COMMUNICATION SKILLS AND INTERPROFESSIONAL COLLABORATION.pptx

COMMUNICATION SKILLS FOR PHARMACIST (COMMUNICATION SKILLS AND INTERPROFESSIONAL COLLABORATION) -

1. ENG304 (Communication skills for Pharmacists) COMMUNICATION SKILLS AND INTERPROFESSIONAL COLLABORATION Kristel A. Honrado, RPh

2. O verview This chapter focuses on enhancing collaborative relationships between pharmacists and other health care providers in order to ensure better patient outcomes. Kristel A. Honrado, RPh

3. Pharmacist Roles in Collaborative Medication Therapy Management -The traditional process of prescribing a drug, dispensing a drug, administering a drug, monitoring a drug regimen, and adjusting drug therapy can be very disjointed—a process that is well documented for its ability to produce avoidable drug-related problems. - Documentation has shown that these problems contribute to poor health outcomes and significant increases in the cost of health care (Webb, 1995). Kristel A. Honrado, RPh

4. Continued.... Recent documentation illustrates that it behooves pharmacists and other providers to engage in developing collaborative arrangements knowing that: • Pharmacists working in collaboration with physicians through a redesigned approach to medication use can prevent errors and reduce drug costs ( Isetts et al, 2003). • When faced with the reality that patient health issues are typically too complex for one health professional to handle, the need for interdisciplinary expertise becomes obvious (Fredrick, 2003). Patient adherence with medications significantly improves when pharmacists and physicians collaborate (Fredrick, 2003). • Confrontational relationships and procedural obstacles can be replaced with collaborative and trusting relationships when both physicians and pharmacists work on reducing feelings of discomfort about each other’s skills, roles, and authority (Fredrick, 2003). Kristel A. Honrado, RPh

5. Continued.... The collaborative approach to the delivery of pharmaceutical care has been championed by others as the one best solution to: • Develop the best outcomes for patients by reducing medication errors, increasing patient safety, and reducing health care costs associated with such errors, and • Improve a patient’s quality of life through well-established and successful initiatives (Mass. Fact Sheet, 2005). Kristel A. Honrado, RPh

6. Continued.... In summary, effective collaborations occurring between two people who represent the same or different disciplines are characterized by: • The coordination of individual actions, • Cooperation in planning and working together, • Sharing of goals, planning, and problem solving, and • Sharing of decision making and responsibility. Kristel A. Honrado, RPh

7. Barriers and Facilitators to Collaborative Partnerships Potential/ additional barriers to collaboration: • Lack of clear definitions for these collaborations so that effective communications among stakeholders can occur, • Lack of a supportive culture at the public, institutional, professional and agency levels so that broad support can be gleaned among colleagues, • Lack of a supportive regulatory and statutory system so that clear articulation of professional responsibilities can occur, • Lack of economic incentives to reward collaborating professionals whosee the benefits of collaboration to outstrip any investment in its costs, • Lack of educational programs that encourage health professionals to work collaboratively, • Lack of understanding by patients about the benefit of collaborative care, which leads to decreased demand for collaborative care, and • Lack of communication technology to allow partners to easily communicate with each other. Kristel A. Honrado, RPh

8. Potential facilitators to developinpg collaborative relationships Four key characteristics of effective collaboration: • Sharing: includes sharing of responsibilities, philosophies of health care, values, planning, interventions, and perspectives such as commitmen to patient-centered care. • Partnering: implies that two or more people will join together in a collegial, authentic, and productive relationship characterized by honest communication, mutual trust, and respect. In addition, partners value the work and perspectives of the other professionals in the partnerships, and each works toward common goals having specific outcomes. • Interdependency: refers to the fact that professionals are interdependent, rather than autonomous, as they work toward meeting patient needs. • Power: is seen as being shared among partners with empowerment accorded to all participants. Sharing of power is based on knowledge and experience rather than functions or titles (University of Toronto, 2004). Kristel A. Honrado, RPh

9. Potential facilitators to developinpg collaborative relationships cont … Recent experience has shown that patient care is improved when pharmacists and other providers engage in building collaborative partnerships using the following strategies: • Recognize they are creating opportunities for change as like-minded individuals come together to tackle an issue important to their common patients, • Mobilize resources to create change, • Develop a shared and common vision of what long-term change will be as they strive for better health outcomes that transcends personal interests, • Seek involvement of other diverse and nontraditional partners, • Choose an effective group structure to assist with open, honest, and trusting communication, and • Develop some type of feedback system so lessons learned can be shared with others. Kristel A. Honrado, RPh

10. Potential facilitators to developinpg collaborative relationships cont … Most collaborative partnerships eventually evolve into more formalized arrangements where parties: • Share a common understanding of the context of their collaboration • Identify the various collaboration partners • Develop mechanisms to govern themselves • Develop mechanisms to handle shared revenues and expenses • Advocate for any needed legislation or professional standards that would strengthen their partnership and also stimulate other partnerships • Develop guidelines for partner relationships • Clearly define their target community • Determine how varying professional cultural issues are handled • Establish criteria for when the collaboration may be dissolved in the future Kristel A. Honrado, RPh

11. Initial Steps to Developing Collaborative Arrangements The following sections focus on developing collaborative relationships with physicians. However, many of the same strategies can be used to develop partnerships with other health care providers, such as nurses, dieticians, physical therapists, physician assistants, social workers, and others. It would be redundant to apply all these strategies to every conceivable partner. Kristel A. Honrado, RPh

12. Building Trust: The Cornerstone to Successful Collaborative Arrangements The specific behaviors in those trusting relationships were that both parties: • Sought input from one another, • Allowed each other to do their jobs without unnecessary oversight, and • Openly discussed success and failure and learned from both ( Tallia et al, 2003). Kristel A. Honrado, RPh

13. Using Communication Skills to Enhance Collaborative Relationships The success of our collaborations with physicians depends more on “soft elements,” such as confidence, trust, and effective interpersonal communication, than it does on “hard elements,” such as computers, Internet access, and other information sharing technologies. The ability to develop any type of a collaborative relationship requires effective communication skills since pharmacists and physicians come from two diverse professional cultures. Kristel A. Honrado, RPh

14. Six Critical Behaviors Within Collaborative Partnerships Relationships have long-term and short-term agendas Relationships are nonhierarchical and based on equality Considering patient perspectives Trust and shared visions are central to these relationships Relationships should demonstrate respect for the culture of each professional Collaborative relationships should be voluntary Kristel A. Honrado, RPh

15. Strategies to build collaborative relationships • Develop joint statements that support patient rights to be involved in making informed decisions affecting drug therapy and that articulate the value that patient trust, safety, and relationships with caregivers always come first. • Host jointly sponsored professional meetings, especially at the local level, to help develop widespread understanding and awareness of physician and pharmacist responsibilities in drug therapy and why collaborative approaches to drug therapy benefit all. • Build effective communication, administrative, and documentation systems that allow pharmacists to share relevant patient information in accordance with applicable ethical standards, accepted medical and pharmacy practices, and state/federal statutes and regulations to provide continuity of care for patients. • Stimulate the development of technology to enhance communication within collaborative practices (e.g., shared patient databases relevant to drug therapy). • Volunteer to work jointly on committees and projects that enhance patient education and adherence, investigate drug therapy issues, and promote better practice guidelines. • Start with a project that has a limited scope, such as monitoring patients on warfarin or patients with diabetes. Expand services after documenting impact. Kristel A. Honrado, RPh