EVIDENCED-BASED RECOMMENDATIONS FOR IMPROVING COLLABORATIVE PRACTICE FOR VETERANS
Creators: name: Sha'Rhonda R. Donald
Publisher: name: Zenodo
Year: 2018

description: The Veterans Healthcare Administration spends 67% of their budget caring for those with chronic illnesses. Addressing the health needs of veterans with multiple chronic conditions requires an interdisciplinary collaborative approach. Collaboration is a process of interactions between healthcare providers that is constant, frequent, and productive. Collaboration requires that all individuals actively engage in processes that facilitate team-based behaviors to meet patient care goals. The purpose of this DNP project was to develop evidence-based recommendations that improve the collaborative practices among healthcare providers caring for veterans. Two hundred sixty-seven palliative care providers from 50 states and 7 countries participated in an online survey and provided qualitative responses to one of two questions: (1) Please describe any thoughts you may have about interdisciplinary teams (IDTs), collaboration, and quality of care? After collecting 86 responses, the open-ended question was modified to read: (2) Can you describe a time when IDT collaboration or communication made a difference in the quality of care for your patients? Modification of the question resulted in 181 responses from participants. Responses were coded and categorized to identify themes about communication and collaboration. Three themes arose from the analysis: collaboration, communication, and IDT. These themes provided insight into the concept of collaboration and its importance in patient care. The iv qualitative themes informed the development of recommendations based on a review of the literature and the TeamSTEPPS conceptual model. Respondents provided exemplars of collaboration and communication processes, their influence on patient and family outcomes. Participants depicted collaboration as a shared interaction among team members that “requires trust, respect, and frequent communication.” Respondents described communication as being “vital,” “important” and “key” that involves frequent and consistent sharing of information to meet patient and family needs. Lastly, IDTs were described as being “essential,” “effective,” and “crucial,” involving various healthcare providers from different disciplines to optimize outcomes. Each of these key elements contributed to the understanding of collaboration and supported the significance of a team-based approach in enhancing patient and family care experiences. Providers characterized collaboration as working together, contributing their knowledge and expertise to meet patient and family care goals. Further research on collaboration can assist in identifying key facilitators and barriers of collaboration to standardize processes used in clinical settings. Standardization can mitigate fragmentation in communication and collaboration resulting in improved patient outcomes. Collaboration should be the standard approach in care delivery. Ultimately, collaboration will lead to a clinical culture of cohesiveness and shared decision-making that should be encouraged and promoted by healthcare leaders.