1. Interprofessional Collaboration
A Social Work Ethic
Shelley Cohen Konrad PhD, LCSW
University of New England
Center for Excellence in Interprofessional
Education
Associate Professor, School of Social Work
October 18, 2013
Waterville, ME

2. Case Discussion
Patricia (Pat) Chalmers is a 31-year-old woman from
Biddeford who prides herself on self-sufficiency and
resourcefulness. She works part-time as a bookkeeper
and gets paid to take care of her aging grandmother with
whom she lives. Pat describes herself as having been a caretaker since
adolescence. It is therefore difficult for her to acknowledge her own needs
or to seek others for help.
Pat is tired of people commenting on her weight, diet, and need to exercise.
She avoids health care as much as possible because she knows she’ll be told
to lose weight or be blamed for “being fat” (her words). “I know what risks I
face” she says. “But I’ve tried everything and nothing works. I’ve accepted
my size and would like doctors to respect that. So far they’ve done nothing
but make me feel bad about myself.”
Pat found herself in the ED with a broken ankle several months ago. The
break was significant enough to require surgery. Labs revealed elevated
glucose levels and surgery was put off until further tests could be done to
determine whether Pat might have diabetes. When a nurse asked Pat about
this possibility, she reacted strongly. “I don’t have the time or money for
diabetes,” she explained. “I just need my ankle fixed so I can get back to work
and take care of Mémé.”

3. Interprofessional Practice Definition
• “occasions when two or more professions
learn with, from and about each other to
improve collaboration and the quality of care”
(CAIPE, 1997).

4. “… interdisciplinary collaboration is the
achievement of goals that cannot be reached when
individual professions act on their own.”
(Bronstein, 1996)

5. Interprofessional Practice is not
•
•
•
•
•
•
Sharing electronic health records
Sole profession teams (neurologist, pulmonologist, radiologist)
Students hearing a talk about another profession
Reporting out at interdisciplinary team meetings
Co-location without intentional collaboration
A physician-only led team

6. WHY IPC IS IMPORTANT
To advance the aim
of improving
health of the
population, enhan
cing patient care
and controlling
costs
To close the gap
between health
education and
practice settings by
aligning their
needs and
interests

7. The Triple Aim
The Institute of Health Care Improvement developed
the triple aim framework to optimize and measure
health systems performance.

8. IPC Guiding Principles
http://www.aacn.nche.edu/education-resources/IPECReport.pdf

9. Institute of Medicine (IOM) 1999
44,000 – 99,000
DEATHS every year
in the U.S. from
preventable adverse
events – medical
errors

10. Crossing the Quality Chasm (2001)
“One approach is to redesign the way health
professionals are trained and to emphasize the six aims
for improvement, which will mean placing more stress
on teaching evidence-based practice and providing
more opportunities for interdisciplinary training.”

11. World Health Organization (2010)
“Once students understand how to work
interprofessionally, they are ready to enter the
workplace as a member of the collaborative
practice team.”
•
•

12. Donald Berwick, former IHI President &
Chief Executive Officer

13. 2.01 Respect
(a) Social workers should treat
colleagues with respect and should
represent accurately and fairly the
qualifications, views, and obligations
of colleagues.
2.03 Interdisciplinary Collaboration
a)Professional and ethical obligations
of the interdisciplinary team as a
whole and of its individual members
should be clearly established.
2.03 Interdisciplinary Collaboration
a) As members of an interdisciplinary
team social workers should contribute
to decisions that affect the well-being
of clients.

14. International Federation of Social Work - 2013
Strategies for intervention, desired end states
and policy frameworks are based on
holistic, biopsychosocial, spiritual assessments
and interventions that transcend the micromacro divide, incorporating multiple systems
levels and inter-sectorial and interprofessional
collaboration.

15. Roles & Responsibilities
• Communicate one’s roles and responsibilities
• Engage diverse healthcare professionals to meet the needs of
patients, families and populations.
• Social workers understand the roles of other disciplines and
accurately and fairly represent the qualifications and
obligations of colleagues.
Resource
Access
Outreach
Emotional
Advocacy

16. Values & Ethics
• Place the interests of patients and populations at the
center of health care.
• Respect unique cultural values and perspectives of
individuals, populations, and health professionals.
• Social workers examine a variety of approaches to
achieve desired outcomes.

17. Communication
• Use respectful and appropriate communication in all situations.
• Listen actively and encourage ideas and opinions of all team
members.
• Social workers strive for cultural competence in
interdisciplinary communication, just as in communication with
clients.
• Social workers understand that relationships are important to
the change process. They engage people as partners in care.

18. Collaborative Leadership
• Strong leaders value contributions of all health team members
and also those of the patient, family, and community.
• Leaders facilitate contributions from all team members and
build support for working together.
• Social work leaders work creatively and effectively to catalyze
social change and address human problems.

19. Teams & Teamwork
• Work with others to deliver patient-centered, communityresponsive care.
• Integrate knowledge and experience of other professions to
inform effective clinical, ethical, and systems-based decisions.
• Social Workers identify professional strengths that enhance the
interdisciplinary team process and contribute to positive client
outcomes.

20. Patient-Centeredness
•
•
•
•
•
Respect for complementary expertise
Value for patients as a vital members of the team
Trust in each other & in the team
Connection & Compassion
Social workers respect and promote the right of
clients to self- determination

21. Social Work as a Health Profession
Public Health Act, 1992
• Titles VII and VIII of the Public Health Services Act (PHA) expanded the
geographic, racial and ethnic distribution of the health care workforce.
• Increased number of providers working in the public health sector and improving
diversity of the public health work force.
• Increased the number of underrepresented minorities in the health care field.
• Minority providers are more likely to treat minority patients and provide health
care to poor, uninsured and publicly insured patients, improving access to care.
• 2001 review of PHA found that training workforce in “interdisciplinary” and
“community-based” concepts was effective and ensured national best practice
sustainability in underserved geographic regions or in service to vulnerable
populations.

22. U.S. Department of Education 1995
“… a new way of preparing all professionals
needs to be built. This will require changes
throughout the campus culture and new
relationships between professional preparation
programs, communities, and clients.”
Allen-Meares, P. (1998). The interdisciplinary movement. J SW in Education, 34(1), 2-5.

23. The Interdisciplinary Movement
“Education on all levels needs to forge institutional ties
with health care providers and incorporate into
curriculum interactions with students from fields such
as medicine, nursing, education, law, economics, and
political science.”
Allen-Meares, P. (1998). The interdisciplinary movement. J SW in Education, 34(1), 2-5.

24. Collaboration
Social Work Model
“Trends in social problems and professional practice
make it virtually impossible to serve clients effectively
without collaborating with professionals from various
disciplines.”
Bronstein, L. R. (2003). A Model for Interdisciplinary Collaboration, Social Work, 48(3), 297-306.

25. Natural Collaborations
Social
Work &
Public
Health
Schoolbased
Practice
Practice
with
Children
&
Families/
Child
Welfare
Social
Work &
Health
Care
Social
work
&
Criminal
Justice
Social
Work &
Social
Service

26. Collaboration takes place when “autonomous, interdependent
stakeholders with their respective competency domains”
organize around common goals for the greater good.
Building Trust
Naming
Power
Inequities
Resolving
Conflict
Individual
Family
Population
Community
Strategies for
cooperation
Managing
Diversity

27. Meet Pat
Patricia (Pat) Chalmers is a 31-year-old
woman who prides herself on selfsufficiency, resourcefulness, and a no
nonsense approach to life…

28. Ethical Dilemma
Pat’s post-surgical team consists of a physical therapist, occupational
therapist, nurse practitioner (who provides nutritional counseling) and a
clinical social worker by way of home visits. A pharmacist offers
medication management and consultation to Pat and the health care
team. Pat’s treatment and medications are paid for by MaineCare. She’s
collecting disability until she returns to work.
While visiting with Pat she shares that she is not complying with her
medication protocol or diet plan. She has not told this to her other
providers and asks you to keep it confidential. “The others are not as
understanding as you are,” she says. “I tell them what they want to hear
so they’ll leave me alone.”
At the monthly phone huddle, the pharmacist voices concern that, with
the exception of her pain medications, Pat does not seem to be refilling
her prescriptions. In regard to the pain meds, the pharmacist also
discloses that Pat has asked the pharmacy twice for an early pain med
refill.
The nurse practitioner states concern that Pat is gaining rather than
losing weight despite insistence that she’s staying on her diet plan. “I
don’t think she’s really committed to her treatment” he says. “She’s
playing Russian roulette with her health.”

29. Ethical Challenge
(b) Social workers for whom a team decision raises
ethical concerns should attempt to resolve the
disagreement through appropriate channels. If the
disagreement cannot be resolved, social workers
should pursue other avenues to address their concerns
consistent with client well- being.
?

30. Collaboration:
A Social Work Method
Collaboration
proposes joint
sharing and
decision-making in
the interest of
change, as well as
changes in
relationships to
facilitate these ends.
Collaboration
assumes the
inevitability of
conflicting ideas;
differentials in
power; and
necessity of
compromise and
continued
advocacy.
Graham, J. R., Barter, K. (1999). Collaboration: A social work practice method. FIS, 80(1), 6-13.

31. National Association of Social WorkersWinter 2013
Making Interdisciplinary Collaboration Work
Interdisciplinary Collaboration can be one of the most rewarding, yet
challenging, aspects of social work practice. It’s also increasingly
essential, regardless of practice setting or client population. [NASW Tools &
Techniques]
Identify and
Understand the
Acknowledge
Be proactive in
seek common
Address conflict
roles and
the differences
establishing and
ground with
and don’t let
Articulate your
responsibilities
among social
maintaining
resentment
role in the team
your
of other team
work and other
collegial
interdisciplinary
accumulate
members
disciplines
relationships
colleagues
http://www.socialworkers.org/assets/secured/documents/practice/interdisciplinarycollaboration.pdf

32. 3 Things
Write down 3 reasons why social workers are
natural collaborative leaders and
interprofessional champions. Offer examples to
your colleagues.

33. Take Away Points
• Interprofessional Collaborative Practice is
consistent with Social Work Ethical Practice
• Social Work has a robust history of leadership in
interprofessional/cross-disciplinary work
• Social Work Organizations must join the
conversation with other national health
leadership groups both as champions and
challengers
• Social workers play a critical role on the health
team; as behavioral health practitioners and
advocates and to raise awareness of health
disparities, social determinants, and social justice

34. Take Away Points
Social Work has a robust
history of leadership in
interprofessional/crossdisciplinary work.
Interprofessional
Collaborative Practice is
consistent with Social Work
Ethical Practice.
Social Work Organizations
must join the conversation
with other national health
leadership groups as
champions and challengers.
Social workers play a critical
role on the health team as
behavioral health experts.
Social workers play a critical
role on the team as
advocates raising awareness
of health disparities, social
determinants, and social
injustice.

35. Shelley Cohen Konrad PhD, LCSW
University of New England
716 Stevens Avenue
Portland, ME 04103
scohenkonrad@une.edu
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