How Can Inter-Proffesional Working Improve the Quality of Health Care

Using appropriate literature this paper will attempt to examine the ways in which interprofessional working can improve the quality of health care. Concepts of interprofessional working will be looked at. Examples observed or carried out on assessment ward in the mental health practice area will be drawn upon to explore the concepts of interprofessional working and quality. Issues relating to interprofessional working will be identified and will explored based on experience. ‘Quality’ is very difficult to define so this will be attempted using certain criteria.The report ‘High Quality Care for All’ published by Lord Darzi (DOH 2009) equates higher quality care with improvements to patient services i. e reducing waiting times for meetings and health care interventions. Also, by giving power to the general practitioner, the report aims to change the way NHS budgets are run. According to the NMC (2008), Nurses must work together with carers, patients, communiti es, groups and other organisations while taking into account their needs and strengths.They must promote health and well being while empowering people to make to make choices and decisions to promote their own self-care. Interprofessional working is an essential concept of the Nursing and Midwifery Council requirement for any qualifying nurse to be deemed competent. This essay will focus on an assessment ward, in a mental health unit at a general hospital. Seeing how important interprofessional working is, key issues affecting interprofessional working will be explored.According to Day (2006), 3 major factors affect interprofessional working. These are systemic, organisation and interactional factors. Systemic factors are factors outside of the organisation that have an impact, be it positive or negative on this organisation. Professional socialisation, professional language, professional tribes and territories, professional codes of conduct and professions/professionalism are all d ifferent aspects of this factor. An example of a key issue would be articulating professional identity.If nurse doesn’t know what unique role they play as a nurse, they will be unable to effectively work together with other professionals. Another factor is the organisational factor. This relates to factors of setup and framework within the organisation. For example, lack of staff during a shift can cause a serious problem cause communication breakdown between management and nursing/healthcare assistants. The last factor that Day (2006) pointed out was the interactional factor.Interactional factors relate to a process of collaboration that occurs between two individuals. Lack of communication, lack of willingness to collaborate and professional stereotypes all come under this factor. Now the factors that can affect interprofessional working have been covered, looking at what works effectively within the chosen admissions ward under the mental health unit is the next step. When looking at those systemic factors it’s apparent that professional language is very important and used through-out the ward among professionals to communicate.For example the nurse asked the student to do go do a UDS screening and some vital obs on patient B. The student nurse is familiar with this professional jargon and carries out what has been asked where as if this was asked of someone on the ward for the first time they would not know what to do. A way to solve this would be to keep professional jargon strictly among professionals and to make communication between a patient and a professional as clear and easy-to-understand as possible.The NMC professional codes of conduct are referred to a lot on the ward when dealing with students and the hospital trust policy is also referred to in an attempt to make all students aware of expectation to pass their respective placements. How does this relate to interprofessional working? Professional codes of conduct always promote go od interprofessional working, for social workers the GSCC (2002) states ‘recognising and respecting the roles and expertise of others from other agencies and working in partnership with them’, for doctors the GMC (2001) states ‘Respect the skills and contributions of your colleagues.Communicate effectively with colleagues within and outside of the team. On the ward, professional socialisation problems were not very apparent because the health care professionals present during meetings were always willing the take on board the different philosophies and theoretical bases present during the meeting and try to reach a common goal for the patient. Open discussions on different perspectives can help other professional overcome this problem.When looking at organisational factors on the ward, the ward appears very well structured as everyone knows what to do any point during the day. The use a of a white board to write down the duties and responsibilities of the professi onals based on the ward made it clear ‘who was doing what’ and limited any confusion. The ward design and function aid interprofessional working by bring all the professionals together regularly and by allowing them to use the same meeting rooms.The regular team meetings also greatly improves interprofessional working on the ward and ward rounds always comprise of health care assistants and nurses who effectively pass on informationâ€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"â€Å"1n from the previous shift to the staff taking the new shift. The doctors round is similar because nurses doctors, ward managers and some other health care professional may be present to discuss patient on a case by case basis. The use of Rio (the intranet patient dat abase) is invaluable as an effective interprofessional tool.Patients are accessible by all health care professionals and progress notes are regularly recorded for patient by a variety of professional so reading through on the ward can give a clear picture of what’s the patient’s current progress. A good team leader is also important in term of interprofessional working. On the ward, the team leader is an essential component. She/he can make or break a ward structure. In this case the ward manager was excellent, friendly, professional and willing to solve any problems that occur between members of staff.The interactional factors also affect the interprofessional working on the ward. Professional stereotyping doesn’t occur much on the ward because most all of the staff come from a wide variety of countries and religions so there is a lot of mutual respect. Professional stereotyping of patients wasn’t a frequent thing but did occasional happen i. e a nurse e xpecting a patient to behave a certain way because of their racial background. Generally negative stereotyping should be frowned upon but positive stereotyping of patient which would improve their outcome should be capitalised on.Way to reduce this would be interprofessional education courses. Issues with lack of communication on the ward were not frequent but did occur. Staff forgetting to mention or document key occurrences or incidents during the day, lead to a few problems with interprofessional working as the doctors could not act on information they did not have. Having had time to look at different issues on the ward and solutions as to how to solve them, the barriers of interprofessional working otherwise not highlighted previously will be looked at.Lack of knowledge about other professionals can cause a break down in interprofessional working. Knowing the different roles people play will aid you when needing to refer a patient or when a patient is concerned with a particula r issues you cannot handle yourself professionally. For example a patients housing issues should be handle by his/her social worker. Another issues is the different levels of authority most systems in healthcare have. This can create a lot of interprofessional working barriers.For example, nurses might find it difficult to communicate with a senior manager because of concerns about their position. Sharing information can also become a barrier when professional do not share all the information they have received regarding a care in their care. This can put other professionals at risk by then giving patients care, without taking into account what the last outcome was. For example, a patient telling a social worker that he cant have ibuprofen tablets because they make him sick.This information not being passed on to the Mental health team could result in ibuprofen being prescribed for him and he subsequently becoming very ill. Conflict can occur regarding the relationship with the pati ent. If a professional is over familiar with the patient it could lead to an impaired judgement and therefore conflict with the mental health team. Team size on the ward also affects the way in which professionals can perform their duties and interact with the other professionals. Conflict can arise if the team is understaffed.Resentment towards management, a lack of willingness to co-operate, undermined patient care can all emerge if these issues are allowed to continue. According to Goodman and Clemow (2010), several strategies can be used to improve interprofessional working which in turn will improve the overall care given to the patient and by definition, the quality of care will improve. Clinical supervision and engaging in reflection. The use of managerial support The development of realistic expectations Reinforcement of professional identityEvaluating current roles and practices Training and education for interprofessional working These are very effective strategies to mini mise barriers in effective communication. Clinical supervision is very important in ironing out minor issues and the communication lines open and transparent. The use of reflection as a tool to improve interprofessional is very good. Reflection can help a professional analyse and review the way in which they have been communicating. Was it effective enough? Was all the information passed on? Was it all understood?Was the information relevant? How was my tone of voice? Was i being fair? These are some of the question a professional can ask themselves to improve their communication with other professionals. Managers are their to support the professional on the ground. The proper use of manager to support any issues or problem you may be having with another professional is essential. People are very diverse and working in a large team of different personalities and philosophies will lead to conflict so it’s important to use the managerial support available to all on the team.Exp ecting realistic outcomes can really improve the interprofessional working because when professional work together they sometimes rely on a number of steps to be completed before, they can start their aspect of patient care. Having an understanding of the workload, stresses and time management issues another professional faces prevent barriers in communication from occurring. The use of badges, uniforms and i. d cards help reinforcement professional identity and improve interprofessional working. If it’s clear what roles a professionals serve the moment they approach any professional on the ward.It grants immediate trust in their role and improves their communication. Reflecting on the formative assessment. It was a very rich learning experience and proved how difficult it is to work in a team when people have serious difference in opinion. At one point the people were excluded from the group and things got very uncomfortable but in the end, we were able to push through our d ifferences and work out an essay which we all agreed to present. Our topic was learning and disabilities and the group scenario was based on my experience in a learning and disabilities placement.So I wrote the scenario which was used during the essay. It was a very good experience from me to reflect on placement and see how my experience on placement was represented in terms of an interprofessional working presentation. To summarise, the topic was introduced and attempts to identify the concepts of interprofessional working and ‘quality care’ were made. A practice setting was identified and was subsequently used to give examples. Following the introduction factors that contribute to interprofessional working were explored. Advantage and disadvantages of interprofessional working were highlighted.Key issues of interprofessional working were identified. These barriers were explained using examples and personal experience in the practice setting. These barriers were explo red in depth and examples were given. Lastly, several strategies were identified that would improve interprofessional working and would prevent barriers from occurring. These were explored and examples were also given. Now that interprofessional working has been explored, the effect is has on professionals, the practice area, the structure of the hospital, the interactions between professional and ultimately the patients.The concept of Quality care explain by Lord Darzi states a number of ways to improve services, patient waiting times, GP involvement in budgets but most importantly it is implied that making improvements between service and their professional i. e interprofessional working will directly improve the quality of care. This essay has tried to show the effects of interprofessional working on professional will always translate to the patient, be it negatively r positively. It is up to the professional of the current of future generations to make sure that our interprofess ional working improves the care we give our patientsREFRENCE LIST Barrett, S. T. (2005). Interprofessional Working in Health and Social Care. China: Palgrave Macmillian Codes of practice. [online] (2010). General Social Care Council. Available from: http://www. gscc. org. uk/cmsFiles/Registration/Codes%20of%20Practice/CodesofPracticeforSocialCareWorkers. pdf [Accessed on April 5 2012] Day. (2006). Inter-professional Working; an essential guide for health and social care professionals. Cheltenham: Nelson Thornes Department of Health. [online]. (2009). High Quality Care for All: Our journey so far. Available from: http://www. h. gov. uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_101670 [Accessed on April 5 2012] Ellis, G. K. (2006). Interpersonal Communication in Nursing: Theory and practice. (2nd ed). London: Elsevier Goodman, R. C. (2010). Nursing and collaborative practice: A guide to inter-professional learning and working. (2nd ed). Cornwall: Learn ing Matters Healthcare Policy. [online]. (2005). British Medical Association. Available from: http://www. bma. org. uk/healthcare_policy/healthcarerural. jsp? page=12 [Accessed on April 5 2012]