Learner Guide: Collaboration Among Healthcare Professionals and Team Work 3B

Collaboration among healthcare providers is an important part of health care in Canada.

Collaboration is also sometimes called “multidisciplinary care” because it is care that is
provided collaboratively by providers from different health disciplines or professions. In
this unit, you will learn about how patients and families experience collaboration among
healthcare providers as an element of patient-centred practice. When healthcare
providers work together to provide collaborative care, conflict sometimes arises.
Therefore, in this unit you will also learn how to create successful relationships and
manage conflict with patients, families, and other healthcare professionals.

At the end of this session, you will be able to answer the following questions:
ƒ What is collaborative practice?
ƒ What problems does collaborative practice solve?
ƒ What are some approaches to resolving conflict in a collaborative manner?
ƒ What skills does collaborative conflict resolution require?
ƒ How is this approach to care different from your experience and education as a
professional or your experience as a patient?
ƒ What will you have to do differently when you provide care collaboratively with
your colleagues?

Preparation
ƒ Read the session materials, write down any questions you have, and bring your
questions to class.
ƒ Answer the reflective questions as you read.

Key Concepts in this Unit

h Collaborative practice
h Conflict resolution

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Learner Guide: Collaboration Among Healthcare Professionals and Team Work 3B

Collaborative Practice

Collaborative practice means that providers from different healthcare disciplines work
together to provide patient care. Health Care promotes collaborative practice as the
preferred way to address the healthcare needs of patients, and many healthcare
professionals are already involved in collaborative practice. As interprofessional
education becomes increasingly common, collaborative practice will also become more
the norm of practice. This course, itself, is an example of interprofessional education
because the participants come from a variety of healthcare disciplines.

In collaborative practice, healthcare providers from different disciplines work together

with both a common goal and an understanding of what each profession contributes.
Each professional brings a different perspective to the team in caring for the patient. The
goal of collaborative practice is to improve patient outcomes through coordinated care
and improved communication. Collaborative practice promotes active participation from
each professional involved in a patient’s care.

Collaborative practice is built on a foundation of patient-centred practice and is

sometimes called interprofessional collaborative patient-centred practice. At the
centre of the team are the patient and his or her family, who should always be
encouraged to be active participants of the team. When patients are too ill to participate
fully in their care, they should be encouraged to be involved as much as they can. In
order to be full participants, patients need to be aware of all possible treatment options
so they can make informed choices about their care.

An interprofessional care team is most effective when each member of the team has a
good understanding of the role, contributions, and needs of the other team members.
When you are part of an interprofessional team, it is important for you to be able to
define your role and responsibilities to other professionals. In defining your role, you
must be familiar with your profession’s code of ethics and standards of practice.
Members of an interprofessional healthcare team have different areas of expertise and
different scopes of practice. The scope of practice of team members is defined by their
educational preparation and licensing body. Scope of practice includes the roles,
functions, and accountabilities that members of a profession are educated for and
authorized to perform. You are responsible for your practice, including knowing your
limitations and maintaining your competency.

What are the benefits of collaborative practice?

When professionals and patients collaborate to provide care, we see the following
benefits:

ƒ Improved communication
ƒ Increased knowledge and respect for each others’ roles and responsibilities
ƒ A shared goal to improve patient outcomes
ƒ Belief that the patient is at the centre of the team

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Learner Guide: Collaboration Among Healthcare Professionals and Team Work 3B

ƒ Shared power and decision-making among team members

ƒ The ability to resolve conflicts

What are the elements of collaborative practice?

(Oandasan, 2005)

1. Sharing:
ƒ Shared responsibilities
ƒ Shared decision-making
ƒ Shared healthcare philosophy
ƒ Shared planning and intervention
ƒ Sharing of different professional perspectives

2. Partnership:
ƒ Two or more partners joined in a collaborative undertaking
ƒ Collegial relationships
ƒ Open and honest communication
ƒ Mutual trust and respect
ƒ Awareness and appreciation of the work and perspectives of others
ƒ Pursuit of a common goal

3. Interdependency:
ƒ Mutual dependency
ƒ Interdependency rather than autonomy
ƒ Optimization of individual contributions
ƒ Achievements of the team as a whole are greater than the sum of the
contributions made of each individual

4. Power:
ƒ Power-sharing among team members
ƒ Empowerment of each participant, whose power is recognized by the other team
members

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Learner Guide: Collaboration Among Healthcare Professionals and Team Work 3B

What are the obstacles to collaborative practice?

Some of the obstacles to collaborative practice are:
ƒ Poor communication
ƒ Lack of clarity about the roles of team members
ƒ Professional power structures

What are some strategies to improve communication?

Direct communication between professionals can be challenging; for example,
professionals from different disciplines may use different terminology and different styles
of speaking. This can result in communication that is not as straightforward as it could
be. However, communication between team members is essential. The following can
help improve interprofessional communication among care team members.

ƒ Agreement on terminology; interdisciplinary teams need to discuss the issue of

language and develop a plan of communication that will be understood by all.
ƒ Agreement to document all information at the time it is received.
ƒ Commitment to provide clear and objective written information that includes
subjective details provided by the patient about his or her own experience.
ƒ Prompt verbal communication of information to the appropriate team members.

What strategies can be used to clarify the roles of team members and reduce
power struggles?
In an effective team, members are familiar with and respect each other’s roles and
scope of practice. They divide the workload and use team resources efficiently. Patients
and professionals determine treatment goals together. Team members communicate so
they can collaborate. Team members respect each other’s professional judgment. They
demonstrate respect by sharing knowledge with and listening to each other. Team
members trust each other and express themselves openly. Between professions, there
can be tensions over power structures, but members of an effective team work as equals
despite having different practice backgrounds. Decision-making is shared; input from all
team members is incorporated. All team members participate in or facilitate team, family,
and community meetings.

Conflict Resolution
As healthcare professionals, we interact daily with patients, families, and colleagues.
Individuals bring their own background, culture, and beliefs to any interaction with
others, which may lead to varying viewpoints and contribute to conflict. Conflict can be
both positive and negative. If conflict is managed well, it can lead to positive changes;
however, if conflict is managed poorly, the effectiveness of the work being done may
decrease (Drench et al., 2003).

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Learner Guide: Collaboration Among Healthcare Professionals and Team Work 3B

Conflict Management Style

(Arnold & Undermann-Boggs, 2003)
People typically respond to conflict in one of several ways. These include:
ƒ Avoidance: withdrawal from the situation. Use of this style may just postpone the
conflict.

ƒ Accommodation: smoothing over the conflict. This may involve compromising or

giving false reassurance. In giving in to others, peace may be maintained in the
short term, but the conflict is likely to appear again.

ƒ Competition: characterized by domination. One party uses power to achieve his

or her own goals regardless of the other party’s needs. There is a lack of
compromise.

ƒ Collaboration: a cooperative style of problem-solving. Both parties commit to

finding a mutually satisfying solution. Collaboration is considered to be the most
effective style for conflict resolution.

Principles of conflict resolution (Arnold & Underman-Boggs, 2003)

1. Identify conflict issues
2. Know your own response to conflict
3. Separate the problem from the people involved
4. Stay focused on the issue and on the underlying motivations of the other person
5. Identify available options
6. Try to identify established standards to guide the decision-making process

Strategies to enhance conflict resolution (Arnold & Underman-Boggs, 2003)

ƒ Prepare for the encounter
ƒ Organize information
ƒ Manage your own anxiety or anger
ƒ Set a time limit on the encounter
ƒ Use therapeutic communication skills
ƒ Use clear communication
ƒ Discuss one issue at a time
ƒ Work together to find options for resolution of the problem
ƒ Request a change in behaviour
ƒ Evaluate the conflict resolution

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Learner Guide: Collaboration Among Healthcare Professionals and Team Work 3B

Reflective Question #1
Describe a situation from your own experience when a conflict was handled well
and the outcome was positive

In your opinion, what elements contributed to the positive outcome?

Reflective Question #2
Describe a situation from your own experience when a conflict was poorly
handled and the outcome was not positive.

What elements contributed to the unsuccessful outcome?

Case Study
You have been working for three days as a new health professional at a community
health clinic. Robert, who has been assigned to orient you to the clinic, has worked
there for five years. You observe that he is helpful with other staff members at the
clinic, but he is not helpful with you. In particular, Robert becomes very defensive if you
ask for his assistance or if you ask him a questions. On one occasion yesterday,
Robert totally ignored you when you asked him a question about a patient. Robert’s
behaviour has become increasingly frustrating as you are trying to become familiar
with your new responsibilities. Other team members have been helpful and friendly
towards you and have gone out of their way to answer all of your questions.

Q: What steps would you take to resolve this conflict?

Orientation to the Canadian Health Care System, Culture and Context is licensed to
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Modification, copying or redistribution of any of the course materials is strictly forbidden.
Learner Guide: Collaboration Among Healthcare Professionals and Team Work 3B

References

h Arnold, K. & Underman-Boggs, K. (2003). Interprofessional Relationships-

Professional Communication Skills for Nurses. St. Louis, Missouri: Saunders.

h Drench, M., Noonan, N., N., & Hallenborg-Ventura, S. (2003). Psychosocial

Aspects of Health Care. New Jersey: Prentice Hall

h Oandasan, I., D’Amour, D., Zwarenstein, M., Barker, K., Purden, M., Beaulieu,
M., Reeves, S., Nasmith, L., Bosco, C., Ginsburg, L. & Tregunno, D. (2005).
Interprofessional Education for Collaborative Patient-Centred Practice: An
Evolving Framework (Executive Summary). Retrieved February 23, 2005 from
http://www.hc-sc.gc.ca/hcs-sss/hhr-rhs/strateg/interprof/summ-somm_e.html

Orientation to the Canadian Health Care System, Culture and Context is licensed to
7 HealthForceOntario Marketing and Recruitment Agency.
Modification, copying or redistribution of any of the course materials is strictly forbidden.