions learn
from and about each other to improve
collaboration and the quality of care.
Inter Professional Teamwork:
Patients cared by several teams from different
medical and other health professionals but stay
in one coordination and collaboration among the
professionals. Provider must has same aim,
same responsibilty and same resources.

 Definition of Transprofessional Education

and Teamwork(3) :
Transprofessional Education
Occasions when two or more professions learn from
and about each other, harmonize and respect to their
culture to improve collaboration and the quality of
care.
Transprofessional team work:
Relationship among medical and other health
professionals provider very close, harmonize and
respect to their culture impressed no a professionals
limits among them To analysis the patient's
problem solving using a collaborative approach in
making a decision
NIN 11
 THE DIFFERENCE OF INTERPROFESIONAL,
MULTIPROFESIONAL &TRANSPROFESIONAL
COLLABORATIVE HEALTH PRACTICE (3)

MONO DISCIPLINE MULTI INTER DISCIPLINE TRANS DISCIPLINE

INTRA DISCIPLINE INTER TRANS
PROFESSIONAL MULTI PROFESSIONAL PROFESSIONAL
PROFESSIONALS
 EVIDENCE BASED CLINICAL PROBLEM SOLVING
AND DECISION MAKING SOAPIER
Date base Date Base Active and
History taking (S) Summary in active Differential
Physical Exam (O) Problems Diagnosis
Lab. Exam (O)

INITIAL PLAN for Solving the Problem

IMPLEMENTATION
P) Diagnostic
Priority
P) Treatment
As Well as Standards
P) Intervention
(Making Decision)
P) Therapy
P) Patient Education
P) Habalitation and Rehabilitation
FOLLOW-UP
PROBLEMs
Evaluation (E) PROGRESS /
LIST
S, O, A Advance PLAN
(New / added) Discharge
REARRANGEMENT
NIN.03
 EXPECTED COMPETENCY FROM IPE
Knowledge: understand the autonomy of each
profession and their respective roles in the
collaboration
Skills : professionalism is maintained, not to
scramble nor contrary but to synergize,
complementary and integrated in holistical services,
humane, ethical and quality. Good communication
skill, give a priority client/patient safety
Attitude : professional, respect to each other,
sincerity cooperated in allignment, has mutual trust
to other professions, openess, dicipline and
responsible
 WHY IPE IS IMPORTANT IN
MEDICAL TEACHING? (2)
Aim of IPE : in order to student will
1.Ready to collaborate (in knowledge, skills,
behaviour, and in perception of professional
collaboration)
2.To improve team work by learning together,
working together, and to observe and review
patient together
3.To increase quality of service
4.To understand about priority of patient
safety
 Working together
To work together requires : people with different
professional interests to value each others
contribution to patient care

Teaming is a complex process of bringing together

differences to create something new. It requires
people to stretch beyond their own belief system
and personal assumption about themselves and
others

Teamwork is essential for high performance,

much like exercise is to health
NIN 11
 The power of multidisciplinary
health care teams

When we work as a team, we achieve a higher

degree of success
Interdisciplinary team
is one of the most widely accepted innovations in
the delivery of medical, mental care, social
services.
Initially, groups come together as a collection of
individuals, they really have commons how
different they are from one another.
 Interdisciplinary team
For creating great results, we offer some
beginning suggestions :
Assume that we each begin from a place of
difference not similarity.
Ask clarifying questions such as You said
the patient is not doing well and why
have drawn that conclusion ?
Ask for help and suggestion from others
Encourage others to ask for help by molding
yourself.
Be accessible and readily offer your assistance
to others
 Collaboration and partnership
Collaborations :
image of people from a range of profession all
working together as equal
To be successful, the health care system
needs to provide supportive structures.

In reality is that collaboration is often much

easier said than done needs preparation
to practice collaborative work IPE
 Development of Medical, Nurses
and other Human Resources for
Health Development

MAIN STEP OF
HEALTH WORKFORCE DEVELOPMENT
(HUMAN RESOURCES FOR HEALTH)

SOURCE : UU NO 36 / 2009 ABOUT HEALTH CHAP 21 AND R HAPSARA HR 2011

31
 MAIN STEP OF
HEALTH WORKFORCE DEVELOPMENT
(HUMAN RESOURCES FOR HEALTH)
1. Planning of Human Resources for Health
(HRH)
2. Education of HRH
3. Management of HRH (Pendayagunaan
SDMK)
^ Distribution
^ Usefull (Pemanfaatan)
^ Carrier Development ( Pengembangan
Karir)

SOURCE : UU NO 36 / 2009 ABOUT HEALTH CHAP 21 AND R HAPSARA HR 2011

32
 MAIN STEP OF
HEALTH WORKFORCE DEVELOPMENT
(HUMAN RESOURCES FOR HEALTH)

4. Supervision and control (Human

Resources Supervision and Quality Control
for Health)
a. CERTIFICATION, REGISTRATION,
COMPETENCY ASSESSMENT, LICENCING
b. HRH INFORMATION SYSTEM
c, RESOURCES FOR HRD (HRD, FINANCING.
FACCILLITY ETC)
d. LEGISLATION

SOURCE : UU NO 36 / 2009 ABOUT HEALTH CHAP 21 AND R HAPSARA HR 2011

33
 IMPLEMENTATION OF
INTERPROFESSIONAL EDUCATION (IPE)

APPROACH IN STRATEGIC PLAN FOR IPE

WE MUST HAVE
1. ACTION PLAN
2. LESSON LEARNT
3. CHANGE OF CONFIGURATION/TRANFORMATION
A. CHANGE
B. INTEGRATION
C. PERIODICAL IMPROVEMENT
4. AUTORITY / POWER

SOURCE : UU NO 36 / 2009 ABOUT HEALTH CHAP 21 AND R HAPSARA HR 2011

 Science Problem System
1900 based based based 2000

Problem- Competency-
Scientific
Instructional based driven local-
curriculum
learning global

Health-
University Academic
Institutional education
Based centers
system

Figure : Three generations of reform

in health education
Frenk Julio, et al 2010
35
 Health education
Traditional model
Educational
objectives
Curriculum

Asesment

Competency-based education model

Health needs Competencies

Curriculum
Health systems Outcomes

Asesment
Frenk Julio, et al 2010
 SPECIAL FEATURES OF IPE :
There were changes in mindset, knowledge and
attitudes of learners/students :
Learners / students understood the basic
principles, concepts and contributions of each
profession
Familiar with the language / terms as well as
the mindset of the various types of professions
Before participating in IPE students / learners
have already mastered the basic knowledge
and specific skills of each profession
 WHY IPE IMPORTANT IN
CLINICAL LEARNING?? : (1)
TEAMWORK in health care is often
required in the practice of various
professions.
Application of interprofessional practice
produce a comprehensive and integrated
services in accordance with the value
(dignity) and the expectations of clients /
patients.
 WHY IPE IMPORTANT IN
CLINICAL LEARNING?? : (2)

The purpose of IPE is to prepare

students for health professions
with knowledge, skills, attitudes
and professional behavior that
are essential to the practice of
interprofessional collaboration.

39
Health and Education System
Health Outcome
Increase
Local Contex

Interprofessional Education
Education and Strengthened
Health System Health System
Collaborative Optimal
Collaborative
Practice Ready Health
Present & Practice
Future Services
Interprofessional Health
Health Education
Workforce Workforce

Fragmented
Health System

Local Health
WHO - 2010
Needs
Interprofessional Education

Present & Collaborative

Future Interprofessional Practice Ready
Health Education Health
Workforce Workforce

Collaborative Practice

Collaborative
Practice Ready Collaborative Optimal
Health
Health Practice Service
Workforce

WHO - 2010
 INTEGRATED TEACHING

Doctor

Assessment
Diagnosis
Cases :
Therapy
Nurse main Others
complaint

Nutritionist
 INTEGRATED TEACHING WITH
OTHER HEALTH PROFESSIONAL

Doctor
Learning Together
Joint Guidance
Joint Research
Patient
Nurse Others
centered

Nutritionist

43
 Implementation of IPE Multi
professional Teamwork
in Pediatric Wards Dr. Sardjito General
and Teaching Hospital
Since 2003 started with discussion of
clinical problem solving conducted by young
doctor (co assistant), young nurse (nurse
assistant / Aners) and young dietitians every
Wednesday morning from 7.30 a.m 9.30 a.m.
2004 developed multidisciplinary team
based clinical education 2010 IPE & MPT
 Implementation of IPE Multi
professional Teamwork
in Simulated Hospital The Real Hospital

June 2006 Jogja Earthquick 6.1 Richter

Scale (Magnitude)
Sice 2003 started with discussion of
clinical problem solving conducted by young
doctor (co assistant), young nurse (nurse
assistant / Aners) and young dietitians every
Wednesday morning from 7.30 a.m 9.30 a.m.
2004 developed multidisciplinary team
based clinical education 2010 IPE & MPT
 Implementation of IPE Multi
professional Teamwork
in Pediatric Wards Dr. Sardjito General
and Teaching Hospital
Sice 2003 started with discussion of
clinical problem solving conducted by young
doctor (co assistant), young nurse (nurse
assistant / Aners) and young dietitians every
Wednesday morning from 7.30 a.m 9.30 a.m.
2004 developed multidisciplinary team
based clinical education 2010 IPE & MPT
 Implementation of IPE Multi
professional Teamwork
in Pediatric Wards Dr. Sardjito General
and Teaching Hospital
Sice 2003 started with discussion of
clinical problem solving conducted by young
doctor (co assistant), young nurse (nurse
assistant / Aners) and young dietitians every
Wednesday morning from 7.30 a.m 9.30 a.m.
2004 developed multidisciplinary team
based clinical education 2010 IPE & MPT
Collaborative Education
 Interprofessional education : achieving a
collaborative practice-ready health workforce

IPE is shape by mechanism that can be

broadly classified into those driven by
Staff responsible for developing, delivering,
funding and managing interprofessional
education
The interprofessional curricula
 Interprofessional education : achieving a
collaborative practice-ready health
workforce
Supportive institutional policies and managerial
commitment (38)
Good communication among participants
Enthusiasm for the work being done
A shared vision and understanding of the benefits of
introducing a new curriculum
A champion who responsible for coordinating
education activities and identifying barriers to
progress (39)
 Research indicates that IPE is more
effective when :

Principles of adult learning are used (e,g

problem-based learning and action learning
sets)
Learning methods reflect the real world practice
experiences of students
Interaction occurs between students
Examples grouped under the interprofessional
learning domains

Teamwork
Roles and responsibilities
Communication
Learning and critical reflection
Relationship with, and recognizing the needs of,
the patients
Ethical practice
 PATIENT SAFETY
Whose responsibilities?

THE IMPLEMENTATION OF
MULTIDECIPLINARY
/MULTIPROFESIONAL TEAM

PSIK UGM
EXERCISE AND UNDERSTANDING
OF IPE BEFORE REAL PRACTICE
TO THE CLIENT / PATIENT MINI HOSPITAL
 Doctors Oath
Nurses Oath
Midwifery Oath
Safety of patients /
clients will always be
my priority

54
55
56
SIX (6) Dimensions of quality in health care :

Equity
Appropriateness
Accessibility
Acceptability : a service oriented towards the
consumer in terms of choice, privacy and
personal service
Efficiency : doing things right; careful use of
resources and clear professional standards
Effectiveness : doing the right things ; the
service provided should fit the needs of the
people served
FIVE STEPS TO SAFER HEALTH CARE
PATIENTS SIDE

Ask questions if you have doubts or concerns

Keep and bring a list of All the medicine you
take
Get the results of any test or procedure,
Talk to your doctor about which hospital is
best for your health needs
Make sure you understand what will happen if
you need surgery
PATIENT SAFETY
SAFER HEALTH CARE :
NO * MEDICAL ERRORS
* POOR QUALITY OF PATIENT CARE
(NURSING ERRORS ?)
* UNNESECERY DEATH/ DISABILITY
The keys:
The good Communication and informative
Teamwork -> Doctor and Nurse Collaboration
The role of the patient / family
Patients Right
Patients Liabilities
Medical Record
 INDONESIA
Jogjakarta
13,677 big & small Islands
220 million people
3.1 - 5.5 million -disabled
Now ??? Thousands new
Disables, handicapped,
diffables
JOGJAKARTA (Smallest Province)
4 million inhabitants
200 Health Centers
Jogjakarta city: 350,000 pop.
20 HC, > 100 Univ.& Academy
Bantul District area : 800.000 pop.
 Background
6.2 Richter Scale tectonic earthquake struck
Yogyakarta and Central Java Province on May 27th
2006
Destroyed 5 districts in Yogyakarta province:
Bantul, Kulon Progo, Gunung Kidul, Sleman, and
Yogyakarta city
1 district in Central Java: Klaten
Bantul The worst suffered area
Among 79.210 populations in Bantul District
4280 people died; 8973 people with severely
injured; and 3250 people with fairly injured
 Background.. cont
More than 17.000 people have been suffering
from fracture; head and spinal injury; followed
with neurological, defecation and urination
defects.
Mental defects such as post trauma stress
disorder (PTSD) found in children, adults, and
elderly people.
 Reasons for Community-Based
Rehabilitation
It will empower the local community to solve their
own problems. External aids will not last for long
period
The typical local characteristic of Yogyakarta people
is that they are always help each other and work
together voluntarily for public need (Gotong
Royong)
By involving local resources and incorporate local
values and wisdom it will increase the sustainability
of the project.
 Consideration for Choosing Two Target Areas:
Jetis & Pleret Sub-District

Pleret consists of 5 villages and 47 sub-villages.

Among 41.975 populations 526 people died;
4.777 people with severely injured (more than
50% of all injured patients in Bantul)
Jetis consists of 4 villages and 64 sub-villages. In
this area 872 people died and 223 people with
severely injured
 Community Based Rehabilitation

Involve :
Health Cadres (A group of ordinary people
who are trained specially and work voluntarily
for providing basic health services)
Youth volunteers
Teachers
Family members of victims
Higher education students (Nursing,
physiotherapy, psychology, and medical
students)
Objectives

1. Producing competent cadres (including health

cadres, youth volunteers, and teachers) who are
able to deliver basic rehabilitation services for
their own community
2. Producing competent cadres (including health
cadres, youth volunteers, and teachers) who are
able to conduct early detection to earthquake
victims that have to be referred to hospitals that
have better rehabilitation facilities.
 Objectives
3. Conducting Mobile Rehabilitation provided by
Integrated Rehabilitation Team (Consists of nurses,
physiotherapist, medical rehabilitation doctors,
psychologist, and pediatricians) in target areas at
sub-district or village level
4. Conducting supervision and monitoring of the basic
rehabilitation activities provided by cadres, youth
volunteers, and teachers
 Output
Competent cadres who are able to provide
basic rehabilitation services and detection of
handicapped and disabilities
The earthquake victims in the targeted areas
receive appropriate rehabilitation services
regularly.
The number of disabilities is reduced while
the live quality increase
 Output
The earthquake victims can regain their self-
confidence and self-reliance as well as to
improve the quality of live.
System of mobile rehabilitation is developed as
a model of Community Based Rehabilitation
(CBR)
Rehabilitation networking is developed, in
which for the future it could be utilized to
strengthen health care provided by Jetis and
Pleret Primary Health Center
Methodology
Approach :
Community Based Rehabilitation (CBR)
defined as strategy within community
development for the rehabilitation,
equalization of opportunities, and social
integration of all people with disabilities. CBR
is implemented through the combined effort
of disabled people themselves, their families
and communities, and the appropriate health,
educational and social services (WHO, 1994).
 Safety of patients /
clients will always be
my priority

71
 Start with Case discussions
Clinical Problem Solving (1)

Socialization IPE & MPT to all Doctors

and Nurse Supervisors
72
 Start with Case discussions
Clinical Problem Solving (2)

Socialization IPE & MPT to Medical and

Nursing Students before starting Clinical
Practice with real patients 73
 EVIDENCE BASED CLINICAL PROBLEM SOLVING
AND DECISION MAKING
Date base
Active and
History taking (S) Date Base
in active
Physical Exam (O) Summary Differential
Problems
Lab. Exam (O) Diagnosis

INITIAL PLAN for Solving the

Problem
IMPLEMENTATION P) Diagnostic
Priority P) Treatment
As Well as Standards P) Intervention
(Making Decision) P) Therapy
P) Patient Education
P) Habalitation and Rehabilitation

FOLLOW-UP PROBLEMs
Evaluation (E) LIST PROGRESS /
S, O, A (New / added) Advance PLAN
REARRANGEMENT Discharge
NIN.03
IMPLEMENTATION IPE & MPT WORK
HOSPITAL INFECTION CONTROL PROGRAM

TRAINING FOR PRACTICING HAND WASHING

FOR ALL STAFF AND PATIENTS
 IMPLEMENTATION IPE & MPT WORK
AFTERNOON REPORT & EVALUATION

MAKING A NEW PLAN

AND REARRANGEMENT,
REMANAGEMENT

SUMMARY TIME INTEGRATED

ORIENTED RECORD
INTERPROFESSIONAL TEAMWORK
MOBILE REHABILITATION

NNN
 Constraints and Problems &
MPT Work
The very difficult problem are changing mindset
of the doctors and improving professional
behavior of nurses
Not equity in welfare
Do nurse collaborate with patients in the
same
way as they collaborate with doctors ?
Do doctors come to the table as equals with
both and patients ?
Do varying degree of professional power
disrupt the processes of collaboration ?
RELA & IKHLAS in responsibility and in
Doctor-nurse-patient Collaboration
Will give many good aspects :
Improve Patient care and safety
Improve Patient and family satisfaction
Nurse satisfaction and retention
Physician and nurses trainee often begin a
potentially collaborative interaction feeling
worried about their patient and sometimes
uncertain of what might be the best thing to do.
Teamwork is essential for high performance,
much like exercise is to health
Decision Making : those steps for Patients
Problem Solving are done with responsibility of
case manager until patient discharge from ward
 Implementation of IPE
in Dr. Sardjito Teaching Hospital (2)
The content of the summaries are :
The result of implementation of patient plan
(doctors, nurses, dietitians, physical therapist
plan)
Evaluation of whether the doctors do their
own management therapy with a nurse or it
conducted by nurse while the doctor is only
giving instructions.
 Implementation of IPE
in Dr. Sardjito Teaching Hospital (3)

The content of the summaries are : (cont)

Does the doctor always control the therapy and
dietary of the patient?
What things that should be done by a doctor but
performed by a nurse without the delegation of
authority?
There are any authentically evidences of
delegation of authority?
Whether doctors often see / read the nurses
medical records??
 Implementation of IPE
in Dr. Sardjito Teaching Hospital (11)
Medical and Nursing Audit, Maternal Perinatal
Audit and Audit of Death
The benefits:
* professional assessment of each profession
To know if there are any deviations in the
medical and nursing care or not
to determine the cause of death and analyze
whether it is natural death or not
to make decision about the cause of death for
Certificate of Death
 Implementation of IPE
in Dr. Sardjito Teaching Hospital (10)

Death Conference
Other concrete activities of IPE &
Multiprofessional Teamwork are discussing for
Auditing patients death and to make Certificate of
death
From the audit of patients death we can learn our
mistakes in management of patient (in the past)
so that those mistakes will not happen again in the
future and can be prevented through appropriate
management of care to patient safety
Vision for a new era of professional education

Transformative Interdependence
learning in education

Equity in health
Individuals Population
Patient-centered based

Frenk Julio, et al 2010

 GADJAH MADA UNIVERSITY
RESEARCH AND TEACHING HOSPITAL
FIRST PHASE

CLUSTER, INTEGRATED,
MULTIPROFESSIONAL TEAMWORK, IPE
 WHO - 2010
Increasing Health
Outcome
Local Conteks
The Health and Training The Strengethenes
System of Health System

Ready The Optimal

Collaborative Collaborativ Health Services
Practice e Practice

Tuntutan Kesehatan
Pendidikan
Saat ini dan Masa yang Tuntutan
akan Datang Interprofesional
kesehatan

Pelayanan Kesehatan
Terpecah-pecah

Kebutuhan
Kesehatan Lokal
(Bushby et al, 2009 Manajemen Interdisipliner DMD
Versi Inggris
IMPLEMENTATION OF INTEGRATED
HEALTH WORKFORCE STRATEGIES

HEALTH
SYSTEM

HEALTH WORKFORCE IHEALTH

PLANNING & POLICY WORKFORCE
MAKING STRATEGIES

EDUCATION
SYSTEM

WHO 2010
HEALTH SYSTEM DELIVERY MECHANISM

Remuneration Financing Commisioning

Capital System
Planning Funding
Streams

FRAGMENTE HEALTH & STRENGHTHE

D HEALTH EDUCATION D HEALTH
SYSTEM SYSTEM SYSTEM

Professional
Risk Registration
Management Accreditation Regulation

Examples of influences that affect inter professional education

education and collaborative practice at the system level
 Health Canada Funded Synthesis

http://www.hc-sc.gc.ca/hcs-sss/hhr-rhs/strateg/interprof/index-eng.php
 Examples of mechanism that shape interprofessional education at the
practice level

Institutional
Staff training support Managerial Learning
commitment outcomes
Champions

Present & Future Collaborative

health Interprofessional Practice-ready
workforce Education Health
workforce

Logistic & Assessment

Scheduling
Adult Contextual
Compulsory
Program learning learning
attendance
content principles
Learning
Shared methods
objectives
 Examples of mechanism that shape
collaboration the practice level
Supportive
Governance Shared management
models Structural operating Personnel practice
protocols resources policies

Collaborative Collaborative Optional

Practice-ready Education health service
health
workforce

Communications
strategies
Conflict Shared Built Space
resolution discussion environment design
policies making
processes Facilitie
s
 Collaboration and partnership
WHY DOCTORS ALWAYS FELT MOST IMPORTANT ???
RESPONSIBILITY & ACCOUNTABILITY
THE DISCRIMINATIVE TO THE EDUCATION
SUPERIORITY & INFERIORITY

CAUSED OF DOCTOR INSTRUCTION MADE DOCTORS FEELS THAT

NURSE ARE THE SUBORDINATE
PAYROLL SYSTEM, INJUSTICE OF LICENCES
THE RATIO OF THE PATIENTS PHYSICIAN / POPULATION
THE RATIO OF DOCTORS AND NURSES
DOCTOR SERVICES ??
NURSE SERVICES ??
 CLINICAL EDUCATION ACTIVITY

DOCTORS - NURSE PARTNERSHIP

WHICH MUST BEGIN WITH THE EDUCATION
PLANTING THE ROLES, RESPONSIBILITIES AND
ACCONTABILITY
FROM THE BEGINNING THERES NO JEALOUSY

PENGHARGAAN PROFESI AROGANSI DAN INFERIORITY

DEMOKRATIS, PARTISIPATIF, PROFESIONALISME, ETIK,
MORAL, HUKUM

FIVE STARS DOCTOR, WORLD CLASS NURSE

 MASTER PLAN
ACADEMIC HOSPITAL UNIVERSITAS GADJAH MADA
(RESEARCH AND TEACHING HOSPITAL UGM)
CLUSTERS MODEL . INTEGRATED SYSTEM

H
E G
D F
C B
A
 MASTER PLAN
ACADEMIC HOSPITAL UNIVERSITAS GADJAH MADA
(RESEARCH AND TEACHING HOSPITAL UGM)
CLUSTERS MODEL . INTEGRATED SYSTEM

K
J
L
I