Collaboration in Professional Practice

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Sheffield Hallam University

Faculty of Health and Wellbeing

Advanced Diploma in Adult Nursing.

Summative Assessment Submission.

– January ’08 Intake

Date of Submission:  20th April 2009

Assignment Title: "Effective Inter-professional Collaboration is key to providing good quality *patient/client/service user centred care"...Discuss.

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The aim of this assignment is to discuss the importance of working inter-professionally within a multidisciplinary team to achieve the best patient-centred care. It will demonstrate developments achieved, and the knowledge gained around this area throughout my training and practice to date. The assignment will focus on the inter-professional care for adults within a hospital environment, as ‘Advanced Diploma in Adult Nursing’ is my course area.

Interprofessional collaboration looks at teamwork, communication, professionalism and modern issues which influence practice at present. Various health care professionals have a range of expertise and skills different to others, their experiences and insights into situations capture dissimilar care needs, therefore enabling the patient to receive the best care. Through working in a multidisciplinary team, different professionals can collaborate with each other in order to benefit the patient and deliver person-centred care.

The Royal College of Nursing (RCN 2007) describes person centred care as; care which is safe and effective, promotes health and well-being and helps to integrate the patient into today’s society and community. Person-centred care also informs, empowers, is timely and convenient (Kendall and Lissauer 2003). It is an approach, which integrates patient ideas, expectations, beliefs, values, culture, emotional needs and social perspectives, whilst ensuring mutual participation in a shared decision-making partnership (Antai-Otong 2006).

Martin and Rodgers (2004) identify that in the past the patient’s health and social care needs were kept separate entity’s, this however identified numerous imperfections between the stages of care; for example elderly patients being discharged from hospital back to the community. It would have been days before appropriate services were set up, thus causing frustration and distress for the anxious patient. Therefore the system needed assessing, Martin and Rogers (2004) stressed that it was time for the social services and National Health Services to integrate, by achieving this it would improve  the quality of the service and benefit the patients.

The government decided in 1997 to implement a plan to reform the National Health Services, this included both inter-professional collaboration and patient-centred care (DOH 2000). The plan aimed to offer the patient individualised care and empowerment of their health conditions. This would lead to a patient led National Health Service that would work closely with the social services, providing the patient with social support once discharged from hospital. It was recognised that for this to commence and holistic care to be achieved a multi-disciplinary approach was essential.  

Multidisciplinary approaches are the key successes to person-centred care. Martin (1997) explains that no group can as an entity create ideas, only individuals can do this. A group of individuals may, however stimulate one another in the creation of ideas. Stewart (2003) adds to this by stating that interdisciplinary teams are composed of two or more disciplines which, actively and continuously, participate in a process of communicating, planning and acting together towards mutually shared goals. Jamieson, Whyte and McCall (2007) believe that working together has the advantage of promoting communication, and harmonisation of service, which is essential in the current climate. Combining professional expertise offers the patient with more holistic care therefore covering all of their needs. Other positive factors of working as a multidisciplinary team are; the efficient use of staff resources through collaboration with professionals, and a more satisfying work environment for staff (Leathard 2000)

One of the areas that the Department of Heath (2000) considered needed improving was the older generation patient discharge. Government statistics in 2002 estimated that a large proportion of elderly patients were medically fit to be discharged but were delayed due to their social circumstances (National Audit Office 2003). The most common contributory factors for delayed discharges were the accesses to long term care facilities and organisation of community support. To combat this, standard two of The Single Assessment Process (SAP) was introduced by the National Service Framework for Older People (2001) the aim was to make sure that the National Health Service and social care services treated older people as individuals and allow them to make choices regarding their own care. In response to this the House of Commons Health Committee (2002) called for a number of key changes, one of them being a named person to coordinate all stages of the patient journey through hospital, up to and beyond discharge. This could take the form of a multidisciplinary discharge liaison team and discharge facilitator who would collaborate between the professionals who were involved with the patient.

Pudner and Ramsden (2000) indicates that an identified discharge coordinator should lead and record communication with all relevant agencies to ensuring that the goals of discharge planning should be patient-oriented and set by the patient, in association with the multidisciplinary team.  The Department of Health (2004) stress the importance for nurses to develop and adapt practice and respond to the ever changing needs of the service provided. However, nurses are being faced with a limited amount of time to become acquainted with their patients as they are being discharged earlier from hospital thus preventing nurses to meet all of the patient’s social needs. This is where collaboration with Multidisciplinary Teams is making a significant difference to the speed and quality of the patient journey (Department of Health and Royal College of Nursing 2003).

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 Discharge coordinators are the allocated bodies that now communicate with the patients and families to gain a broader view of the patient’s requirements, during and after discharge. Their aim is to work closely with nurses and patients on a day to day basis; this allows the coordinator to keep a track of their patient's length of stay and their condition. This information is then used as a vehicle for coordinating and controlling the work of other health professionals including: social services and physicians. They communicate information to these professions who undertake the discharge of the patient in a timely ...

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