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June 1, 2022

Practice Expectation Spotlight

Practice Expectation Spotlight: Collaborative Care in Practice

Consider these scenarios:

  • An RN attends a meeting with the client, family and other health care team members where the client talks about personal treatment decisions.
  • An RN(NP) and a client review a specialist’s assessment and treatment recommendations to decide which recommendation that the client will try.
  • A group of professionals work together to reduce barriers to further implementation of RN(AP)s in areas of the province where clients need services.

These examples demonstrate collaboration in practice.  RNs are expected to work collaboratively and cooperatively with clients, families and other health-care providers in providing for the health care of the client and communicate effectively and appropriately with them.

Other aspects of this practice standard for collaboration include:

  • ensuring that you understand your role and the role of other health-care providers in providing for the health care of the client;
  • explaining to the client or their representative your role and responsibility;
  • complying with any collaborative care decision tool in place at the practice setting where you and other health-care providers are providing for the health care of the client;
  • giving your full name and designation of membership class to the client, their representative and any other person involved in the client’s health care;
  • treating other health-care providers with respect; and
  • recognizing the skill, knowledge, judgment, and roles of others involved in the client’s care.

Collaboration may seem straight-forward, particularly when everyone agrees, and the necessary resources are plentiful.  However, we live and work in spaces where agreement doesn’t always happen, and resources have limits.  And this means collaboration is even more necessary to achieve better for the clients we work with.

So, if you are asking what it takes to collaborate effectively, let’s take a closer look at the Practice Direction Interprofessional Collaborative Care. It describes the competencies required.

Practice Direction Interprofessional Collaborative Care

Expectation 1 – Client Centered Care: Practitioners seek out the input and engagement of clients, integrating their information, and valuing them as partners in designing, implementing, and evaluating care/services.

An elderly person repeatedly asks for discharge from a rehab unit so he can go home where he is happiest.  While the rehab team knows there are risks for his return home at this point and know he could get stronger in hospital, they discuss and arrange supportive options with him for his discharge.

Expectation 2 – Role Clarification: Practitioners understand their own role and competence, as well as the roles of those in other professions, and use this knowledge appropriately to establish and meet client goals.

An RN begins a job in a long-term care facility where she recognizes the need to continue her competence development in communicating with families.  She also ensures she understands the Occupational Therapist’s role as she has never directly worked with this profession before.

Expectation 3 – Team Functioning: Practitioners acknowledge team dynamics and group processes to enable effective interprofessional team collaboration

An Administrative Assistant position is open for a time, changing the team’s workload.  Together, the RN(AP) and other team members meet to understand how this vacancy impacts each other.  They design interim solutions to ensure that client care will not be negatively impacted, and they agree to meet in a week to review the impact of their temporary workflow adjustments.

Expectation 4 – Collaborative Leadership: Practitioners recognize that different team members may assume leadership roles as appropriate to the task undertaken.

Three RNs from different units act as the in-charge nurse for the weekend shifts.  There are several transfers, discharges, and admissions among each of these units that need to occur to create capacity in the Emergency Department.  The RN on Unit 1 connects with the other RNs and with housekeeping staff to facilitate a smoother transition for the clients involved in the bed moves.  The other staff members acknowledge the informal leadership role of this RN for the weekend.

Expectation 5 – Interprofessional Communication: Practitioners take responsibility to communicate with others in a collaborative and responsive manner.

A RN(NP) reaches out to the extended care team after a client received another prescription for a PRN benzodiazepine, contrary to the plan of care developed between the client and RN(NP).  In communication with the team, the RN(NP) recognizes the added need for access to the care plan and treatment decisions.  The RN(NP) also relays information on reasons why the client’s health risks benzodiazepine prescription outweighed potential benefits.

Expectation 6 – Interprofessional Conflict Resolution: Practitioners actively engage themselves and others in dealing effectively with interprofessional conflict.

A group who has come together to update a practice guideline cannot understand why the others will not compromise on the final section.  The Chair recognizes this as a previous unresolved conflict that influenced the lack of uptake of this guideline’s previous version.  The Chair brings the group together to work through a process where they can discuss the different views, conflicting options.  From there, they can review current research/data on the issue and assess risks/benefits of each option.

The next time you refer to collaborating, ask which of these competencies am I seeing?  And which of these competencies would we still need to apply? As you practice the interprofessional collaborative competencies, you will support a more positive experience and better client health outcomes overall.


Interprofessional Collaborative Care Practice Direction

Practice Expectations for RNs