IPE is an approach to learning that requires planned interaction among learners from different professions. It is defined as:
"Occasions when two or more professions learn with, from and about each other to improve collaboration and quality of care."
— The Centre for the Advancement of Interprofessional Education, 2002.
IPE is focused on professionals:
- Gaining an understanding of how professional roles and responsibilities complement and overlap each other
- Understanding the limits and scope of each other's professional roles
- Respecting the distinctive contributions of each profession
- Understanding the need for co-operation, co-ordination, and collaboration across professions
- Working to improve the quality of care by focusing on the needs of, and actively involving, the patient / client
Key to IPE is that there is an active exchange of information, knowledge and understanding.
Learning becomes an exchange among and between learners from different professions that changes how they perceive themselves and others.
In this way, IPE is different from a process in which students from different professions simply attend the same lecture, or attend a lecture delivered by a health professional from another discipline.
Ultimately, IPE sets the foundation for professions to work together more collaboratively for the benefit of the patient / client. It is all about fostering better, safer, high-quality, patient-centred care.
The worldwide trend is for health organisations to move from a position of fragmentation, to a position of strength. That fragmentation currently comes from working in silos and in isolation—the different professions all approaching the patient / client separately and with a potentially narrow focus. The strength comes from different professions working collaboratively; sharing knowledge and expertise, and approaching the patient / client from a "whole person" focus.
If we put ourselves in the patient's / clients' shoes, let's take a look at two examples:
Working in silos
Brian, an 81-year-old man with poor mobility, currently living in an independent villa in a retirement village, is about to be discharged home after a laparoscopic cholecystectomy. On the day of discharge, over a period of five hours, he is seen by the pain team, the surgeon and medical team, the physiotherapist, the nurse, the occupational therapist, and the social worker.
The physiotherapist, nurse, occupational therapist, and social worker all ask him the same or similar questions about how he is going to manage at home, what activities he can do, and the support he is going to need. Once seen by all these people, he is sent to the transit lounge on a different floor, where another nurse brings him his discharge information / medications.
Brian, an 81-year-old man with poor mobility, currently living in an independent villa in a retirement village, is about to be discharged home after a laparoscopic cholecystectomy. On the day of discharge he is first seen together by the pain team, surgeon, and nurse. They decide from a post-surgery perspective he is ready to be discharged, however they are aware the family have concerns about how he will manage at home.
They ask for the input of the interdisciplinary team to assess how he will manage at home and ask them to then have a brief meeting with the registrar and nurse to decide a joint discharge management plan. The interdisciplinary team decide the skills of the physiotherapist and social worker are most needed in this situation, but that they will call on the nurse and occupational therapist if needed.
Together the physiotherapist and social worker meet with Brian and a broad physical and social needs assessment is undertaken using completing a common assessment / recording format. Together with the registrar and nurse, they decide on a funded pack of community home support.
By 11am, Brian has been given a copy of the discharge information—including the home support care—and has had the discharge medications and wound care instructions explained by his nurse.
How would IPE have helped in this setting?
- Learning in an interprofessional way would have prepared the staff for working more collaboratively to meet Brian's needs
- Collectively, the team would be prepared and able to tap into each other's specialist skills, for the benefit of Brian
- The team would have been communicating more effectively
- The team would have been working effectively together, towards the common goal of meeting Brian's needs in an efficient way
With the world moving towards more collaborative practice in healthcare, IPE provides the following benefits:
- Students experience an increased understanding of the roles and skills of other professions
- Students demonstrate an improved respect towards other professional groups due to this increased understanding
- Students learn how to build interprofessional networks, and their value
- Students are better able to interact and work collaboratively, which therefore improves outcomes for individuals, families, and communities
- IPE helps to ensure that nothing "falls through the gap" relating to the patient / client, due to the team working collaboratively
- Staff engage in more collaboration and better understand the roles of others
There are a number of factors contributing to a worldwide desire for health professionals to work more collaboratively and effectively together:
- "The World Health Organisation (WHO) and its partners recognise interprofessional collaboration in education and practice as an innovative strategy that will play an important role in mitigating the global health workforce crisis" (Framework for Action on Interprofessional Education & Collaborative Practice, WHO, 2010)
- The world is experiencing a global health worker shortfall of nearly five million, which is impairing the provision of essential, life-saving interventions
- There are current financial drivers to do more, with less
- Funding opportunities are becoming increasingly scarce with increased competition as health services vie for the same funding
"Demand for services is rising rapidly. But there are constraints on finances, and a shortage of skilled professionals in some areas and health-related occupations" (Ministry of Health).
Nationally, we have some challenges ahead of us. Many of the Government's health targets relate to the need for improvements in health associated with chronic diseases and for those with the highest health needs. Collaborative practice has been shown to improve these health outcomes, and so students should be prepared for working in a collaborative practice environment.
At a more local level, the Southern District Health Board has signalled a desire to move towards interprofessional learning as part of its responsibility as a provider for clinical education for health professional students: