Interprofessional Collaboration

1. Interprofessional Collaboration North Battleford May 28, 2011

2. SchoolPLUS Write a word, a phrase or symbol that represents what you know about SchoolPLUS Step 2: Individually write and report Step 1 - huddle

3. More than a program...SchoolPLUS ... • New organizational environment • Distributed and roving leadership • Matrix organization • Empowers everyone in the community • Envelopes a community school philosophy and principles • “throes of creating a new society”

4. The school has two functions: • 1. to educate children and youth – nurturing the development of the whole child, intellectually, socially, spiritually, emotionally and physically and • 2.      to support service delivery – serving as centres at the community level for the delivery of appropriate social, health, recreation, culture, justice and other services for children and their families.

5. Interprofessional Partnerships Social Services School Division Health T SLP Education OT Multiple professions within different sectors Interprofessional within one system

6. Interprofessional Collaboration (IPC) • …Interprofessional refers to relations between different professional groups and that each one of these will have a distinctive professional culture. Collaboration is an active and ongoing partnership, between people from diverse backgrounds, who work together to solve problems or provide services. • Mutual reciprocal effort among professionals, families, [children] and other caregivers to deliver effective intervention [assessment, prevention, evaluation] to children and their increased physical, emotional, [social] and academic well-being (Mostert, 1996).

7. Sound familiar? Multi-Sector... • A teacher stops a12-year old boy, Darius, in the hall noticing that he is carrying a leg to a table that is ‘hidden’ under his coat. The teacher reports the event to the principal, who in turn involves the police resource officer. When confronted with “Why are you carrying a table leg?” Darius replies, “for protection”. Darius’s mother is out of the province and has left her son with a neighbour but the neighbour knows nothing of the arrangement. The principal wants Darius suspended. The police resource officer wants him charged. The teacher is indifferent. The youth probation officer is considering breaching Darius for breaking the conditions of his probation order. The child protection worker wants the boy moved to Dales House. Some staff argues that the school’s safety must come before Darius’s interest. The Dales House staff argues for not disrupting the his education and want him left in school. Discuss the collaboration issues.

8. High Collaborating Contracting Community-building Novelty, Complexity, & Interdependence Coordinating Cooperating Connecting Communicating High Low Role and Rule Changes, Transaction Costs, Infrastructure Requirements, and Governance Needs (Lawson, 2003)

9. Collaboration involves: • Interdependence - each requires the other to succeed. • Changing the rules. Categorical vs shared funding • Implies shared responsibilities for results • Unity of Purpose • intentionally disrupting conventional boundaries • Equitable relationships- not hostile takeovers • Pooling and sharing of resources • Changes discourses and identities • New roles • collaboration changes people’s lives, not just their job.

10. Collaboration Dynamics

11. Interprofessional Team Work University of Leicaster, UK • Youtube • 11:21 – Sure Start • http://www.youtube.com/watch?v=Fh7tIr4Tl1o

12. Benefits and Barriers to IPC

13. Finding “equitable” partnerships… Challenge status & traditional hierarchies

14. Feeling like you are overwhelmed? Increase level of Communication

15. Partnerships in perspective… Changing roles & responsibilities

16. Quantitative Data: Benefits Measured Outcomes: Typical Process Measurements: improving assessments referral procedures, shortening waitlists, prioritizing cases and improving recruitment and retention • Increase engagement with learning • Improve academic outcomes • Improve trust and support between families and schools • Improve information sharing • Formalize protocols/changing structures • Enhance access to service • Target services appropriately

17. Qualitative data: Benefits • The Psychologist stated: • And I didn’t know that before (teaming) and I never looked at that before, I only looked at how they were paying attention, but I didn’t SEE the other stuff. And, I didn’t know what that other stuff was. I didn’t know that sucking on your arm and constant fingers in the mouth is a sensory need. I would have just focused on [whether] he is attending to the teacher, answering questions. Is he putting up his hand? I would have not noticed all the other stuff. There is always stuff that I would miss, like the visual stuff and all these visual perceptional things they do. I am already learning to look at kids writing. Is he writing on the line? Are his words high, small? And they taught me that.

18. Why IPC? • Health, justice, social care and learning are “intertwined” • Purpose of school has changed over the years

19. Beyond good care and services • “co-production” – • services alone will not alleviate the harms associated with poverty and social exclusion • S+ “manufacturing” new environments - creating new inclusive structures • Changing systems and structures • IPC is often conceptualized in terms of “proximal” rather than “distal” factors which draws attention from the underlying causes of marginalization, oppression and exclusion

20. Proximal Factors –respond to individual/family health and social needs. Distal Factors – concerned with systemic issues Marginalization, oppression and exclusion related to: Social class Race Gender - (isms) Poverty Housing, unemployment etc. • Classroom routines, instructional strategies • Managing medications • School breakfast, lunch programs • Anger management programs • Swish/Dental Health Programs

21. Keeping Your Eye On Both... • IPC opens up “new spaces” to talk about and change the conditions that create disadvantage in the first place: • Challenge: “Disadvantage inevitably exists and the only strategy available is to match the service provision to the degree of disadvantage”. • Ambulance or a fence?

22. Learning to Collaborate: • Competencies (CIHC, 2010) • Interprofessional Communication • Student/ family/community centered care • Role Clarification • Team Functioning • Collaborative Leadership • Conflict Resolution

23. Attending to Team Functioning • IPC based on more than convenient or social relationships. Must transcend personal affinity or biases. • Jargon Words – “PPP” or “YO” • Organizational Mapping • Confidentiality issues • “Circle of care” and “need to know info”

24. b: Multi-Point Communication a: Single Point Communication Map your team. Who talks to who?

25. Education Omission or Dominant Duck?

26. Professional Development is necessary… Goal Roles & Reality

27. Case Studies: GROW G:What are the goals of the players/ professionals? • Are the goals common? Is it family or student centered? • How do professional perspectives influence goals? • List potential conflicting goals. • Imagine a common goal. • What would need to happen to create a common goal?

28. GROW R: Roles and Reality • Self Assessment and Assumptions • What do you know about the situation? What is the effect or result of the current reality? • Clarify your role and the role of others? What do you need to know about the other? What do they need to know about you? • Difficult to “know what you don’t know”! • Quote page 8

29. Role Clarification: Homework

30. GROW O: Opportunities and Options • What are some options to work together to support the student? • What results would you get from various types of partnerships? (collaborating, cooperating, connecting, etc.)

31. GROW W: Way forward – the WILL • So what will you do now? • How will you co-construct with a partner? • What do you “see” differently? • Are you willing to negotiate? Change? • What might stop you from moving forward?

32. Work on Case Studies

33. Now what does SchoolPLUS mean to you?

34. Learning as participation [is] not simply a way of acquiring skills but also of developing an identity and sense of belonging in a community (Barr, 2005). Professional self developed in silos Interprofessional Self

35. Reference Opportunities Journal of Interprofessional Care http://www.informaworld.com/smpp/title~content=t713431856 Journal of Research in Interprofessional Practice and Education http://www.jripe.org • Canadian Interprofessional Health Collaborative • www.cihc.ca Health Canada http://www.hc-sc.gc.ca/hcs-sss/hhr-rhs/strateg/interprof/index-eng.php • Interprofessional Health Collaborative of Saskatchewan • http://www.usask.ca/ipe/about_ihcs/index.php • Examples: http://www.usask.ca/ipe/activities_inventory/projects/index.php