Leading by example: The role of accreditors in promoting interprofessional collaborative practice

Introduction

The field of interprofessional education (IPE), interprofessional continuing education (IPCE), and interprofessional collaborative practice (IPCP) continues to evolve with a growing body of evidence demonstrating a positive impact on practice and patient outcomes (e.g. Reeves et al., 2016). With this evolution, there is opportunity for a broader discussion of the roles and responsibilities of different stakeholders in ensuring that health care professionals practice collaboratively, safely, and effectively. Stakeholders include but are not limited to individual health care providers; faculty; continuing education (CE) and continuing professional development (CPD) providers/organizations; professional membership associations and specialty societies; employers; accrediting and certifying organizations; and regulatory bodies. Each has a role in ensuring that health care professionals engage in CPD to maintain competence throughout their careers.

As the accreditors of the largest health care professions (medicine, nursing and pharmacy) in the United States, we have taken a significant step to leverage our role in this endeavor. Representing over five million physicians, nurses, and pharmacists who engage in CPD for their professional careers, we have created a unique program and credit system to incentivize development of and participation in IPCE. Joint Accreditation for Interprofessional Continuing Education™ offers CE providers a unified, streamlined accreditation process and set of standards. We have also held summits to convene the CE community, produced educational resources and reports, and initiated collaborations across the continuum of healthcare education and professions to further the development of IPCE. These strategies have led to a significant increase in the number of organizations developing team-based education, and an increase in the ability to measure team performance and patient outcomes. Our interprofessional collaboration can be operationalized by other stakeholders, and collectively, we can continue to positively impact health care practice and patient outcomes globally. In this editorial, we share lessons learned from our journey and identify opportunities for other stakeholders to join together.

Our journey

Our journey to interprofessional collaboration developed slowly at first, but always with a vision of using our role as accreditors to incentivize organizations to develop IPCE. We started simply, meeting several times a year to share our own accreditation criteria and identify opportunities for collaboration. We identified mutual goals of decreasing documentation burden for our CE provider community, improving alignment between our accreditation criteria requirements, ensuring we maintained foundational principles such as independence in CE, and developing a strategy to embed team-based education into organizations. Our first attempt, a streamlined application, was not successful. Although our CE providers were able to complete one application for accreditation, they were also required to write and submit three different self-study documents, addressing three different sets of accreditation criteria. We regrouped and tried again. Eventually, we developed our joint accreditation program criteria, successfully piloted the program with a small group of organizations, solicited feedback, and revised our criteria. Today, our joint accreditation program continues to flourish, and we are currently adding other health care profession accreditors to the program.

We learned many lessons throughout our interprofessional collaborative journey. We learned that we are more alike than we are different. We learned that it takes energy, trust, mutual respect, a willingness to build consensus and relinquish or adapt some of our individual approaches, and commitment to collaborate, but the end result is well worth the effort. We work together on issues that impact our shared learner community such as addressing the opioid epidemic in the United States, identifying the most effective strategies to engage learners in IPCE, and measuring the impact of team-based education on practice and patient outcomes.

Opportunities

We have learned that it is critical to continue to listen to our community of educators and learners, and work together to identify opportunities for further advancing IPCE. One of the themes we’ve heard continuously is that it is imperative to get buy-in from leadership and stakeholders across the healthcare system in order to successfully drive improvements in team delivery and patient care. Toward that end, we encourage other stakeholders to develop partnerships and use their own levers to move the interprofessional field forward. We also encourage stakeholders to publish and share their own experiences, including successes and failures. We provide several suggestions for consideration though we realize that globally, stakeholders are subject to the contexts of their own environments.

Individual health care professionals

We encourage health care professionals to identify their own learning gaps and seek out team-based education as appropriate. Health care professionals should also identify members of the teams with which they practice, and include the patient and caregiver as members of the health care team. We realize that not all learning needs are best addressed through IPCE, but we also know that health care is not delivered by individuals practicing in silos. It’s important for health care professionals to be open to learning in collaboration with members of other professions and to share their own knowledge generously with others (Chappell, Regnier, & Travlos, 2017).

Faculty

We advise faculty within the health professions to seek out faculty development opportunities in team-based education. Teaching in an interprofessional environment often requires faculty to gain new skills including managing learners from different backgrounds, creating a safe learning environment, and understanding the context of the practice environment (Davis, Clevenger, Posnock, Robertson, & Ander, 2015; Silver & Leslie, 2009). Faculty engaged in and supportive of IPCE rapidly understand and appreciate the value of team-based education.

CE and CPD providers/organizations

We encourage CE/CPD providers to develop strategic education plans that include IPCE. CE/CPD providers can identify opportunities for team-based education by thoughtfully analyzing gaps to determine if they could best be addressed by team-based education, single profession education, or a combination of both, and determining how this education can support health care priorities at the institutional, community, national, or international level. IPCE programs can be a strategic resource, supporting quality-improvement and safety initiatives, and can be the stimulus for collaboration with public health departments and other stakeholders. Involving patients and caregivers in IPCE as planners, faculty and learners, can motivate powerful and lasting change.

The impact of IPCE programs will be expanded if CE/CPD providers seek out opportunities to collaborate with other organizations to develop team-based education, and explore opportunities to partner with health care organizations to evaluate the outcomes of participation in team-based education. CE/CPD providers should also share best practices, stories, and outcomes related to team-based education.

Professional membership associations and specialty societies

We encourage professional membership associations and specialty societies across the health professions to recognize and support team-based education, and to collaborate to address issues that impact the delivery of patient care. These organizations can implement strategies such as including team education as a member benefit, publishing resources for members, and collaborating with colleague organizations across the health professions to offer IPCE activities.

Employers of health care professionals

We encourage employers of health care professionals to invest in and support team-based education for their employees. Employers can choose to make team-based education a mandatory component of annual CPD. Employers also have opportunity to create an environment that is conducive to collaborative learning and practice, a critical component for success (McMahon, 2017).

Accrediting and certifying organizations

Collaboration among health care profession accreditors facilitates IPE, IPCE, and IPCP through the alignment of requirements and processes for CE providers and learners. Strategies may include team-based education as a component of accreditation criteria, as the accreditors for academic degree programs and residency programs have done in the United States and in other areas globally; collaborating as accreditors across the care continuum; and developing criteria for commendation or “stretch goals” that reward organizations for developing team-based education.

Organizations that certify individual health care professionals are encouraged to consider developing interprofessional certifications as a method to recognize team-based practice, including team-based education in maintenance of certification and licensure requirements, and recognizing IPCE credit towards requirements for recertification or revalidation. Organizations that accredit healthcare institutions, such as the Joint Commission, can require that institutions create and sustain IPCE programs as part of their institutional strategy.

Regulatory bodies

We recommend that regulatory bodies incorporate accredited team-based education into their CPD requirements. We believe that the evidence-base supporting the relationship between IPE/IPCE and improvements in practice and patient outcomes is strong enough to justify including it in regulatory requirements (Reeves et al., 2016). Regulatory bodies can also elevate the visibility and value of IPCE by recognizing IPCE credit towards requirements for licensure as appropriate.

Next steps

As we evolve in our own interprofessional collaborative journey, we continue to support the interprofessional field in a variety of ways. We are developing tools and resources for organizations to develop team-based education, and we support other organizations in doing the same. We participate in venues to share our experiences in supporting team-based education such as the Global Forum on Value-Based Continuing Education at the National Academies of the Sciences, the National Center for Interprofessional Practice and Education, the Alliance for Continuing Education in the Health Professions, and the Conjoint Committee on Continuing Education (National Academies of Sciences, Engineering and Medicine, 2017). We have convened leadership summits for our jointly accredited organizations to share their stories, best practices, and outcomes. We have also published two publically available reports that highlight the outcomes from those summits (Joint Accreditation for Interprofessional Continuing Education, 2016; 2017).

Concluding comments

Most of the emphasis in IPE has been on the undergraduate or graduate levels, accounting for about eight years in the life of the health care professional. During the decades they spend in practice, health care professionals rely on CPD to improve their practice and patient care. To effectively integrate IPCP throughout healthcare systems across the world, we need to make IPCE an integral part of CPD for all health professions. Each healthcare stakeholder has an important role to play in this evolution. Through working and learning together, we will generate new models for team-based education and care delivery. By applying the tenets of IPCP beyond individual healthcare teams to collaborations among systems, regulatory bodies, accreditors, and institutions, we can create sustainable frameworks for transforming all health care into collaborative care.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.