This month's continuing education (CE) article is the second installment in a 2-part series. "Arterial Disease Ulcers, Part 2: Treatment" (page 462) gives readers a comprehensive overview of the clinical interventions required for a team to treat a patient with arterial insufficiency. The authors underscore the concept of "team play" collaboration, joint decision making, and interprofessional comprehensive care. This CE exemplifies the Institute of Medicine's (IOM's) call for interprofessional collaboration practice (ICP); cooperative learning and clinical practices emphasizing patient-centered care, quality, safety; and better outcomes for our patients. However, the transformation of the clinical environment and changing the individual/organizational behaviors needed to operationalize the concept of collaborative care are a subject of debate.
Although we can agree in principle that ICP is the right approach, how do we operationalize it, what about the logistics, how do we reimburse practitioners for moving from perceived efficient silos to a slower methodical interactive and time-consuming approach? And, while we are pondering these questions, the field is moving forward. The IOM recommends specific training based around specific knowledge, skills, and attitudes or needed for teamwork, including identification and intervention of patient safety concerns.1 There are a variety of approaches to create an environment for optimal learning; one method is through "learning communities." Fundamentally, the context in which we practice healthcare is a "learning community," and the authors of this month's CE activity create a framework for understanding how a community of practitioners focuses on patients with difficult diagnosis requiring complex professional interactions. However, in order to achieve interprofessional collaboration and practice communities, we must be trained in and add to the emerging science of interprofessionality. "Interprofessionality concerns the processes and determinants that influence interprofessional education initiatives, as well as determinants and processes inherent to interprofessional collaboration."2
As we embrace the concept of collaborative practice and interprofessionality, we also need to approach the concepts with evidence-based practices, which is now emerging coincidental to the looming healthcare shortages.3 The World Health Organization has developed a "Framework for Action on Interprofessional Education and Collaborative Practice." In terms of the evidence, new research is emerging in the medical education field. An excellent systematic review from the Best Evidence Medical Education collaboration initiative4 outlines the emerging trends and classification of interprofessional outcomes needed to link education to future practice models; certainly, these can be applied to the education and practice of wound care.
"Many ideas grow better when transplanted into another mind than the one where they sprang up." -Oliver Wendell Holmes
Richard "Sal" Salcido, MD, EdD
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