IPE Simulation Series is a three-part series that focuses on using Simulation in the classroom and in practice. Part 1 focuses on “Tips for Successful IPE”.
By: Judy Murphy and Melanie Cason
Interprofessional education and practice are critical to patient safety and improved patient care. The Agency for Healthcare Research and Quality, in collaboration with the Department of Defense, developed an evidence-based program to change the culture and improve communication among health care providers. Team STEPPS (Team Strategies & Tools to Enhance Performance and Patient Safety) is a free program of study that can be done independently. At the conclusion of the 12 modules, the learner does a teach-back session to become a master trainer. Many of the tools provided in this program can help foster interprofessional practice. Here are some tips we have found helpful for a successful IP experience.
Changing the culture is Tip #1. This can be done by working with various departments to develop simulations that engage all professions. When health care providers from different professions work together they come to realize the value of other professions. IP communication improves patient safety because providers are more likely to speak up if something doesn’t feel right.
Check out a powerful YouTube video that promotes the importance of communication and listening to the patient. Sue Sheridan lost her husband and has a permanently disabled son because of lack of communication and not listening to the patient.
Tip #2: Practice improves performance. At the Providence VA Medical Center, we pushed to have space for a simulation center. Once we got the space we named it the Interprofessional Simulation Center. In our center we run many interprofessional simulations, mock codes, and provide opportunities for deliberate practice to everyone interested in improving their skills. Since we started doing monthly mock codes, the chief of respiratory noted that “codes run more smoothly and are more organized than in the past.”
Tip #3: Be calm and respectful. If another provider raises his\her voice to you in a confrontational way say, “I heard you, you don’t need to raise your voice.” Use closed loop communication to let the leader know that you heard and to confirm that you heard correctly. Thank all participants at a mock code for taking the time to learn and work with others. Respect, appreciation, and even a smile can go a long way toward enhancing mutual respect.
Tip #4: Assign roles early, whether an emergency or just a family care planning meeting. Knowing one’s role will also significantly improve communication and patient safety. Organization and structure will enhance all teamwork.
Tip #5: Don’t forget to include the patient in all decisions. Do not ignore what older patients say. They know their bodies better than you. One of our mothers suffered nerve damage when she was sent to x-ray for a spiral CT. She told the technician, “I cannot raise my arm over my head. I have a nonunion fracture and severe osteoporosis.” The technician did not listen.
Interprofessional education and practice should begin during the academic years and continue throughout one’s career as a health care provider. Working together promotes a collegial relationship between providers and improves patient care.
We have some other suggestions to consider to promote interprofessional teamwork.
Consideration #1: Consider the culture and climate of the organization. Teamwork education needs to be provided prior to the activity. What is needed? How will it be delivered? How will it be evaluated? (Eddy, Jordan, & Stephenson, 2016)
Consideration #2: In-situ versus simulation lab? Consider the logistics and the goals of the activity. Is videotaping needed for optimal debriefing? If in a health care facility, verify if policies are in place for recording employees. If consent is required, be sure it is obtained.
Consideration #3: Prebriefing and debriefing. In order to promote effective debriefing it is essential to establish the ground rules, such as those used in crew resource management. All are allowed to speak up. Avoid the trap of the “highest ranked” participant inadvertently shutting down the debriefing by stating something like, “We don’t have any problems with teamwork.”
Above all, use your influence as a simulation expert to advocate for interprofessional education as an important component of improving patient safety and the health care environment. Lives depend upon it.
Eddy, K., Jordan, Z., & Stephenson, M. (April 2016). Health professionals’ experience of teamwork education in acute hospital settings: A systematic review of qualitative literature. JBI Database of Systematic Reviews and Implementation Reports, 14(4), 96-137. doi: 10.11124/JBISRIR-2016-1843