Interprofessional practice and person-centred care: moral contexts and ethical conflicts in the US and Canada

Author:
Phillip G. Clark University of Rhode Island, USA

Search for other papers by Phillip G. Clark in
Current site
Google Scholar
Close
Restricted access
Get eTOC alerts
Rights and permissions Cite this article

Health and social care services and systems increasingly promote both interprofessional practice and person-centred care. This discussion first examines the clinical and community-based contexts for providing interprofessional practice and person-centred care through the lens of personal, interpersonal, interprofessional and organisational values. Emerging conflicts among values are highlighted using the concept of moral distress, with examples from US and Canadian settings. The comparison then moves to the systems level, examining different US and Canadian contexts for improving the quality and reducing the cost of care. Finally, implications and applications are presented, focusing on interrelationships among the individual, interprofessional team and organisation.

  • Bachynsk, N. (2020) Implications for policy: the Triple Aim, Quadruple Aim, and interprofessional collaboration, Nursing Forum, 55(1): 5464. doi: 10.1111/nuf.12382

    • Search Google Scholar
    • Export Citation
  • Beck, J., Falco, C.N., O’Hara, K., Bassett, H.K., Randall, C.L., Cruz, S., Hanson, J.L., Dean, W. and Senturia, K. (2023) The norms and corporatization of medicine influence physician moral distress in the United States, Teaching and Learning in Medicine, 35(3): 33545. doi: 10.1080/10401334.2022.2056740

    • Search Google Scholar
    • Export Citation
  • Berwick, D.M. (2020) The moral determinants of health, Journal of the American Medical Association, 324(3): 2256. doi: 10.1001/jama.2020.11129

    • Search Google Scholar
    • Export Citation
  • Berwick, D.M., Nolan, T.W. and Whittington, J. (2008) The Triple Aim: care, health, and cost, Health Affairs, 27(3): 75969. doi: 10.1377/hlthaff.27.3.759

    • Search Google Scholar
    • Export Citation
  • Bodenheimer, T. and Sinsky, C. (2014) From Triple to Quadruple Aim: care of the patient requires care of the provider, Annals of Family Medicine, 12(6): 5736. doi: 10.1370/afm.1713

    • Search Google Scholar
    • Export Citation
  • Brandt, B., Lutfiyya, M., King, J.A. and Chioreso, C. (2014) A scoping review of interprofessional collaborative practice and education using the lens of the Triple Aim, Journal of Interprofessional Care, 28(5): 3939. doi: 10.3109/13561820.2014.906391

    • Search Google Scholar
    • Export Citation
  • Bryan, S. and Donaldson, C. (2016) Taking triple aim at the Triple Aim, Healthcare Papers, 15(3): 2530. doi: 10.12927/hcpap.2016.24585

    • Search Google Scholar
    • Export Citation
  • Canadian Nurses Association (nd) Position statement on interprofessional collaboration, www.cna-aiic.ca/en/nursing/nursing-tools-and-resources/interprofessional-collaboration.

    • Search Google Scholar
    • Export Citation
  • CHSRF (Canadian Health Services Research Foundation) (2012a) Evidence Synthesis for the Effectiveness of Interprofessional Teams in Primary Care, Ottawa, ON: Canadian Nurses Association, www.cna-aiic.ca/en/nursing/nursing-tools-and-resources/interprofessional-collaboration.

    • Search Google Scholar
    • Export Citation
  • CHSRF (2012b) Interprofessional Collaborative Teams, Ottawa, ON: Canadian Nurses Association, www.cna-aiic.ca/en/nursing/nursing-tools-and-resources/interprofessional-collaboration.

    • Search Google Scholar
    • Export Citation
  • Clark, P.G. (1989) The philosophical foundation of empowerment: implications for geriatric health care programs and practice, Journal of Aging and Health, 1(3): 26785. doi: 10.1177/089826438900100301

    • Search Google Scholar
    • Export Citation
  • Clark, P.G. (1995) Quality of life, values, and teamwork in geriatric care: do we communicate what we mean?, The Gerontologist, 35(3): 40211. doi: 10.1093/geront/35.3.402

    • Search Google Scholar
    • Export Citation
  • Clark, P.G. (1997) Values in health care professional socialization: implications for geriatric education in interdisciplinary teamwork, The Gerontologist, 37(4): 44151. doi: 10.1093/geront/37.4.441

    • Search Google Scholar
    • Export Citation
  • Clark, P.G. (2006) What would a theory of interprofessional education look like? Some suggestions for developing a theoretical framework for teamwork training, Journal of Interprofessional Care, 20(6): 57789. doi: 10.1080/13561820600916717

    • Search Google Scholar
    • Export Citation
  • Clark, P.G. (2014) Narrative in interprofessional education and practice: implications for professional identity, provider–patient communication, and teamwork, Journal of Interprofessional Care, 28(1): 349. doi: 10.3109/13561820.2013.853652

    • Search Google Scholar
    • Export Citation
  • Clark, P.G. and Drinka, T.J.K. (2002) Exploring responsibility, accountability, and authority in geriatric team performance, in M.D. Mezey, C.K. Cassel, M.M. Bottrel, K. Hyer, J.L. Howe and T.T. Fulmer (eds) Ethical Patient Care: A Casebook for Geriatric Health Care Teams, Baltimore, MD: Johns Hopkins University Press, pp 20829.

    • Search Google Scholar
    • Export Citation
  • Clark, P.G., Cott, C. and Drinka, T.J.K. (2007) Theory and practice in interprofessional ethics: a framework for understanding ethical issues in health care teams, Journal of Interprofessional Care, 21(6): 591603. doi: 10.1080/13561820701653227

    • Search Google Scholar
    • Export Citation
  • Clark, P.G., Ansello, E., Helm, F. and Tanzer, R. (2023 ) Growing older with intellectual and developmental disabilities: implementing and evaluating a project ECHO for dementia education, Gerontology & Geriatrics Education. doi: 10.1080/02701960.2023.2168269

    • Search Google Scholar
    • Export Citation
  • Curran, V. (2007) Collaborative Care, Primary Health Care Transition Fund Synthesis Series on Sharing Insights, Ottawa, ON: Health Canada, www.canada.ca/content/dam/hc-sc/migration/hc-sc/hcs-sss/alt_formats/hpb-dgps/pdf/prim/2006-synth-collabor-eng.pdf.

    • Search Google Scholar
    • Export Citation
  • Drinka, T.J.K. and Clark, P.G. (2016) Healthcare Teamwork: Interprofessional Practice and Teaching, 2nd edn, Santa Barbara, CA: Praeger.

    • Search Google Scholar
    • Export Citation
  • Frenk, J., et al. (2010) Health professionals for a new century: transforming education to strengthen health systems in an interdependent world, The Lancet, 376(9756): 192358. doi: 10.1016/S0140-6736(10)61854-5

    • Search Google Scholar
    • Export Citation
  • Gachoud, D., Albert, M., Kuper, A., Stroud, L. and Reeves, S. (2012) Meanings and perceptions of patient-centredness in social work, nursing, and medicine: a comparative study, Journal of Interprofessional Care, 26(6): 48490. doi: 10.3109/13561820.2012.717553

    • Search Google Scholar
    • Export Citation
  • Gocan, S., Laplante, M.A. and Woodend, K. (2014) Interprofessional collaboration in Ontario’s family health teams: a review of the literature, Journal of Research in Interprofessional Practice and Education, 3(3): 119. doi: 10.22230/jripe.2014v3n3a131

    • Search Google Scholar
    • Export Citation
  • Gray, M. and Jani, A. (2016) Promoting Triple Aim healthcare in countries with universal healthcare, Healthcare Papers, 15(3): 428.

  • Hutchinson, G.S. and Korazim-Kőrösy, Y. (2017) Do national welfare systems have an influence on interdisciplinary collaborations within schools of social work and their communities? The case of the Nordic countries, International Social Work, 60(1): 4560. doi: 10.1177/0020872814559561

    • Search Google Scholar
    • Export Citation
  • Institute for Healthcare Improvement and the Hartford Foundation (2020) Age-Friendly Health Systems: Guide to Using the 4Ms in the Care of Older Adults, Boston, MA: IHI, www.ihi.org/Engage/Initiatives/Age-Friendly-Health-Systems/Documents/IHIAgeFriendlyHealthSystems_GuidetoUsing4MsCare.pdf.

    • Search Google Scholar
    • Export Citation
  • IPEC (Interprofessional Education Collaborative) (2023) IPEC Core Competencies for Interprofessional Collaborative Practice: Version 3, Washington, DC: IPEC, www.ipecollaborative.org/assets/core-competencies/IPEC_Core_Competencies_Version_3_2023.pdf.

    • Search Google Scholar
    • Export Citation
  • James, B.C. and Savitz, L.A. (2011) How intermountain trimmed health care costs through robust quality improvement efforts, Health Affairs, 30(6): 118591. doi: 10.1377/hlthaff.2011.0358

    • Search Google Scholar
    • Export Citation
  • Jameton, A. (1984) Nursing Practice: The Ethical Issues, Englewood Cliffs, NJ: Prentice-Hall.

  • Karam, M., Brault, I., Van Durme, T. and Macq, J. (2018) Comparing interprofessional and interorganizational collaboration in healthcare: a systemic review of the qualitative research, International Journal of Nursing Studies, 79: 7083. doi: 10.1016/j.ijnurstu.2017.11.002

    • Search Google Scholar
    • Export Citation
  • Kayser-Jones, J. (1986) Distributive justice and the treatment of acute illness in nursing homes, Social Science in Medicine, 23(12): 127986. doi: 10.1016/0277-9536(86)90290-x

    • Search Google Scholar
    • Export Citation
  • Lukey, A., et al. (2021) Facilitating integration through team-based primary healthcare: a cross-case policy analysis of four Canadian provinces, International Journal of Integrated Care, 21(4): 112. doi: 10.5334/ijic.5680

    • Search Google Scholar
    • Export Citation
  • Lutfiyya, M.N., Brandt, B., Delaney, C., Pechacek, J. and Cerra, F. (2016) Setting a research agenda for interprofessional education and collaborative practice in the context of United States health system reform, Journal of Interprofessional Care, 30(1): 714. doi: 10.3109/13561820.2015.1040875

    • Search Google Scholar
    • Export Citation
  • Martin-Rodriguez, L.S., Beaulieu, M.D., D’Amour, D. and Ferrada-Videla, M. (2005) The determinants of successful collaboration: a review of theoretical and empirical studies, Journal of Interprofessional Care, 19(S1): 13247. doi: 10.1080/13561820500082677

    • Search Google Scholar
    • Export Citation
  • McCauley, L., Phillips, R.L., Meisnere, M. and Robinson, S.K. (eds) (2021) Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care, Washington, DC: National Academies Press, www.nap.edu/catalog/25983/implementing-high-quality-primary-care-rebuilding-the-foundation-of-health.

    • Search Google Scholar
    • Export Citation
  • Mery, G., Majumder, S., Brown, A. and Dobrow, M.J. (2017) What do we mean when we talk about the Triple Aim? A systematic review of evolving definitions and adaptations of the framework at the health system level, Health Policy, 121(6): 62936. doi: 10.1016/j.healthpol.2017.03.014

    • Search Google Scholar
    • Export Citation
  • Nundy, S., Cooper, L.A. and Mate, K.S. (2022) The Quintuple Aim for health care improvement: a new imperative to advance health equity, Journal of the American Medical Association, 327(6): 5212. doi: 10.1001/jama.2021.25181

    • Search Google Scholar
    • Export Citation
  • O’Leary, N. and Boland, P. (2020) Organization and system theories in interprofessional research: a scoping review, Journal of Interprofessional Care, 34(1): 1119. doi: 10.1080/13561820.2019.1632815

    • Search Google Scholar
    • Export Citation
  • Ploeg, J., Markle-Reid, M., Fisher, A., Bookey-Bassett, S., Chambers, T., Kennedy, L., Morsy, M. and Dufour, S. (2017) An exploration of experts’ perceptions on the use of interprofessional education to support collaborative practice in the care of community-living older adults, Journal of Interprofessional Care, 31(5): 63847. doi: 10.1080/13561820.2017.1347610

    • Search Google Scholar
    • Export Citation
  • Romanow Commission (2002) Building on Values: The Future of Health Care in Canada, Ottawa, ON: Government of Canada, https://publications.gc.ca/collections/Collection/CP32-85-2002E.pdf.

    • Search Google Scholar
    • Export Citation
  • Russell, G.M., et al. (2018) Contextual levels for team-based primary care: lessons from reform interventions in five jurisdictions in three countries, Family Practice, 35(3): 27684. doi: 10.1093/fampra/cmx095

    • Search Google Scholar
    • Export Citation
  • Schön, D.A. (1987) Educating the Reflective Practitioner, San Francisco, CA: Jossey-Bass.

  • Sidani, S. and Fox, M. (2014) Patient-centred care: clarification of its specific elements to facilitate interprofessional care, Journal of Interprofessional Care, 28(2): 13441. doi: 10.3109/13561820.2013.862519

    • Search Google Scholar
    • Export Citation
  • Steenkamer, B., Drewes, H., Putters, K., van Oers, H. and Baan, C. (2020) Reorganizing and integrating public health, health care, social care and wider public services: a theory-based framework for collaborative adaptive health networks to achieve the Triple Aim, Journal of Health Services Research and Policy, 25(3): 187201. doi: 10.1177/1355819620907359

    • Search Google Scholar
    • Export Citation
  • Thistlethwaite, J., Jackson, A. and Moran, M. (2013) Interprofessional collaborative practice: a deconstruction, Journal of Interprofessional Care, 27(1): 506. doi: 10.3109/13561820.2012.730075

    • Search Google Scholar
    • Export Citation
  • WHO (World Health Organization) (2010) Framework for Action on Interprofessional Education and Collaborative Practice, Geneva, Switzerland: WHO, https://apps.who.int/iris/bitstream/handle/10665/70185/WHO_HRH_HPN_10.3_eng.pdf;jsessionid=326497879C8F0249076CE45925028CE9?sequence=1.

    • Search Google Scholar
    • Export Citation
  • Wilkinson, G.W., et al. (2017) No equity, no Triple Aim: strategic proposals to advance health equity in a volatile policy environment, American Journal of Public Health, 107(S3): S2238. doi: 10.2105/AJPH.2017.304000

    • Search Google Scholar
    • Export Citation
  • Yeandle, S., Chou, Y.C., Fine, M., Larkin, M. and Milne, A. (2017) Care and caring: interdisciplinary perspectives on a societal issue of global significance, International Journal of Care and Caring, 1(1): 325. doi: 10.1332/239788217x14866278171183

    • Search Google Scholar
    • Export Citation
Phillip G. Clark University of Rhode Island, USA

Search for other papers by Phillip G. Clark in
Current site
Google Scholar
Close

Content Metrics

May 2022 onwards Past Year Past 30 Days
Abstract Views 416 416 68
Full Text Views 169 169 7
PDF Downloads 91 91 7

Altmetrics

Dimensions