3. Why Has it got to be Multi Professional ? The extent to which different healthcare professionals work well together can affect the quality of the health care that they provide. If there are problems in how healthcare professionals communicate and interact with each other, then problems in patient care can occur. If Professionals learn & work together it affects: Attitudes about other disciplines – enables greater understanding & respect Knowledge, skills, abilities &Behaviour: Individuals’ transfer of interprofessional learning to their practices

4. Why Has it got to be Multi Professional ? Creates an environment of balanced power relationships through shared leadership, decision making, authority, and responsibility. Enables diverse voices for decision making. Enables Sharing knowledge with each other openly. Enables a team to Work collaboratively with patients/clients and their families to plan and deliver care.

5. http://www.wimp.com/pitcomparison/

6. Integration in Healthcare There is much talk of this and it can be : vertical (secondary and primary care), horizontal (primary, community and social care), virtual (systems and processes) real (mergers and acquisitions). Historically, the NHS= lot of superficial structural integration Little co-ordination and collaboration from the patient's perspective

7. Making Integration Between Professions work Use a defined and registered population; Assure that incentives are aligned Shared and joint accountability- no wriggle room or blame Seamless IT and information systems Shared clinical protocols and pathways collaboration between clinicians and managers; authentic patient involvement; relentless focus on quality improvement systems; collaborative organisational cultures; and inspired leadership

8. How to Make it Multi Professional? Although the primary focus of some models has been on hospital ward settings where ‘students work in interprofessional teams, while under supervision, to manage the care of patients’ the training model been used in community health care settings Focus on the practice of the staff & immerse in work-based settings. The research literature on practice-based interprofessional education and training has been mostly outcomes-oriented (mapped against Kirkpatrick’s framework of evaluation) and focused on evidencing the generally positive impact of such initiatives on student satisfaction, knowledge, skills, attitudes, and performance [ Does not evidence how and why learning occurs within interprofessional settings, and important to use a realist approach to evaluation within the interprofessional education and training field to address this shortcoming Chris Roberts & Koshima Kumila (2015)Student learning in interprofessional practice-based environments: what does theory say? BBC eduation

9. What do we need to Consider to Be Successful? Attitudes about other disciplines or about working with other professions; Knowledge, skills, abilities around interprofessional education and collaborative practice; Behaviour: Individuals’ transfer of interprofessional learning to their practices; Organizational level: Interprofessional collaboration at the level of the organization organizational culture and organizational readiness; Patient satisfaction: Referring only to the aspects of patients’ satisfaction involving interprofessional collaboration; Provider satisfaction: Referring only to the aspects providers’ satisfaction involving teamwork processes or work environment involving interprofessional collaboration.

10. Tips Practicing and collaborating with colleagues, patients/clients and families in a way that fosters respect, trust and understanding. Understanding their individual roles and expertise, reflecting on their practice, being confident in their abilities and expertise, knowing the standards and boundaries of their practice and recognizing when it’s time to turn things over to other team members. Developing communication and conflict-management skills.

11. Kings Fund Key points for improving Teamwork (Ham. C,2015) Consider creative ways to increase staff interaction and team- building, e.g., forums, away days. Use recognised tools to identify the preferences, strengths, weaknesses, traits within the team, e.g., Myers-Briggs Type Indicator, Belbin. Consider the organisational culture within your maternity unit; is it open to change, innovative, or are there pockets of resistance to change? Work with staff to address some of the organisational culture issues that can hamper success. Consider applying an organisational or safety culture analysis tool to help determine areas for further development such as MaPSaF.

12. References Daly, G. (2004) Understanding the barriers to multiprofessional collaboration. Nursing Times; 100: 9, 78–79. Roberts and Kumar BMC Medical Education (2015) 15:211 DOI 10.1186/s12909-015-0492-1 Canadian Interprofessional Health Collaborative (2010) A National Interprofessional Competency Framework Canadian Interprofessional Health Collaborative (2012) An Inventory of Quantitative Tools Measuring Interprofessional Education and Collaborative Practice Outcomes, August

13. References cont.. Barr, H (2010) Interprofessional Education in the United Kingdom: Historical Perspectives, A supplement to: Creating an Interprofessional Workforce: An Education and Training Framework for Health and Social Care Ham C (2015) Reforming the NHS from within Beyond hierarchy, inspection and markets, Kings Fund Zwarenstein M, et al., (2009) Interprofessional collaboration: effects of practice-based interventions on professional practice and healthcare outcomes (Review)

14. Acute Frailty Network frailty@nhselect.org.uk @acutefrailty www.acutefrailtynetwork.org.uk