Leadership Development for Interprofessional Education and Collaborative Practice

This book is unique in taking the wealth of global experience in interprofessional education and practice, together with the huge amount of literature on leadership, and looking at the developments that have taken place internationally with regard to implementing interprofessional education and practice in a variety of settings.

This book is about leadership in promoting, developing, and sustaining interprofessional education and collaborative practice to improve health and social care services in the expectation that they will then respond more effectively to the needs of individuals, families, and communities beyond the capacity of any one profession alone. This chapter recalls the endeavors of six of the pioneers — Jack McCreary and George Szasz in Vancouver, DeWitt Baldwin in Nevada, Nils-Holger Areskog in Linköping, and Patrick Pietroni with Marilyn Miller-Pietroni in London.

‘Effective interprofessional education (IPE) enables effective collaborative practice, and effective collaborative practice strengthens health (and social care) systems and improves health outcomes’ (WHO, 2010, p. 5). However, it is acknowledged that training and developing a collaborative practice-ready health and social care workforce is not sufficient, supportive management practices and champions across agencies are required with the resolve to change the culture and attitudes of health (and social care) workers (WHO, 2010). An open, inclusive, collaborative culture is required which is risk-aware, supports learning for improvement and provides structures that enable interprofessional teams throughout the patient pathway to strive to improve services and increase patient safety (Lamb & Clutton, 2010).

This chapter explores the challenges that confront leaders in healthcare and education, especially in relation to improvement and achieving collaborative patient-centered care. Two case studies illustrate the impact existing challenges place on patients and staff. The value of leaders and organizations using a Strength-based Leadership (SBL) approach (see Chapter 4) for developing interprofessional teams is discussed, especially in relation to steering the development of safety and improvement protocols, including the World Health Organization’s (WHO) surgical safety checklist. Throughout, questions are provided with guidance for leaders on how to apply this approach to their own work settings. Key messages for sustainabil- ity of interprofessional collaborative practice for improvement and increased patient safety conclude the chapter.

Higher education institutions are increasingly asked to be more responsive to the needs of community and to ensure that graduates are truly work ready (Patrick et al., 2008; Samuels, 2012; Universities Australia, 2008). The Universities Australia position paper, A national internship scheme: enhancing skills and work-readiness of Australian university graduates (Universities Australia, 2008), called for collaborative action between universities, governments, industry, and community organizations to enhance the employability skills of graduates. Engagement through partnerships with the community has been shown to generate new knowledge and enhance the teaching and learning process (Bernardo et al., 2013). Such partnerships, if of sufficient quality, ensure that students have the opportunity to engage in authentic practice-based learning experiences where they can develop the capabilities to be ‘work ready’ (Barraket et al., 2009; Choy & Delahaye, 2009; Flemming, 2012; Orrell, 2011; Peach et al., 2012; Ure et al., 2009).

Traveling through the United States (US) in 1831, the Frenchman Alexis de Tocqueville observed the unique culture of burgeoning American society. Capturing the pioneering spirit of the diverse land, he wrote in Democracy in America (Tocqueville, 2003), ‘America is a land of wonders, in which everything is in constant motion and every change seems an improvement.’ The principles of self-determination and democracy upon which the US was founded and described by Tocqueville have led to a society that values decentralized governance structures and entrepreneurial success. Within this milieu, America has proven to be a leader in innovation, particularly in adopting and enhancing the best ideas from other countries. Interprofessional education (IPE) appears primed to follow a similar path.

This chapter describes and analyses a strategy to improve the capacity and quality of care of the maternal and child healthcare workforce throughout the city of Bogota between 2004 and 2011, referencing significant landmarks acknowledged by participant health professionals. We report how a network of health professionals developed a community-based approach to ensure an equitable head start for children in the city of Bogota. The health professionals worked together to improve their competencies in maternal and child healthcare, while building a knowledge network based on existing evidence of how an equitable start in life provides the structure to build citizenship and human and social capital (Sen, 1999). Overall we believe that this process was an excellent example of leadership in action.

As we describe the birth of Maharashtra University of Health Sciences and its Department of Medical Education we explain the context purpose, development, and evolution of this initiative and its unique inherently interprofessional nature. We will discuss the variety of change strategies and leadership influences that have played a role at the multiple stages of evolution of this work.

This chapter is about a change process and the leadership required, recognizing that once change occurs nothing can be the same again. Collaborative practice in healthcare has been shown to contribute to better health outcomes in many parts of the world (WHO, 2010). Interprofessional education (IPE) that produces collaborative-practice-ready professionals has thus been practiced in many health professions’ educational institutions worldwide for decades (Oandasan & Reeves, 2005; WHO, 2010). In the Philippines, however, IPE is a new practice and no health professional educational institution in the country has thus far reported experiences in IPE. Though one or two health professional service organizations claim to practice interprofessional collaborative patient care, no accounts of these experiences have been published. Likewise, community engagement is a practice not widely utilized by health professional educational institutions in the country. In some parts of the world, particularly the United States, national organizations and state health departments have been recommending the community engagement of health professional schools (Commission on Community-engaged Scholarship in the Health Professions, 2005; Coffman & Henderson, 2001) as an essential strategy for improving health professional education to achieve ‘a diverse health workforce, increase access to health care, and eliminate health disparities’ (CCE, 2005, p. 5).

This chapter discusses how interprofessional learning and collaborative practice were embedded into the curricula of a large, diverse health faculty in New Zealand, and the leadership processes required to facilitate a cultural change.

The need for leadership at all levels of the academic setting has been espoused by many, including Schmitt and colleagues (2013). Academic leaders need to be informed, recognize the value of interprofessional education (IPE), and provide the resources and mechanisms required for successful sustainable IPE.

Interprofessional collaboration has an increasing profile in tertiary education organizations. Most Australian and New Zealand medical, nursing, and allied health standards documents and curricula now outline the need for interprofessional learning and practical experience of team-based activities. Likewise there would be few Australasian universities that did not include the need for lifelong learning amongst their list of desired graduate attributes.

Being involved in editing this book has been a journey for me in many ways. I have been involved in interprofessional education (IPE) for over two decades and prior to that had been working in a collaborative sense in a primary healthcare team as a general practitioner (family physician) without knowing or having heard about ‘interprofessional practice’ (IPP). This book has reminded me again of why both IPE and IPP are important not only to me but for the communities we serve as health professionals. I have jour- neyed backwards into the early days of IPE and forwards into its potential for transforming healthcare and education in many countries around the world. The focus on leadership has also helped me reflect on the similari- ties and differences between being a ‘leader’ and being an interprofessiona ‘champion’ and the journey to become either or both of these. Obviously we cannot define ourselves as leaders and champions without external valida- tion but the stories presented here help us realize what such validation may be based upon.