Breaking down walls between healthcare professions

Teamwork in healthcare, as in many other areas, involves professionals from different fields: doctors, nurses, pharmacists, psychologists, physiotherapists, nutritionists, social workers, diagnostic test technicians, among others. Any health professional has often experienced difficulties in collaborating with other professions, often in situations not related to technical-scientific issues. At such times, it is inevitable to think that the result of a joint work could be better, faster or just simpler and happier. We are then talking about developing interprofessional care.

The development of interprofessional care is essential to increase the quality of health services, reducing clinical error, increasing the efficiency of services, improving professionals' satisfaction with their work and improving clinical outcomes.

In everyday life we often hear expressions such as:

But do we use these terms correctly? It is convenient to reflect on the use of the interprofessional definition and distinguish it from interdisciplinarity, as well as multiprofessional from multidisciplinary:

• Multidisciplinary: different areas of knowledge within the same profession, working in the same place;
• Multiprofessional: services composed of providers from different professions;
• Interdisciplinary: cross-activity between different disciplines with true collaboration;
• Interprofessional: true collaboration and sharing between different professionals.

The World Health Organization issued a report in 2010 entitled Framework for Action on Interprofessional Education & Collaborative Practice, which defines interprofessional care:

Thus, it is important for health professionals to develop skills to increase collaborative practice, in order to improve care provided to patients. In practice, we are talking, for example, about doctors and pharmacists working more closely, bringing their different perspectives to clinical cases that may lead to better patient care and common learning. We easily realize that there still is a great lack of knowledge about what is the daily life of colleagues from other professions working in our institution. It is important to emphasize that interprofessional care is distinguished from concepts that, despite being associated with, are not mandatory for interprofessional care to occur, namely skill mix and task transfer. These two concepts advocate for the transfer of responsibilities and competencies between professionals, while collaborative practice involves only a set of attitudes that promote closer and more effective work between different professions, in order to make the most of everyone's competences. Several institutions list the skills that health professionals need to promote interprofessionalism in health teams. The Canadian Consortium for Interprofessional Collaboration has published a list of six behavioral skills that can be developed:

1. Collaborative leadership
2. Team management
3. Role clarification
4. Interprofessional communication
5. Interprofessional conflict management
6. Patient-centredness

Having these competencies in mind, the focus of leadership should be to implement initiatives and develop behaviors that promote greater proximity between professionals, together with knowledge and information sharing, so that it directly improves the treatment plans offered and the working environment. For example, rethinking how shift rounds are performed, how patients' clinical plans are defined, or by implementing communication tools universally understood by practitioners.

These are behavioral skills that can be developed at the team and the individual level, and there are several tools that can be adopted to promote interprofessional care. Another example is the implementation of interprofessional meetings in health services, or adopting collaborative leadership attitudes that can lead to projects involving different professions, thus solving problems and improving the way the same service operates in an interprofessional manner.

Articles on each of the competencies will be published shortly, with some practical examples of how they can be developed and stimulated in the workplace. We are counting on you to enhance collaboration between health professionals!