Interprofessional Collaboration in Health Care

Interprofessional Collaboration in Health Care Interprofessional Collaboration in Health and Social Care is changing the face of service delivery based on governments attraction to this concept. This essay is an attempt to identify and evaluate weaknesses that affect interprofessional working, using a practice based critical incident (see Appendix A). In order to achieve this, a model of critical reflection, a combination of systematic analytical tools (SWOT, PESTEL) and use of relevant theories are adopted to unearth various assumptions and their sources with a view of engaging the application of theory to practice which will consequently improve provision of services to end users in practice with the added benefit of improving interprofessional working. The various influencing factors identified from the analysis that conflate in the arena of interprofessionalism makes it a very complex, yet desirable concept to embrace and implement for the effective delivery of service within health and social care. The case for a Model of Critical reflection Reflection has been defined as a process of reviewing an experience of practice in order to describe, analyse, evaluate and so inform learning about practice Reid (1993). Researching various models of critical reflection (Gibbs reflective cycle (1988), Stephensons framework of reflection (1993), Fook and Askeland (2006) indicated a number of variables which are relevant in the evaluation and reflection on practice situation. For the purpose of this particular case study, I have chosen to reflect on the critical incident described in Appendix A by using Fooks model of critical reflection. This model; Focuses on identifying underlying assumptions with a specific purpose of fostering improvement in professional practice Fook and Askeland (2006,p), Highlights power as a critical element of transforming the revealed assumptions with a view to create a positive change in the practice situation. The concept of power in critical reflection is relevant in the social, cultural, professional and political context with the aim of gaining a sense of personal power therefore more control and choice, through the exposure of dominant assumptions in operation. Fook (2006), Foucault (1983) cited in White et al (2006, p44). Fooks model enables reflection on awareness and use of power in the course of performing my professional role. Fook also emphasises the place of emotion, communication, dialogue and learning in this model of critical reflection. This is particularly relevant to the practice situation as it led to competence queries in the light of the ensuing reverberation. This model of critical reflection is a valuable tool, enabling better decision-making, improved ability to work with uncertainty and multiple perspectives, resolve dilemmas, recognising the use and power of emotion, and better ability to learn from practice. Fook and Askeland (2006) My choice of Fooks critical reflection model helps me to take a look at what I do, why I do it, unearthing relevant hidden assumptions influenced by my cultural, social, professional and political beliefs (see PESTEL analysis in Appendix C). It also enables me to reframe myself in view of the revealed assumptions behind my thinking that affects my practice. This model seeks to empower by giving choices and creating new knowledge when the process of reflection is practised. It could also potentially reaffirm personal beliefs that may have been previously separated from professional roles which inadvertently create conflict. Interprofessional Concept Interprofessional concepts that are apparently relevant to the practice situation are collaboration and communication. The key weaknesses identified were due to lack of communication and failings in collaboration between the pharmacy, social services professions and general practitioner (GP) engaged in the care of the older people in the community. In order to analyse the practice situation, two analytical tools are adopted namely SWOT analysis considers the strengths and weaknesses in the case and also the opportunity and threats embedded in it. (Appendix B). PESTEL analysis This tool relates the situation to its external environmental factors with a view to identifying influences and impacts of the environment.( Appendix C) The two major areas of weakness focused on are: The gaps in collaboration between pharmacist, social workers and GPs in the community. Poor communication between Health and Social Care (HSC) professionals in the community. Literature Review The concept of interprofessional collaboration has been defined as working together with one or more members of the health care team where each makes a unique contribution to achieving a common goal. Each individual contributes from within the limits of his/her scope of practice. Broers et al (2009), College of Nurses Ontario (2008), Makowsky et al (2009). The Health and Social care policy on joined up working Department of Health (DoH 2000) has been regarded as a major document pointing the way to or representing one of the imperatives for the modernisation agenda. Health and Social Care policies has witnessed several changes in the last twenty five years with a shift in focus from institutional to community care with an attendant upsurge in service commissioning, which created an increasing role for primary care. Karban Smith (2006). The need for greater collaboration and communication has been highlighted by the recent increase in major enquiries into several aspects of health and social care (Victoria Climbie inquiry report by Laming (2003), Baby Ps case). Loxley (1995) asserted that the recognition of health and welfare within society as an interactive, adaptive process without an end becomes the only creative basis for strategies, policies and practices and as such, the ability to collaborate is thus an essential in this interactive process. The National Service Framework for Older people DoH (2001) clearly demands that the NHS and local authorities work in partnership to promote health ageing and prevent disease in older people. DoH (2001). Various government policies has emphasised partnership and joint working as the main focus to drive improved care to users of health and social care services. DoH (1998a) Partnership in Action (1998b); Working Together (1998c); First class service; quality in the new NHS) Leathards(2003) review on McGraths (1991) study on interprofessional teamwork in Wales found that joint working led to more efficient use of staff, efficient service provision and a more satisfying work environment. Other benefits include the value of knowledge sharing, potential for comprehensively integrated services, efficient use of public funds and the avoidance of duplication and gaps in services. The New NHS-modern and dependable: DoH (1998). The governments objective is to build a reliable health service where patients have access to high quality services based on identified need, building on integrated care between health and social care where each have equally important roles to play. The White paper (1998) sets out the framework for the partnership, with the intention to remove barriers to effective collaboration in the existing systems and provide new incentives for joint working across agencies. The role of Pharmacists in interprofessional collaboration. The pharmacy professions code of ethics is traditionally based on the medical model of health, where duty of care is to the patient and mainly prescriptive and paternalistic. Naidoo and Wills (2009). There are no strong evidences to support joint working between community pharmacy and other health and social professions despite a strong need for collaboration for the delivery of excellent patient care across the primary and secondary interface. Makowsky et al (2009) review indicates that collaborative working relationships between nurses and physicians have been the focus of several researches, but relatively little work has investigated the integration and nature of collaborative relationships pharmacists have with other health care practitioners. The review stated that most investigations into professional relationship between pharmacy and other healthcare profession has been on physicians satisfaction attitudes or perceptions towards specific aspects of pharmacy practice, pharmaci st roles, perceived barriers between physicians and community pharmacists, unmet needs in the medication use process, physician expectations of pharmacist and physicians receptiveness to clinical pharmacists. Competencies of the Future Pharmacy workforce a publication by the Royal Pharmaceutical Society of Great Britain (2003/2004) highlights the need for greater levels of collaboration between pharmacists across all sectors and boundaries as the way forward for relevance within the healthcare workforce. The Pharmacy White paper (year) also emphasised the role of pharmacists in providing services in the present NHS structure and this would necessitate a greater awareness and participatory collaboration with other healthcare professionals. Barriers to Interprofessional Collaboration In spite of the laudable and apparently desirable benefits of interprofessional collaboration, in reality there are barriers that limit effectiveness of this concept between health and social care professionals as apparent in my practice situation. Historically, barriers such as professional cultures, different forms of accountabilities between health and social services, political agendas, rigid boundaries, departmental survival existed and still remain to challenge present day twenty-first century health and social care. Hardy et al (1992) cited in Leathard (2003) identified five categories of the challenges facing joint working within health and social care as; Structural issues such as service fragmentation, gaps in services. Procedural matters which hinders joint planning through different budgetary planning cycles and procedures. Financial factors such as different funding mechanisms, administrative and communication costs Status and legitimacy, for example local responsibilities are based within a democratically elected arena and in contrast, all services are commissioned and centrally run by the NHS. Professional issues which include problems associated with conflicting views and ideologies about users, professional self-interest, competition for domains, as well as differences between expertise, specialism and skills. Leathard (2003) noted more barriers such as practitioners isolated with little management support, inequalities in status and salary, differing leadership styles, lack of clarity about roles as damaging to inter professional collaboration. It has been noted that service users and carers as typified by the examples in the practice situation (see appendix A) often experience frustration and distress in trying to organise the type of care they want or support needed as a carer. This process, involving contact with different agencies and each with different assessment processes, often leave users and carers unclear as to who should be doing what and how it all links together. DoH (1998a) Joint working has been identified by the DoH (1998) as needed at three levels; strategic planning, service commissioning and service provision. In the practice of pharmacy in the care of the community, service provision must deliver an integrated package that avoids the burden of complex bureaucracy. Barriers to Joint Working: Communication Another weakness identified in the SWOT analysis, (see Appendix C) is poor communication. Information sharing in the appropriate context is important in helping to promote informed decision making and aid the provision of user-focused care. On the other hand, incorrect information can destroy or reinforce negative or destructive stereotypes and therefore limit the range of options offered to the user. Hammick et al (2009). Poor communication can be a barrier to effective information sharing in professional practice. The lack of clarity in the process of communication experience in my context can also be down lack of awareness of how the agencies work together. Meads et al (2005) states that poor systems and lack of parity between different professionals can be major risk factors, particularly with regards to effective communication. In the inquiries into the events that led to Victoria Climbies death in 2000 and the Bristol Royal Infirmary incident, systemic failures that led to poor communications were highlighted. The issue of communication was further complicated by the fact that I had no prior knowledge of any disability suffered by the patient that would necessitate any form of assessment set out by the Disability Discrimination Act (2004), I assumed that the clients GP would be aware of the process of referral for patients needing support with their medicines as they are usually their first point of call. Carers expectation was that all service providers talked to each other in a way that gets things done smoothly. Reflecting on what I have learnt on interprofessional collaboration, the situation became clearer as I realised that different organisations have different operating procedures which, despite attempts at collaboration, can still be conflicting. External influences on the practice situation such as legal factors (see Appendix C) include issues such as patient confidentiality and data protection requirements which make it imperative that proper channels of communication are followed to protect clients privacy. This raises ethical and legal questions on how much is too much or too little to exchange with other agencies. I have learnt that the failings in the practice situation described is not a clear cut failing by a single person, but a classic example of how the barriers to interprofessional working can have a direct impact on both the service user and provider. Systems Approach to Joint Working: A resolve A systemic approach to collaboration as stated by Payne(1997) in Hammick et al(2009) is relevant to interprofessional practice as it sees individuals as social beings, affected by and influencing others around them, the organisations with which they have contact and the wider society, drawing attention to relationships, structure, processes and interdependence. The whole systems concept developed by Bertanlanffy (1971) describes the exchange across permeable boundaries between systems and environments. This characteristic of the systems theory is crucial in its application to service organisations, like the NHS and social service. The key elements from the systems theory as concurred to by Loxley(1997) and Willumsen (2008)relevant to understanding collaboration in interprofessional practice is interdependence and interaction, emphasis on management of processes, the recognition of equifinality the achievement of the same goal from different starting points. Loxley (1997) asserts that it is possible to manage complexity and differences through the recognition and use of common properties which apply to both parts and to a whole when experiences are shared. For the whole systems approach to work, the right conditions as advocated by Maddock and Morgan (1999) in Leathard (2003) include; Support for communication between users and frontline staff Involvement of actively committed staff Appropriate performance measures supporting change and staff development Management and practitioners sharing the same agenda on quality and funding issues A senior management team with a unity of vision. The benefits of the whole systems approach as shown by the study on delivery of services to older people across health and social care in Brighton and Hove, Sussex Callanan (2001) include; initiatives to identify gaps in services, an improvement in the services provided in the multidisciplinary assessment and review, improved flexibility to meet users needs and the enabling of small changes which would result in significant improvements in service provision. The whole systems approach with the theorised benefits is not without its limitations. CSIP(Care Service Improvement Partnership) Older People Team cited in the whole systems approach , a document paper by the NHS Wales(2006) concluded that for most places, a whole systems approach is a statement of aspiration rather than a statement of achievement as there are limitations inherent in the approach. Conclusion The way forward may be more opportunities for joint learning among health and social care professionals in practice. Integrating joint learning in the whole systems approach to effective collaboration might in some way resolve some of the perceived barriers. Learning together reflectively will challenge traditional barriers, professional barriers and compartmentalised thinking. Karban and Smith (2006). They argued that a model of critical and reflective practice acquired through learning together will enable future practitioners develop a shared understanding of the world and ways of working together based on creating a shared dialogue within communities of practice that will enhance the experience of service users. Forming multidisciplinary teams in the care of the community for specific target population may also be effective in closing the gap in collaboration between pharmacy and other health and social care profession. In order to avoid the reoccurrence of the incident discussed in my practice situation, I will seek to implement the following Raise awareness/understanding of referral process among professionals engaged in the management of older people with disability by writing a letter to all agencies concerned. Organise seminars at local GP meetings with other healthcare professionals involved in the care of older people with the view of clarifying the referral procedures for effective provision of service

Political Dispute in the Early 19th Century

During the 1800's, Americans in the North and South often had conflict but could no longer resolve their political disputes through compromise by the year 1860. In this time period, compromise was not an option because slavery and states rights' caused political disputes between the north and south. The two political parties in the north and south lost their ability to cooperate and by the mid 1800's increased the issue of the division of the states.The North and South in the nineteenth century were different in lifestyle and morale as well as economy. The north had a booming industrial economy while in the South, cotton was the major economic leader. Because of this congress was continuously addressing controversial matters and providing answers that did not satisfy either one side or both. The early 1800s were full of the North and the South making many attempts at reconciliation that just fell short. Among those were the Missouri Compromise of 1820 and the Great Compromise of 1850 .Other attempts led to the Tariff/Nullification Controversy, anti slavery debates in congress, and the Kansas-Nebraska Act. Whether it was one side or the other there was always someone to oppose or defy the other side. Laws put in place eventually led to the succession of the southern states and the Civil War.The issue of slavery became an even greater concern when the Louisiana Purchase territories were to enter the Union as states. The question was, would new territories enter the Union as slave or free states? The South wanted a balance of power. They knew that if the North were to have more free states, then slavery in the south could be facing extinction through congress.In an attempt to conciliate with the South, the North agreed upon the Missouri Compromise of 1820. Through this slavery was banned above the 36 degrees 30 minute line and Missouri entered as a slave state and Maine a free state. For a while, it retained the balance of power. However, tempers in the south rose again later in the 1820s over high tariffs. The tariffs benefited the north but threatened southern cotton exports. In 1828 the tariff was around 50%. President Jackson modified it to around 33% in 1832 only to have South Carolina nullify it in the state. It raised the question  of whether or not the federal government could legally impose protective tariffs and whether it was constitutional for a state to nullify a federal lawThe political view on slavery and states rights grew as compromise between the north and south political parties began to collapse during the mid 19th century. Henry Clay stated that it is impossible for South Carolina to become an independent state. A report of the American Anti-Slavery Society was opposed to slavery naming slave owners as â€Å"man stealers† and believed that slaves should be free. Political compromise was not greatly effected by their belief but the Compromise of 1850 resulted in the Fugitive Slave Law being passed which caused the collapse in the political parties.The issue of slavery continued to increase as compromise slowly disintegrated. Abolitionism increased by the encouragement of Frederick Douglass, a leader, who promoted freedom for all slaves. Also, â€Å"Uncle Toms Cabin† published by Harriet Beecher started up abolitionism in the North while the South to oppose against abolitionists. Senator Daniel Webster who is opposed to secession stated that the North is not complied with the Fugitive Slave Law. In addition, a New York Tribune comparing working class men in the north to southern gentlemen caused more conflict between the states over the issue of slavery. The division of the states over the issue of slavery enhanced the collapse of compromise between the North and South political parties.

Unbiased Report Exposes the Unanswered Questions on Personal Success Essay Samples

Unbiased Report Exposes the Unanswered Questions on Personal Success Essay Samples What Is So Fascinating About Personal Success Essay Samples? You can have a look at our Argumentative Essays when that is the sort of essay you're trying for. Essays, generally, covers different topics. Writing a profile essay offers you the freedom to handpick the topic of your preference. These seven sample essays respond to a range of thought-provoking questions. Bridget's essay is extremely strong, but there continue to be a couple little things that could be made better. Our private statement writers would love to present a set of private statement examples for your reference. Don't forget to begin your essay strongit should be able to spark the interests of your readers. The author starts with a rather in depth story of an event or description of an individual or place. Introducing Personal Success Essay Samples It's simple to point out an essay that's been written solely for the interest of it. The essay is broken up into three key components. An excellent essay is one which leaves a long-lasting impression. Unlike another sort of essays, personal essays are somewhat more flexible and versatile. You might be quite surprised to discover that success of a personal essay may greatly be based on the subject you select. The perfect way to learn how to begin a personal essay is to get a crystal clear picture of the primary features it should contain and its key requirements. Stephen's essay is quite effective. The secret to writing a good profile essay is to pick a personal profile essay example of an entertaining subject. Because that endeavor is intimidating, it's often hard to choose where to begin. Various things to various individuals, since the situation demanded. To be effective in life is something every individual wishes for. A prosperous person have above average performance, it is going to be shown in the six essential places. It will be simpler for the readers to comprehend the point too. 1 interesting view about success is it means something different to every individual. You should give a mental image of the individual or the place you're writing about. The total format of your essay, for example, font size and margins, will solely are based on the instructions offered to you. Folks respond to various treatments in their very own unique ways. Happiness is something which can extend to a whole population. It is not a luxury it is the essence of living when joy is missing in our lives life becomes meaningless. While a lot of people assume that happiness is important than success, while other felt hay an individual cannot be happy unless he's successful, I do believe that happiness play a major part in our life and I think that it's the secret to success. Family members and friends can help individuals that are addicted by recognizing a few of the behaviors drug users show. Education plays an essential part in shaping successful individuals. So, it is a necessary means of eradicating the unemployment problem. Success usually is connected with money and achieving material targets. Education is a significant medium of acquiring essential knowledge and techniques. Successful small business leaders do not trust the formal system won't be restricted to the control and command. Successful and productive leaders should have good communication with people and set a direction to that objective. Some definition of succeeding is all about personal achievement, like getting good grades, sports awards or within a work promotion. Happiness comes from personal accomplishment, it's not a feel-good luxury, but it's necessary for our well-being. For someone, success is a great career, promotion on the job. After defining success one ought to write what success means in various regions of life.

Different Styles Of Parenting Styles - 1708 Words

According to the New York Metro Parents, a website that combines nine regional print magazines in New York’s Metropolitan areas, several studies of babies left to cry in their rooms show that parents can’t love a child too much. Ferberized children tend to grow up to be extremely successful later in life. These children grow up to be tomorrow’s doctors, firefighters, and millionaires of Silicon Valley. (Hogan and Haskell, 2). Most of today’s kids have one of the following types of parents: Indulgent, Authoritative, Neglectful, Authoritarian*. These are generally regarded as the four main types of parenting. These four styles of parenting are the stereotypical parenting styles most people identify one or both of their parents as. Indulgent parents tend to coddle their children and protect them from disappointment. Authoritative parents are people who have reasonable demands and rules usually met by children who respond well and listen to them. Though they have high expectations, these parents’ children tend to meet or exceed the expectations due to the resources the parent’s provide. These parents are known by some children as the â€Å"golden guardians.† They are what every parent who has ever purchased a parenting book strives to become. Authoritarian parents have extremely high expectations that are almost impossible to meet and very strict rules that must be followed unconditionally. These adults are the origin of parental nicknames such as â€Å"Scary Gary† and â€Å"EvilShow MoreRelatedThe Different Parenting Styles1024 Words   |  5 PagesParenting styles have been described as the collection of parents’ behaviors which create an atmosphere of parent-child interaction across situation (Mize and Petit, 1997). 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