Implementation of an interprofessional communication and collaboration intervention to improve care capacity for heart failure management in long-term care

Abstract

Heart failure affects up to 20% of nursing home residents and is associated with high morbidity, mortality, and transfers to acute care. A major barrier to heart failure management in nursing home settings is limited interprofessional communication. Guideline-based heart failure management programs in nursing homes can reduce hospitalisation rates, though sustainability is limited when interprofessional communication is not addressed. A pilot intervention, 'Enhancing Knowledge and Interprofessional Care for Heart Failure', was implemented on two units in two conveniently selected nursing homes to optimise interprofessional care processes amongst the care team. A core heart team was established, and participants received tailored education focused on heart failure management principles and communication processes, as well as weekly mentoring. Our previous work provided evidence for this intervention's acceptability and implementation fidelity. This paper focuses on the preliminary impact of the intervention on staff heart failure knowledge, communication, and interprofessional collaboration. To determine the initial impact of the intervention on selected staff outcomes, we employed a qualitative design, using a social constructivist interpretive framework. Findings indicated a perceived increase in team engagement, interprofessional collaboration, communication, knowledge about heart failure, and improved clinical outcomes. Individual interviews with staff revealed innovative ways to enhance communication, supporting one another with knowledge and engagement in collaborative practices with residents and families. Engaging teams, through the establishment of core heart teams, was successful to develop interprofessional communication processes for heart failure management. Further steps to be undertaken include assessing the sustainability and effectiveness of this approach with a larger sample.

Operationalization of bandura’s social learning theory to guide interprofessional simulation

“…Consistent with previous studies, students expressed an increase in their own understanding of interprofessional collaboration, improved communication, and support of one another as they now start to understand the convergence of their roles in the bigger picture of patient care. [10,11] Students in this study stated their desire to continue using IPS and suggested increasing access to this strategy in the educational curriculum. The theme, early implementation, established that students comprehend collaborative simulation as a valuable learning tool to foster confidence in their roles as nurses and social workers.…”

“…[4,8,9] Interprofessional practice is a key component for effective communication, improving patient care, increasing understanding between professions, reducing fragmented care, and improving patient safety. [5,[10][11][12][13][14][15] Inclusion of simulation enhanced interprofessional education (IPE) or interprofessional simulation (IPS) can allow health professionals to see the health care team's collaborative impact on patient care. [7,16] In the clinical setting, health care professionals are expected to work in teams, yet, there is limited academic exposure to other allied health students and little preparation is done in traditional classrooms to practice with other allied health students; a gap in curriculum that supports an interprofessional approach exists.…”

“…[20] Research that demonstrates effective teamwork as part of the curricular design and aligned with a guiding framework is needed. [7,10,11,14,23,24] To support this gap in the literature, social work and nursing departments from one university sought to provide a collaborative pilot simulation experience using Bandura's social learning theory as the guiding framework for the IPS design.…”

Condition-Specific Pamphlets to Improve End-of-life Communication in Long-term Care: Staff Perceptions on Usability and Use

“…[44][45] There are a variety of tools and processes that may be helpful in developing more structured procedures for pamphlet distribution and follow up. For example, the Palliative Performance Scale which is a scale developed to identify when patients may benefit from endof -life care, or the 'surprise question' which prompts staff to use their clinical judgment to identify residents who could foreseeably die within a particular time frame, could be used to identify residents and families who would benefit from receiving a pamphlet [46][47] . Both of these triggers can be reliably used by care aides and support staff in LTC.…”

Recommendations for integrating physiotherapy into an interprofessional outpatient care setting for people living with HIV: a qualitative study

“…Authors of a qualitative descriptive study explored the impact of introducing an initiative to increase interprofessional communication among healthcare professionals working with patients with heart failure. After introducing strategies to enhance communication, professionals felt they had greater knowledge of heart failure, and felt patients had improved clinical outcomes 33. While the importance of interprofessional communication within an outpatient service is evident, further research is needed to address how to optimise communication along the healthcare continuum, particularly with episodic illness where the continuum may not always be predictable, nor linear in nature.…”