Interprofessional Collaboration

Interprofessional Collaboration

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Collaboration Tip

Interprofessional Collaboration: Using Stakeholder Mapping to Build Commitment to Quality Improvement

By Marsha Hughes-Rease, MSOD, MSN, RN
NKC Consultant and Educator

Interprofessional collaboration is becoming increasingly important in a value-based purchase system. No one Health care provider can ensure that the patient receives the highest quality of care without collaborating with other providers. The Canadian Interprofessional Health Collaborative (CIHC) defines interprofessional collaboration as "the process of developing and maintaining effective interprofessional working relationships with learners, practitioners, patients/clients/families, and communities to support optimal health outcomes." According to CIHC, "Elements of collaboration include respect, trust, shared decision making, and partnerships."

Magnet®-designated hospitals are expected to employ clinical nurses who assume leadership roles in collaborative activities to improve the quality of care as reflected in Source of Evidence EP12 in the 2014 Magnet® Application Manual. A robust governance structure for decision making at the unit level provides an excellent forum to fulfill this requirement. When initiating a quality project at the unit level, it’s common for many key interprofessional stakeholders to be overlooked. (A stakeholder is a person or group that is involved in or affected by a course of action.) The later they are brought into the change process, the more likely there will be resistance to the change.

One way to facilitate interprofessional collaboration and accelerate the change process is to identify your stakeholders at the very beginning and develop action steps to ensure their commitment to achieving the goal. Here are some tips and a tool to help you map stakeholder commitment and develop action strategies to ensure collaboration.

Tips for Stakeholder Commitment Mapping

  1. Brainstorm which stakeholders should be included as part of the change initiative or could be impacted by the change initiative.
  2. Looking at Figure 1, place each individual or group in the stakeholder column.
  3. Identify the current commitment of the individual or group to the change initiative using Figure 1 (For an explanation of the meanings of the letters or words at the top of each column, see Figure 2.) In this example, the current commitment of the physician group to interprofessional rounding is perceived to be zero since the majority of them may not even know about the initiative. Looking at the direction of the arrow, the desired commitment is to make them part of the group for making the change happen.
  4. Draw an arrow from the column representing the current commitment of the stakeholder to the desired commitment needed for each individual or group.
  5. Develop action strategies to move the individual or group from its current level of commitment to your desired level of commitment. If you know that you already have some members of a group who support the change initiative, enlist their help in developing strategies to target their colleagues.
  6. Determine the critical mass of individuals or groups that you believe is needed to align with the change agenda to ensure success.

You are probably looking at this mapping process and thinking, "This will take too long!" However, I would encourage you to think about how long it may take to reach your goal if you fail to get all the key players on board. Sometimes you have to go slow in order to go fast. In other words, it is to your advantage to take the time to engage stakeholders, tackle the tough issues early on, and then speed through implementation.

My consulting colleagues and I recognize how important the unit governance structures and processes can be to ensuring improved quality outcomes. This is just one tool we can introduce to help your units and departments accelerate change in your hospital and ambulatory care settings.

This article was originally published in June 2015.

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