Winnipeg Regional Health Authority (MN)

  • Susan Bowman, Manager, Physiotherapy and Orthopedic Clinic and Interim Manager, Occupational Therapy and Speech Language Pathology, Winnipeg Regional Health Authority, Winnipeg, Manitoba 
  • Kathleen Klassen, Manager, Nursing Initiatives, Winnipeg Regional Health Authority, Winnipeg, Manitoba 
  • Paul Komenda, Medical Director, Home Hemodialysis, Manitoba Renal Program, Winnipeg Regional Health Authority, Winnipeg, Manitoba 

Advancing Interprofessional Collaborative Care Teams in the Winnipeg Health Region

Mounting evidence links interprofessional collaborative care to improved patient outcomes, patient safety, patient/health provider satisfaction with care, and health system efficiency. Numerous reports have articulated high level core competencies of effective interprofessional teams which can be used to assess and evaluate teams interested in advancing their collaborative practice. Many of these identified competencies resonate as having face validity, however evidence describing how to measure whether a team has achieved such competencies and which of these indicators teams should focus on to enhance team performance remains poorly defined within health care contexts.

Within the Winnipeg Regional Health Authority (WRHA), there is evidence from recent critical incident and mortality reviews, staff satisfaction surveys and Accreditation Canada reports suggesting team effectiveness is often suboptimal. Despite realizing a number of key accomplishments related to the advancement of collaborative care and interprofessional education within the WRHA since 2008, a standardized, evidence informed program aimed at improving and evaluating interprofessional collaborative care team performance is required. This intervention project developed and piloted a team evaluation platform able to: 1) diagnose current team functioning using evidence informed, measurable indicators and; 2) provide a concrete and actionable roadmap to guide teams in improving their interprofessional collaborative team performance.

A scoping literature review, extensive stakeholder consultation, a region-wide survey, and focus groups were conducted to inform the final selection of eight indicators of effective, high-performing teams and a step by step process to assess and evaluate teams against these indicators. The program was piloted over a period of eight weeks with two interprofessional teams in the WRHA. Focus groups and questionnaires were used to evaluate the program.

Team members from both pilot sites described the program as an effective and expedient way to diagnose team strengths and to identify areas to improve team performance. The selected indicators and the process by which to evaluate the teams proved effective despite the differences in pilot team function, patient population, and team composition. An important finding of the pilot was the need to build in follow-up sessions with each participating team to capitalize on the initial momentum and energy associated with the various team self-assessments and engagement with external facilitators. As well, access to skilled external facilitators to guide this work and supportive team leadership were deemed critical to the success of the program.

The need to clearly define team membership is an essential first step. Engaging clerical and support staff in the team evaluation was invaluable as was ensuring formal and informal clinical leaders were involved in the process. Providing the level of evidence and rationale for the inclusion of each indicator used in this evaluation platform strongly added to the credibility of this work, particularly to the participating physicians. Having a select number of indicators also helped teams focus on actionable and meaningful steps to improve collaborative care.

As a result of this intervention project, policy implications and recommendations relative to sustainability of this program have been presented to WRHA Senior Leadership. These include the need to educate teams about the importance of collaborative care and provide them with the necessary time and resources to participate in this work. Linking this program to interprofessional educational initiatives in health sciences faculties is essential in order to enhance consistency between pre-licensure and post-licensure education around collaborative care competencies. This program is able to identify interprofessional collaborative care teams that are best suited to host interprofessional student placements and that are ready to mentor students in collaborative care best practices.