Much of the care we provide is complex and requires the contributions of many knowledgeable and experienced professionals. To satisfy the National Academy of Medicine recommendations of providing safe, timely, effective, efficient, equitable, and patient-centered care, healthcare professionals must function as highly collaborative teams.
One of the essentials for doctoral nursing education and advanced nursing practice is interprofessional collaboration for improving patient and population health outcomes. Advanced practice RNs (APRNs) should establish, participate in, and provide leadership for interprofessional teams in oncology care.
Building an Interprofessional Team
Including a variety of health professionals is essential to achieve holistic care. For oncology, common team members include APRNs; oncology nurses; nurse navigators; medical, surgical, and radiation oncologists; pharmacists; dieticians; social workers; clinical trials coordinators; physical therapists; genetics counselors; pathologists; and other clinical specialists. Outside of clinical roles, representation from information technology, quality improvement, and administration may be needed. As care becomes more complex, key stakeholders contribute unique perspectives and insight from essential disciplines.
Using Models as a Basis
New models of interprofessional collaboration are emerging in cancer care, including education, interprofessional tumor boards, documentation, psychosocial support, and cancer survivorship care with cardio-oncology services. Using models for interprofessional collaboration may contribute to quality improvement activities in various settings. A successful example of interprofessional team collaboration helped to improve communication, workflow, and turnaround times in an adult infusion clinic.
Applying Collaboration to Practice
A clinical example of an interprofessional collaborative project took place in our outpatient infusion center. We identified a communication problem with intake information, anticipated time for admixture of medication, and notification of the completed product being available for infusion. The workflow caused longer wait times, decreasing patient and staff satisfaction.
We convened a group of stakeholders, including pharmacists, nurses, nurse managers and APRNs, pharmacy technicians, and informational technology pharmacists. Together, we developed a computer app that compiles a patient’s current height, weight, chair number, and any comments. Nurses input the information, and the app sends it to the pharmacy to review and begin preparing the admixture.
Next, we installed a video board in the nursing station to display patients, drugs, and time to completion of the drug admixture. When the product is ready for the nurse, the patient information moves to the completed area on the right side of the screen. Additionally, pharmacists and technicians educated nurses in huddles about the preparation times for specific drug admixtures, which allowed nurses to set realistic expectations with patients and schedule patient visit times appropriately. The results speak for themselves: the collaboration has improved communication, efficiency, and nurse and patient satisfaction.
Schot et al.’s systematic review described three main categories for contributions to interprofessional collaboration:
- Bridging the gaps: overcoming obstacles such as professional perspectives, social or emotional work, communication divides, and task divisions
- Negotiating overlaps: resolving professional conflicts
- Creating spaces: organizing the necessary environment for interaction
APRN participation in interprofessional groups is necessary for patient care and exemplifies the leadership and contributions of advanced practice nursing.