EMS Insider, Expert Advice, Healthcare Reform

Responding to the Call for Interprofessionalism

In the past 10 years, healthcare education and practice has seen a greater focus on interprofessionalism as a crucial part of safe and effective patient care. Interprofessionalism occurs when multiple healthcare workers of different professional backgrounds come together to learn and collaborate on ways to develop the highest quality of care for patients. This focus on quality and collaboration led to the formation of the Interprofessional Education Collaborative (IPEC), a partnership of many of the accrediting and certifying bodies of several healthcare professions.1 In 2011, an IPEC expert panel from the fields of nursing, pharmacy, dental, public health and physician education released a report on the core competencies of effective interprofessionalism:

  1. Values and ethics for interprofessional practice,
  2. Roles and responsibilities,
  3. Interprofessional communication, and
  4. Teams and teamwork.1

Coincidentally, these four core competencies are those that are exemplified by the field of EMS.

Interprofessionalism: Implications for Practice & Education

As demonstrated by the IPEC core competencies, interprofessionalism is already embedded in the day-to-day practice of EMS providers. Clear and concise communication with shift partners, other first responders and members of the receiving facility are paramount. The EMS team changes rapidly with phases of each call: from response to scene, to online medical direction and radio communications, to finally (and arguably most important), patient hand-off at the receiving facility (see Figure 1).

Interprofessionalism in EMS

Each phase of EMS care involves an important, interprofessional interaction between patient care team members. As an organization that serves the community, EMS plays a role in identifying and amplifying the patient voice in healthcare. The example that the EMS profession sets is one that should be shared with other healthcare professionals who are focused on the in-patient setting. Conversely, in order to function at the highest level within the healthcare delivery system, EMS providers need to have a working knowledge of these other members of a patient’s healthcare team.

While these concepts have always been obvious for EMS providers, the interprofessional movement is becoming increasingly impactful as the field of community paramedicine is developed. New principles of long-term care and disease management are quickly becoming part of the EMS scope of practice, and interprofessional education could play a vital role in the development of these new gaps in knowledge. Flight paramedics and in-hospital providers already have a glimpse of what these gaps are like. An opportunity for further research exists in this area, as the best way to develop the optimal education and delivery of care by community EMS providers has only just begun.2,3 Though especially important for community paramedics, these learning methods and principles are vital to the development of an effective and professional EMS workforce for the 21st century.

The Opportunity for EMS Engagement

As shown by the composition of the IPEC organizations, other healthcare professions are already beginning to develop a focus on these four core competencies. The opportunity for EMS to share its knowledge and learn from other members of the healthcare team is quickly emerging.

Recently, many accrediting bodies of healthcare professions education programs have begun to require some degree of interprofessional education and familiarity with different health professions within a curriculum.4–6 Some colleges and universities are already integrating emergency medical services into their interprofessional programs, with effective simulations and results.7 For most institutions that are still developing their programs, or have not started an interprofessional initiative, the field of EMS (especially its educational programs) needs to ensure that prehospital care becomes part of these collaborations. At this moment, the field of EMS has an opportunity to solidify its place as a stakeholder in the domain of interprofessionalism.

Future Directions

As EMS develops into the 21st century model of collaborative, patient-centered, quality driven care, it will become increasingly important to refine educational opportunities to fit the expanding roles of EMS in healthcare. Concurrently, as the field of interprofessionalism is developed and integrated into healthcare systems as a whole, the burden is on EMS educators and professionals to ensure their representation. Occupational therapy, physical therapy and other allied health professions who participate in the post-hospital care of a patient are already represented on many interprofessional collaborations.8 It is the obligation of EMS to ensure prehospital care is treated the same way. There may be logistical, geographical and resource barriers to interprofessional education, but many existing programs have found ways to overcome these barriers, such as simulation and online collaborations.

For those who are considering further professional development, these types of interprofessional learning experiences provide exposure and perspectives on the roles and scopes of each field. Through matriculation to other healthcare professions, other fields have the ability to see the real capabilities of EMS experience, which may be underappreciated in an office or hospital setting. Finally, the integration of EMS into interprofessional collaborations has broader implications for the profession. The more familiar other fields are with EMS scopes and roles, the more responsibility the healthcare system can place on EMS. The recent advancement of community paramedicine is the greatest evidence of this growing trust.

Right now is a critical time for EMS professionals and educators to ensure that prehospital care is part of the interprofessional movement. To become part of it, research local interprofessional collaborations, reach out to national organizations, contact regional healthcare schools and continue to collaborate with other members of the patient care team.

For more information, visit the American Interprofessional Health Collaborative at https://aihc-us.org.

References

1. Interprofessional Education Collaborative Expert Panel. (May 2011) Core competencies for interprofessional collaborative practice. American Association of Colleges of Nursing. Retrieved June 22, 2016, from http://www.aacn.nche.edu/education-resources/ipecreport.pdf.

2. Mulholland P, Barnett T, Spencer J. Interprofessional learning and rural paramedic care. Rural and Remote Health. 2014;14(3):1­–13.

3. Williams B, Boyle M, Brightwell R, et. al. A cross-sectional study of paramedics’ readiness for interprofessional learning and cooperation: results from five universities. Nurse Educ Today. 2013; 33(11):1369–1375.

4. Liaison Committee on Medical Education. (March 2014) Functions and structure of a medical school: standards for accreditation of medical education programs leading to the MD degree. Western Michigan University. Retrieved June 22, 2016, from http://med.wmich.edu/sites/default/files/2015-16_Functions-and-Structure-2015-6-16.pdf.

5. Accreditation Review Commission on Education for the Physician Assistant. (May 2016) Accreditation manual: accreditation standards for physician assistant education, 4th ed. Retrieved June 22, 2016, from http://www.arc-pa.org/documents/AccredManual%204th%20edition%20May%202016%20FNL.pdf.

6. American Association of Colleges of Nursing. (n.d.) Leading initiatives: interprofessional education. Retrieved June 22, 2016, from http://www.aacn.nche.edu/ipe.

7. Jefferson Chronicle. (Spring/Summer 2015) 2015 interprofessional education simulation day. Jefferson College of Health Sciences. Retrieved June 22, 2016, from http://www.jchs.edu/sites/default/files/publications/2015-Spring-Summer%20Jefferson%20Chroncile.pdf.

8. Hadley D, Ward K, Sen S, et. al. (2015) Pharmacy, physical therapy, occupational therapy, and physician assistant professional student perspectives on an interprofessional education workshop. University of the Sciences Document of Innovations. Retrieved June 22, 2016, from https://www.usciences.edu/teaching/innovations/innovations2015.pdf.