Interprofessional collaboration is defined by the World Health Organization as the coming together of

Interprofessional collaboration is defined by the World Health Organization as the coming together of multiple health staff from different interdisciplinary departments within an organization and in the community to deliver supreme quality healthcare. 

In the case stated by Dr. Steberg here is the list of people that I would have on my team:

I would want to start a Root Cause Analysis (RCA) on this problem.  The first person that I would have on the team is the patient safety officer nurse.  Our patient safety officer nurse conducts all RCA’s.  This person would be the leader of the RCA. 

The next person would be the nurse manager of the unit where the errors have occurred.  By having the manager, we can know the schedules and the nurses that have made the errors.  We also will know the education that they have to prove that they understand the process and procedures for medication administration. 

The next person that I would have is a pharmacy person, pharmacy supervisor or manager. The pharmacy can help to identify is there were any medication errors while putting meds in the pyxis machine.  The pharmacy can also help to identify if there are any problems with look a like or sound alike.  The pharmacy is having records of the medications and tell if proper processes were followed.

The next person would be a quality management nurse.  This nurse can help to track trends.  They are also able to review charts as another set of eyes on the chart and the process.  If the problem is happing in one area it is likely that the issue exists in another area. 

I would also have a person from the IT department.  The IT staff can help us investigate computer process that were taken or not taken when administering medications.  All the computers in our facility are repaired and monitored by the IT department. 

I would also have frontline staff nurses (1-2) to help understand their process and any roadblocks that they come up against.

Then next step would be to have a Root Cause Analysis group.  This group would include all the people that I have listed above.  At the VA Medical Center, we have a form that we complete.  This form is completed by the person that identified the problem.  This form is then given to the leader of the RCA.  The VA Medical Center uses Microsoft Teams as a communication board.  We would set up an RCA team for this review.  This team’s site allows for us to post information and save documents and communicate with each other.  The leader then writes up the problem on a form that allows us to identify the problem, list who is involved in each process.  We also make a list of possible reasons that the errors occurred.  The team is called together for a meeting to discuss why we are here and are given the write up what we are reviewing. We are given 1 week to do our own research and come up with possible reasons of who, what, where, when, and why.  The second meeting starts that “whiteboard” process we place everyone’s ideas and solutions on the board.  We can track these through the team’s site.   When the team meets again, they agree on steps that need to be taken.  The majority needs to agree, and we always investigate the reasons why the others do not agree.  As I stated in each person that I would put on my team, you know what they are responsible to for reviewing.  We want to have an RCA wrapped up in 3-4 weeks.   The RCA leader (patient safety officer) will assign the jobs and date the each are due.    In the end when there are tasks that need to be completed to finish the RCA, the safety nurse officer will assign them to the respective person on the team.  The task will be completed and documented what was done to complete the task. 

Rebecca

Hagemeier, N. E., Hess, R., Hagen, K. S., & Sorah, E. L. (2014). Impact of an interprofessional communication course on nursing, medical, and pharmacy students’ communication skill self-efficacy beliefs. American Journal of Pharmaceutical Education, 78(10), 186. https://doi.org/10.5688/ajpe7810186

Vertino, K. (2014). Effective interpersonal communication: A practical guide to improve your life. OJIN: The Online Journal of Issues in Nursing, 19(3), 1

White, K. M., Dudley-Brown, S., & Terhaar, M. F. (2016). Translation of evidence into nursing and health care (2nd ed.). Springer Publishing Company.

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