(Published - 6 May 2019)
Suppose a patient is admitted to a healthcare facility after having a stroke. They are initially seen by a nurse during admission and, once stabilised, will be seen by the doctor who will advise on further procedures and tests. Thereafter, the patient will be seen by other professionals depending on their condition. This might include an appointment with the physiotherapist, occupational therapist, social worker, psychologists and others, if necessary. Each professional will have their own treatment plan and will do their own assessments. This traditional system of intervention allows for duplication, a waste of time and an increase in health costs. With an inter-professional approach to healthcare, the patient becomes the focus and is part of the team. A team approach is taken in assessment and treatment, thereby saving time and costs, and avoiding duplication. The patient receives holistic care, resulting in increased health outcomes.
Traditionally, health and social science professions have trained students within professional silos. Once they start working as professionals, the result is poor referrals between professionals, the duplication of services and poorer health outcomes for the patient.
Working within a coordinated team will automatically limit medical errors and save patients medical costs, which is critical in the South African context. For far too long the patient has been marginalised while health professionals decided what was best for the patient.
The truth is, the health and social challenges in our society have become so complex that one profession can no longer make a significant difference. For instance, physiotherapy alone cannot solve all your health problems. Our healthcare system requires graduates who can competently work within teams and practice collaboratively to improve health outcomes of patients, families and communities.
What is needed is interprofessional education (IPE), which is when students or members of two or more professions learn with, from and about each other to improve collaboration and the quality of care for the patient.
With an IPE approach, the patient is placed at the centre and the health professionals collaborate to provide the best possible care, increasing health outcomes automatically. But South Africa is not there yet. Transforming our healthcare system will require a transformation in how we train our students and future healthcare professionals.
IPE is the critical approach that higher education institutions like universities need to adopt – an approach that will adequately prepare future healthcare professionals if we want to see a significant decrease in the burden of diseases in South Africa and even beyond.
The Canadian Interprofessional Health Collaborative (CIHC) provides an easy framework to implement IPE based on six competencies that students need to attain in order to successfully work within a team. These competencies are role clarification, team functioning, interprofessional communication, conflict resolution, collaborative leadership and patient/family/community-centred care. IPE leads to health professionals working collaboratively (collaborative practice), which the World Health Organization (WHO) defines as “when multiple health workers from different professional backgrounds work together with patients, families, carers, and communities to deliver the highest quality of care.”
Many studies already reveal the benefits of IPE, which include improvement of attitudes towards other health professionals, increases in collaborative knowledge and skills, and changes in behaviour and practice with resulting benefits to recipients of care. One of the leaders in the field of IPE is the Interprofessional Education Unit (IPEU) at the University of the Western Cape (UWC), which, for the past 18 years, has formalised a curriculum across the continuum of learning within the Faculty of Community and Health Sciences (CHS).
In order for IPE to be successful, there needs to be support within academic institutions, facilities of care and financial support from leaders and the Department of Health.
Dr Gérard Fillies is a senior lecturer at UWC’s Interprofessional Education Unit.