Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE (Open Access)

Accreditation as a lever for change in the development of the collaborative practitioner in the Australian health system

Fiona Kent https://orcid.org/0000-0002-3000-9028 A E , Lynda Cardiff B , Bronwyn Clark B F , Julie Gustavs C , Brian Jolly D , Josephine Maundu B , Glenys Wilkinson B and Sarah Meiklejohn A *
+ Author Affiliations
- Author Affiliations

A Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Vic, Australia.

B Australian Pharmacy Council, Brindabella Business Park, Canberra Airport, ACT, Australia.

C Australian Medical Council, Kingston, ACT, Australia.

D School of Medicine & Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, NSW, Australia.

E Royal College of Surgeons in Ireland, Dublin, Ireland.

F Health Professions Accreditation Collaborative Forum (HPAC Forum), Kingston, ACT 2604, Australia.

* Correspondence to: info@hpacf.org.au

Australian Health Review https://doi.org/10.1071/AH24165
Submitted: 7 December 2023  Accepted: 15 August 2024  Published: 3 September 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Objective

Patient expectations in the Australian healthcare system are for coordinated, collaborative practice. There is a need for education institutions, health services, accreditation authorities, and consumers to work together to achieve this goal. As part of a larger body of work, we sought to understand how these stakeholders contribute to the development of collaborative healthcare practice.

Method

Nineteen focus groups were conducted in 2022 with 84 participants consisting of education providers (n = 62), consumers (n = 10), representatives from the Health Profession’s Education Standing Group (n = 8), and health service practitioners (n = 4). Framework analysis was initially undertaken to understand facilitators of, and barriers to, collaborative practice and learning. In a secondary analysis, the themes were re-organised according to the Bolman and Deal domains of organisational practice, to make explicit the structural, human resource, political, and symbolic factors deemed useful for re-imaging a process for learning about and incentivising collaborative practice.

Results

There are multiple factors across healthcare settings that both facilitate and challenge the development of collaborative practice. Co-location of professions and participation in formal interprofessional processes such as team meetings and handovers facilitated learning collaborative practice, although traditional cultures which perpetuate siloed models of healthcare, power differentials between the professions, funding structures, and information sharing limited opportunities. The ‘value’ of collaborative practice was facilitated through both consistent curriculum messages throughout health professional courses and positive role modelling.

Conclusions

Education institutions, health service practitioners, accreditation authorities, and consumers can work together to facilitate the development of collaborative practice through attention to policy and processes, curriculum activities, student participation, health service activities and practice, and resource allocation.

Keywords: accreditation, collaborative practice, education providers, health professions education, health service, interprofessional education, interprofessional learning, workplace learning.

References

Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet 2010; 376(9756): 1923-58.
| Crossref | Google Scholar | PubMed |

World Health Organization. Framework for action on interprofessional education & collaborative practice. 2010. Available at https://www.who.int/publications/i/item/framework-for-action-on-interprofessional-education-collaborative-practice

Australian Health Professional Regulation Authority. Interprofessional Collaborative Practice Statement of Intent. 2024. Available at https://www.ahpra.gov.au/News/2024-03-13-Interprofessional-Collaborative-Practice-Statement-of-Intent.aspx

Bogossian F, Craven D. A review of the requirements for interprofessional education and interprofessional collaboration in accreditation and practice standards for health professionals in Australia. J Interprof Care 2021; 35(5): 691-700.
| Crossref | Google Scholar | PubMed |

Dunston R, Canny B, Fisher A, Forman D, Moran M, Oates M, et al. Securing an interprofessional future for Australian health professional education and practice. Australasian Interprofessional Practice and Education Network; 2020.

Suter E, Arndt J, Arthur N, Parboosingh J, Taylor E, Deutschlander S. Role understanding and effective communication as core competencies for collaborative practice. J Interprof Care 2009; 23(1): 41-51.
| Crossref | Google Scholar | PubMed |

Duckett S, Willcox S. The Australian health care system. Melbourne: Oxford University Press; 2015.

Schadewaldt V, McInnes E, Hiller JE, Gardner A. Experiences of nurse practitioners and medical practitioners working in collaborative practice models in primary healthcare in Australia – a multiple case study using mixed methods. BMC Fam Pract 2016; 17(1): 99.
| Crossref | Google Scholar | PubMed |

Grymonpre RE, Bainbridge L, Nasmith L, Baker C. Development of accreditation standards for interprofessional education: a Canadian Case Study. Hum Resour Health 2021; 19(1): 12.
| Crossref | Google Scholar | PubMed |

10  Frank JR, Taber S, van Zanten M, Scheele F, Blouin D, on behalf of the International Health Professions Accreditation Outcomes Consortium.. The role of accreditation in 21st century health professions education: report of an International Consensus Group. BMC Med Educ 2020; 20: 305.
| Crossref | Google Scholar | PubMed |

11  Bolman LG, Deal TE. Reframing organizations: Artistry, choice, and leadership. John Wiley & Sons; 2017.

12  Meiklejohn S, Cardiff L, Clark B, Jolly B, Maundu J, Walters T, et al. “The patients first and foremost” Collaborative Practice in the Australian Health Care System. MedEd Publish 2024.

13  Amineh RJ, Asl HD. Review of constructivism and social constructivism. J Soc Sci Lit Lang 2015; 1(1): 9-16.
| Google Scholar |

14  Krueger RA, Casey MA. Focus group interviewing. In: Newcomer KE, Hatry HP, Wholey JS, editors. Handbook of practical program evaluation. John Wiley & Sons, Ltd; 2015. pp. 506–34.

15  Ritchie J, Spencer L. Qualitative data analysis for applied policy research. In: Bryman A, Burgess RG, editors. Analyzing qualitative data. Routledge; 2002. pp. 173–94.

16  Canadian Interprofessional Health Collaborative. Accreditation of Interprofessional Health Education. Interprofessional health education accreditation standards guide. Health Canada; 2011.

17  Reeves S, Fletcher S, Barr H, Birch I, Boet S, Davies N, et al. A BEME systematic review of the effects of interprofessional education: BEME Guide No. 39. Med Teach 2016; 38(7): 656-68.
| Crossref | Google Scholar | PubMed |

18  Gum LF, Sweet L, Greenhill J, Prideaux D. Exploring interprofessional education and collaborative practice in Australian rural health services. J Interprof Care 2020; 34(2): 173-83.
| Crossref | Google Scholar | PubMed |

19  Schadewaldt V, McInnes E, Hiller JE, Gardner A. Experiences of nurse practitioners and medical practitioners working in collaborative practice models in primary healthcare in Australia–a multiple case study using mixed methods. BMC Fam Pract 2016; 17: 99.
| Crossref | Google Scholar | PubMed |

20  Ascione FJ, Najjar G, Barnett SG, Benkert RA, Ludwig DA, Doll J, et al. A preliminary exploration of the impact of accreditation on interprofessional education using a modified Delphi analysis. J Interprof Educ Pract 2021; 25: 100466.
| Crossref | Google Scholar |

21  Mattiazzi S, Cottrell N, Ng N, Beckman E. Behavioural outcomes of interprofessional education within clinical settings for health professional students: A systematic literature review. J Interprof Care 2023; 38: 294-307.
| Crossref | Google Scholar | PubMed |

22  Rogers GD, Thistlethwaite JE, Anderson ES, Abrandt Dahlgren M, Grymonpre RE, Moran M, Samarasekera DD. International consensus statement on the assessment of interprofessional learning outcomes. Med Teach 2017; 39(4): 347-59.
| Crossref | Google Scholar | PubMed |