Improving Healthcare Safety/Policy Interprofessional Collaboration

Improving Healthcare Safety/Policy

Interprofessional collaboration

"In groups of interdependent people, organizations create sense out of possible chaos" (Berwick 2002: 18). One of the values of organizations is their ability to bring together individuals of different backgrounds, and to coordinate their efforts in an effective manner. However, very often the resources of organizations are not optimized. Doctors and nurses find themselves at odds with administrators and other entities that have an impact upon patient care. Even physicians from different specialties find themselves 'at war' with one another when creating a treatment plan, based upon their different perspectives.

However, if professionals collaborate, a more complete treatment plan can be created for a patient. The nurse's holistic perspective upon treating the patient with reference to the patient's social and environmental context must inform a doctor's plan for a diabetic. The diabetic may have difficulty monitoring his or her diet and administering insulin for psychological or economic reasons. Within the hospital environment itself, if a pharmacist has concerns about prescribing a particular drug and feels there is an error, based upon his or experience, he or she should be able to raise the issue with the doctor. Tens of thousands of Americans die every year from preventable medical errors, according to Crossing the quality chasm: The IOM Health Care Quality Initiative. Through communication and a better knowledge of how the individual aspects of a patient's treatment fit into a larger plan of care, these errors can be prevented.

Interprofessional collaboration must also encompass individuals without medical degrees. Healthcare administrators should have greater knowledge of the efficacy of different types of treatment and how life is 'really like' on a daily basis for providers, when attempting to implement more efficient standard operating procedures and streamlining a hospital budget. Even health insurance agencies should seek to become more aware of the science behind medical issues to become more aware as how allocating resources for preventative or alternative care can result in cost savings in the long-term overall.

Q2. Public policy that currently is impacting current practice

So-called managed care was originally instituted to reduce the costs of care by creating gateway systems designed to reduce unnecessary treatments. However, in the experience of many healthcare providers, insurance companies add additional, expensive bureaucracy and red tape to prevent overuse. Insurance companies often create a system of incentives whereby more conscientious physicians are penalized for giving patients needed care. Within some managed care systems, physicians who perform more procedures and spend more time with patients than is deemed necessary are penalized or physicians are simply paid based upon their number of patients, rather than the extent of the care they give to patients (Jecker 1998).

Managed care was designed to reduce the tendency of physicians to please patients with 'good' health insurance by allowing them to take drugs (such as brand-name medications or antibiotics) when they were not strictly necessary or have tests for which there was little indication that they would be beneficial for the patient. One of the most controversial aspects of managed care was the insistence that patients obtain referrals for specialists and the need to remain 'in network' for treatments. This was despite the fact that medical opinion might vary widely in terms of the best way to treat an illness. A patient with cancer might receive a recommendation for surgery from one specialist and for radiation from another and the insurance company's policy about what specialist was in 'the plan' and what procedures were deemed medically necessary would prejudice this highly personal decision on the part of the patient.