Interprofessional Collaboration is Referred to the Practice

Introduction

Interprofessional collaboration is referred to the practice in which multiple healthcare workers from various professional background are seen to work harmoniously and collaboratively to provide highest quality care to the patients (Reeves et al., 2017). It is frequently used in healthcare because it conceptualises that sharing each other’s perspectives in arranging care for the patient by professionals leads them to resolve their complex healthcare needs (Karam et al., 2018). Moreover, interprofessional care helps to boost patient safety, enhanced and error-free medication practise, effective control of hazardous situations and improve patient outcomes by creating early recovery and less stay at the hospital. However, certain human factors such as lack of communication, unassertiveness at work, complacency and others negatively impact the progress of interprofessional collaboration in healthcare practise to create better patient outcomes. This is evident from the report of Care Quality Commission (CQC) where it is mentioned that out of the 468 Never Events (preventable serious care incidents) reported in 2017-18, 96% was caused by human activity which could be prevented with effectively regulated human actions (chpso.org, 2019). Thus, in this study, the way two key human factors which are complacency and lack of assertiveness influences interprofessional collaboration and care practises is to be discussed. This is to develop an overview of the actions influenced by the factors causing hindered patient outcomes in interprofessional care.

Impact of complacency in an interprofessional team in health and social care

In healthcare, complacency means uncritical self-satisfaction of individual mainly when they are accompanied of being unaware of the actual danger or deficiencies to be caused by the action (Cullati et al., 2019). The complacency in interprofessional team care delivery is raised when there are various hierarchical structures to be followed in deciding the collaborative care of the patient (Anderson et al., 2017). This is because people or health professionals in the higher hierarchy initiate to think they are highly competent and over the top in knowledge compared to others in the lower hierarchy to make care decision. It leads them to avoid considering the view and opinions of others in the interprofessional care team who are at the lower part of the team out of self-satisfaction and decisive of the care opinion. This instigates to raised error in care as certain essential opinions from the lower hierarchy are neglected which are beneficial for the care delivery (Chan et al., 2017). One instance of complacency is in the case of Elaine Bromiley where she died due to the attitude of the higher and experienced professional in the inter-professional team to overlook the ideas and instructions of the subordinate nurses out of self-satisfactory feeling and decision making. It is evident from the study of Chałupnik and Atkins (2020) where it is mentioned that the emergency equipment that is Tracheostomy was made available by the nurses along with an emergency bed at the intensive care unit to support recovery of the patient. However, the nurses are unable to force the three higher experienced consultants in avoiding intubating and follow the emergency procedure as they ignored their views out of feeling of self-competence and satisfaction that they care revive the patient in the can’t intubate, can’t ventilate state. It led to create health crisis for Elaine making her die in the end as there was one person seen to be in-charge of the situation and the perception and cognition of others such as nurses were ignored out of complacency (Lindqvist, 2016). Thus, in the interprofessional team, effective relationship between the various professionals irrespective of the hierarchical condition is to exist so that complacency is not raised among the higher experienced people which break the shared decision process initiative needed for effective teamwork in delivering quality and positive health outcomes for patients. In inter-professional teamwork between nurses and other physicians, effective electronic patient monitoring report is to be maintained by the nurses so that they can be used by the other professionals as a reference in deciding progressive support needed by the patient. This is because the patient reports contain vital health signs based on which the physicians can decide the extent of dose of medication and other assistance needed by the patient (Chan et al., 2017). However, the study by Flenady et al. (2020) mentioned that the rise of complacency among nurses who are one of the professional levels in inter-professional team care leads to hindered patient monitoring and error in care delivery. This is evident as the nurses out of complacency at times feels that the patient monitoring report are baseless and are not holistically involved in clinical judgement due to which they are not required to be maintained properly. It led them to create improper patient monitoring reports which on reference by the physicians in the interprofessional team caused to deliver duplicated healthcare or errored health support to the patients that disrupts their safety and ability of attaining well-being (Flenady et al., 2020). In inter-professional collaborative care, the sharing of situational condition of the patient is essential as it leads the professionals further understand the roles to be played by each of them and the common prospective to be followed to meet goal of care. Moreover, it creates link between the professionals regarding the way they are to support one another to ensure enhanced health of the patient (Grim et al., 2019). In contrast, the study by O'Hara et al. (2018) mentioned that lack of shared situational information among the inter-professionals makes them to fail to provide effective professional support to the patient, in turn, making the patient face fatal condition. It is mainly raised due to presence of complacency among the professionals in the interprofessional team where they neglect to create awareness of the situation out of the assumption that they are completely satisfied with own performance and need not worry regarding others. This can be proved from the case study of Victoria Climbe where complacency of the professionals at different steps led the individual to die. In the first instance, when Climbe was taken Kounao for the first time in the Ealing Council for Homeless Persons Unit to arrange for housing facility, they were seen by Winter who was a homeless person’s officer. Winter ignored the reason behind different photograph of Climbe being used in the passport as she felt that their application was already going to be rejected on the grounds of habitual residence. Therefore, expressed no concern regarding Climbe as she felt complacent regarding her duties (Power, 2019). In the second instance, a social worker, as well as a police officer, was allocated to respectively make home visit to Climbe in monitoring her situation. However, out of complacency or being personally pleased to believe that Climbe has scabies they avoided to perform their duties causing her to face further abuse and ultimately face fatal condition out of the negligence of the collaborative actions of the professionals. The presence of enhanced communication is required to be present among individuals for effective inter-professional collaboration in delivering quality care. This is because it helps them to share each other’s views and opinions to reach enhanced care decision by considering different context of the problem (Cullati et al., 2019). As argued by Schwindt et al. (2019), lack of communication between inter-professionals develops as a result of complacency which leads to create hindered patient safety. This is because complacent attitude makes the professionals feel they are pleased with their own actions and avoid taking into consideration other’s views by develop detailed communication in determine the care condition for the patient which at times leads to error in care and compromise patient safety. This is evident from the instance of Victoria Climbe where the consultant paediatrician along with being named child protection physician (Schwartz) in the Brent social services avoided to communicate in accessing opinion or views from other doctors and nurses. They had mainly diagnosed that Climbe did not have scabies and the wounds are due to abuse but Schwartz out of complacency of his reputation and experience ignored to communicate with them and mentioned Climbe to have scabies. It created opportunity for Kounao to further abuse Climbe at home eventually leading to her death (Power, 2019).

Impact of lack of assertiveness in interprofessional team in health and social care

In healthcare, assertiveness mainly focusses on the ability of the physicians or clinicians to effectively communicate their concern and views as patient advocate to one another as it encourages to make collaborative decision-making to delivery quality care to the patients (Omura et al., 2017). In inter-professional collaboration for care delivery, it is responsibility of each of the professionals to learn regarding their responsibility so that they can adhere to their own role and develop mutual respect by not interfering in one another’s working context (Busari et al., 2017). However, hindered or lack of assertiveness makes the professionals in the inter-professional team develop differences among one another which causes inefficient exchange of information leading to breakdown and crisis for patient safety (Abbasi et al., 2019). This is evident from the study of Omura et al. (2017) where it is mentioned that lack of assertiveness among professionals to express their views and challenge the superiors in case they are making wrong decision that is threatening towards the life of the patient and is a sign of incompetence leads to cause fatal consequence for the patient. The assertiveness influence in interprofessional care can be explained through the case of Daniel Pelka. In his case, it was seen that the health visitor and social services when he was taken to the emergency services determined that he has multiple bruises and has a broken arm that may be instance of abuse. However, when the doctor mentioned Daniel to face the situation due to accident neither of the social service carer was seen to be assertive in challenging the superior doctor to develop investigation behind the real cause of the bruises and facture on Daniel. This negligence and lack of assertiveness in making communication and awareness led Daniel to face further abuse and eventual death (Morriss, 2017). In the study by Hood et al. (2017), it is mentioned that effective assertiveness among inter-professional team leads the professionals to clearly understand and recognise their roles and duties along with the become aware of the shared actions to be performed by them. This is because assertive interaction resolves conflicting ideas and confusion among the professionals that hinder them to work collaboratively. However, lack of assertiveness in communication, influences professionals in the inter-professional team fail to develop effective understanding of each other’s role out of aggressive and challenging attitude to disrespect others. This in turn creates chaotic healthcare situation and hindered quality care to be delivered leading the patient to face deteriorated health condition. The lack of assertiveness in inter-professional team leads to create challenging relationships with one another. This is because unassertive professionals in the teamwork are found to fester problem by not clarifying them with others with whom they have issues. It leads the professionals to avoid supporting one another as they feel they are being dominated by other in turn creating hindered care delivery for the patient leading to their negative health outcome (Abbasi et al., 2019). The study by Busari et al. (2017) mentioned that lack of assertiveness in inter-professional team makes them fail to execute critical decision-making for complex healthcare of patients. This is because without confidence and self-assurance among the inter-professional team members, it is impossible for them to decide solution of exact care to be delivered to the service users.

Conclusion

In conclusion, the influence of human factors in inter-professional team care delivery leads affect patient safety, positive health outcome, collaborative practise and others. It is initially evident from the report of the CQC which mentions that most of the preventable care errors occurs as a result of negative influence of human factors in inter-professional care delivery to the patient. The presence of complacency in inter-professional collaborative care mainly occurs due to extensive hierarchical structure which results to create care error eventually leading them to face death. The complacency in inter-professional care also impact to hindered patient safety because open communication to share and link roles to ensure quality care and protection of the patient could not be established. This is evident from the case instances of Daniel and Climbe who due to complacency in inter-professional care develop fatal health consequences as timely care could not be reached to them. The human factor such as lack of assertiveness in inter-professional collaborative care in the health and social care is seen to influence creating hindered creative thinking, critical care analysis, sharing of care ideas and others. This is because lack of assertiveness in inter-professional care causes hindered communication, dishonest relationships, conflict and hindered understanding of each other’s role between professionals.

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