Interdisciplinary... Continued from Page 26 making (within and across disciplines), and fosters respect for the contributions of all providers.” 2 In the collaborative health care mod- el, patients may become participants in SUBSCRIBETODAY ! $2400 8 ISSUES only (GST $25.20; QST/HST $27.12) Name: ___________________________ Clinic Name: ______________________ Address: _________________________ City: ____________________________ Prov: ____________________________ P.Code:___________________________ Tel: _____________________________ Fax: _____________________________ e-mail: ___________________________ PLEASE CHECK ONE: Doctor of Chiropractic Other Practitioner Graduate Student Chiropractic Assistants Other ______________________ Please Specify TYPE OF PRACTICE Solo Group Chiropractic Integrated Disciplines Other ______________________ Please Specify Not in Practice - Student AREYOU? (SELECT ONE) Owner t Associate t Assistant t Employee t Other ______________________ t Please Specify PAYMENT: Cheque - Payable to Annex Publishing & Printing Inc. Amex Visa MC Account #: ____________________________ Expiry: ___________________________ Signature: ____________________________ Date: ________________________________ TO SUBSCRIBE: Tel: 866-790-6070 Fax: 877-624-1940 Mail: Canadian Chiropractor c/o Annex Publishing & Printing Inc. P.O. Box 530 Simcoe, Ontario N3Y 4N5 e-mail: [email protected] www.canadianchiropractor.ca GST#867172652RT0001 | APRIL 2010 0410CC t t t t t t t t t t a customized, multi-modality care plan into which they are entered after evalua- tion by an individual within the practice system (for example, a nurse practitioner, a family physician, one of the chiroprac- tors, etc). Collaborative practices often – but not always – are made up of practitio- ners who can address a particular focus of concern (for example, pain management) and, as such, a patient has available, to him/her, strategies from a variety of heal- ing practices to address the physical as well as mental/spiritual/social elements of their illness. What is particularly attrac- tive, for a patient, is finding all of these “under one roof,” thus simplifying the clinical elements of the healing process. Also worth pointing out, “Collabora- tion is a complex activity taking a variety of forms and changing over time.” 4 With- in a group health care practice, collabo- ration may be informal or may involve a referral/planning/execution/follow-up structure that includes regular group ‘rounds’ and, even, educational sessions. The themes that immediately emerge, then, are that interprofessional collabora- tive practice requires a team dynamic, a patient-centred focus, and that it is a pro- cess. FEATURES OF INTERPROFESSIONAL COLLABORATIVE PRACTICE There exists a wide body of literature dis- cussing the group dynamics, advantages and possible pitfalls of interdisciplinary collaborative practice, including how this pertains to those disciplines that, for vari- ous reasons, struggle for recognition and/ or acceptance within the medical system. - search and experience in this area, Laura Bronstein identifies five elements of an interdisciplinary collaboration model that reflect the challenges and rewards inher- ent in this sort of work. These are inter- dependence, newly created professional activities, flexibility, collective ownership of goals and reflection on process. As she expands on each of these, some salient points stand out: 1. A solid professional identity, on the part of each member is necessary for successful teamwork. If a member of the team is part of a profession where identity is not well established – or the member is not well entrenched within this identity – it will under- mine the security of that member within the team, thus diminish- ing his/her impact and utility to the group and the client. 2. Collaboration can result in protocols and activities that are more effective than if the same professionals were to work on their own. This can also serve to increase the expertise of each member of the collaborative team. Flexibility includes the ability to compromise, of course, but also encompasses the fortitude to allow some shifting, within the group, when designating leadership roles. Leadership, in a particular project, should reflect individual patient needs rather than preconceived pro- fessional hierarchical distinctions. 4. There should be shared responsi- bility in reaching team goals – all team members should be included throughout the process. This also means there will be shared account- ability. 5. Collaborators must continue to pay attention to the development of the collaborative process of which they are members and must be willing to discuss their progress within the col- laborative journey, how it can be im- proved upon, and how to strengthen the effectiveness of relationships within the group. Bronstein’s review also summarizes the factors that influence this interdis- ciplinary collaborative process. These, she lists as: professional role (strong values and ethics, commitment to the team), structural characteristics (are case- loads, schedules, etc, manageable?), personal characteristics (including how members view other people’s roles and disciplines) and whether the members have a history of collaboration or not. PATIENT-CENTRED, PATIENT- CENTRED, PATIENT-CENTRED A point of caution is to be made vis-a-vis the possible consequences of collabora- www.canadianchiropractor.ca
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