ARTICLE
The value of interprofessional health care
Sandra Grace | Faculty of Health , Southern Cross University
The prevalence of complex chronic health conditions
In 2017-2018 , the Australian Institute of Health and Welfare estimated that 20 % of Australians ( 4.9 million people ) had two or more of ten selected chronic conditions : 1 mental and behavioural conditions ( 4.8 million people or 20.1 %); back problems ( 4.0 million people or 16.4 %); arthritis ( 3.6 million people or 15.0 %); asthma ( 2.7 million people or 11.2 %), diabetes mellitus ( 1.2 million people or 4.9 %); heart , stroke and vascular disease ( 1.2 million people or 4.8 %); osteoporosis ( 924,000 people or 3.8 %); chronic obstructive pulmonary disease ( 598,800 people or 2.5 %); cancer ( 432,400 people or 1.8 %) and kidney disease ( 237,800 people or 1.0 %). This state of health is known as multimorbidity . Moreover , a significant number of Australians not only have multimorbidity , but have complex multimorbidity – that is , ‘ three or more chronic conditions affecting three or more different body systems within one person , without defining an index chronic condition ’. 2
Despite this prevalence of complex chronic conditions , the Australian health system is largely designed to manage single conditions . Payment systems , for example those for diabetes mellitus and asthma care plans , are designed for single disease management . 2 Such a focus overlooks the complexity of care requirements for patients with multiple chronic conditions . 3 One strategy that aims to improve patient safety and quality of care is building and strengthening opportunities for interprofessional practice .
Interprofessional practice
Interprofessional practice refers to collaboration among health practitioners from different professions . 4 It is widely acknowledged to ‘ reduce duplication of effort , restrict clinical error , improve safety and enhance the quality of patient care ’. 5 In 2010 , the World Health Organization established guidelines for interprofessional care and education as a strategy to address poor service delivery and reduce errors . 6 These guidelines were also intended to play an important role in addressing the global health workforce crisis .
A number of both enablers of and barriers to interprofessional practice have been described in the literature . For example , a study exploring enablers of and barriers to the development of interprofessional practice between osteopaths and medical doctors treating paediatric patients in Quebec found that the strongest enabler of the development of interprofessional collaboration was positive clinical results reported by patients . 7 Others included previous training of the osteopaths in other health disciplines , clinical experience , the perceived safety of osteopathy , and patients ’ requests for collaboration . Barriers included health professionals ’ uncertainty about others ’ roles and limited scientific evidence supporting osteopathy . Other studies have reported a range of professional , organisational and cultural factors that have impeded interprofessional collaboration and consequently timely , safe and effective healthcare . 8 For example , the way that health professionals are enculturated and their differences in status can be further barriers to collaborative care .
Many health professionals have limited understanding of the roles of other health professionals and consequently of how to work together . 8 This is particularly true for natural medicine practitioners . A qualitative study in 2014 found that the full range of health disciplines that could be included in interprofessional practice was not being realised , and this was due , at least in part , to mainstream medical health practitioners ’ lack of education about natural medicine . 9
JATMS | Autumn 2021 | 27