Interprofessional Collaboration in the ICU: Determinants of Success in an End of Life Care Project
CCCF ePoster library. Swinton M. Oct 26, 2015; 117357; P26 Disclosure(s): The 3 Wishes study was peer-review funded by the Hamilton Academy of Health Sciences and Covenant Health (Alberta).
Ms. Marilyn Swinton
Ms. Marilyn Swinton
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Abstract
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P26


Topic: Other


Interprofessional Collaboration in the ICU: Determinants of Success in an End of Life Care Project



Marilyn Swinton, T. Rose, F. Toledo, T. Hand-Breckenridge, A. Woods, A. Boyle, F. Clarke, N. Zytaruk, L. Saunders, M. Shears, R. Sheppard, D. Cook

Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Canada | Spiritual Care, St. Joseph's Healthcare, Hamilton, Canada | Spiritual Care, St. Joseph's Healthcare, Hamilton, Canada | Spiritual Care, St. Joseph's Healthcare, Hamilton, Canada | Palliative Care, St. Joseph's Healthcare, Hamilton, Canada | Palliative Care, St. Joseph's Healthcare, Hamilton, Canada | Critical Care, St. Joseph's Healthcare, Hamilton, Canada | Critical Care, St. Joseph's Healthcare, Hamilton, Canada | Critical Care, St. Joseph's Healthcare, Hamilton, Canada | Critical Care, St. Joseph's Healthcare, Hamilton, Canada | Emergency Medical Associates, North Cypress Medical Center,, Cypress, United States of America | Departments of Medicine and Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Canada

Introduction: The literature on interprofessional collaboration indicates that collaborative practice allows health care professionals to learn with, from, and about each other, while utilizing the unique skills and abilities of each professional group (Curran). The synergy created by collaborative practice helps to ensure that the care received by a patient and family is superior to the care that can be delivered by any one clinician individually.

Objectives:

To describe factors that contributed to the first intentional collaboration of clinicians from critical care, palliative care, and spiritual care in a project developed in the Intensive Care Unit (ICU) to improve end of life (EOL) care for dying patients.



Methods: The 3 Wishes Project aims to elicit and fulfill a set of 3 wishes with the hope of bringing peace and dignity to critically ill patients at the EOL and to ease the grieving process for families. During the enrollment of 60 patients and analysis of 200 qualitative interviews (60 with family members of enrolled patients and 140 with clinicians who cared for these patients), the 3 Wishes Project team conferred quarterly over the course of 2 years, in-person (at meetings and retreats) and by conference (by e-mail and telephone), to analyze the determinants of success of this interprofessional collaboration.

Results: Determinants of this successful collaboration emerged in 2 groups: the genesis and the growth of the 3 Wishes Project. Factors considered key to the genesis were the project's relevance to patient care, a shared purpose, and the team members' mutual respect. Growth of the 3 Wishes Project has been supported by factors different from those which birthed the project. Factors considered key to the growth were the structure and consistency of the project, non-hierarchical leadership, and ongoing reflections on our shared learnings. These 7 determinants of successful interprofessonal collaboration allowed us to see patients through a different lens, illuminating them holistically in the context of their lives -- an experience which broadened the scope of practice for all clinicians and team members.

Conclusion:

Interprofessional synergies fostered by the 3 Wishes Project energized the team to 'walk the walk together' while providing clinical care, enhancing education and evaluating the impact of the project. Understanding the factors that make interprofessional initiatives successful can offer insights into how to create and develop novel initiatives in the complex ICU setting.



References: Curran, V. Interprofessional Education for Collaborative Patient-Centred Practice Research Synthesis Paper. Centre for Collaborative Health Professional Education Memorial University. http://www.med.mun.ca/getdoc/58a756d2-1442-42ed-915b-9295b6d315c6/Curran--Resarch-Synthesis-Paper.aspx
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