The role of interprofessional collaboration on the discharge planning in the neonatal intensive unit

Rationale: Interprofessional collaboration (IPC) occurs when ???multiple health workers from different professional backgrounds work together with patients, families, careers and communities to deliver the highest quality of care??? (WHO, 2010, p. 13). Successful discharge planning for patients from hospitals is dependent upon IPC (Shepperd et al., 2004). The purpose of this study is to identify and examine barriers or facilitators to IPC as they pertain to discharge planning on a neonatal intensive care unit (NICU). Methods: Case study design using an online survey, participant observation and semi-structured interviews for data collection. Healthcare workers on a NICU at a large Canadian teaching hospital were surveyed to determine their views on the discharge planning process, leadership and IPC. Participant observations took place during the weekly IPC rounds to observe the healthcare workers when discussing discharge plans and to identify key informants for interviews. Based on these observations, 10 health care workers were selected to interview to gain a more in depth understanding of IPC in the discharge planning. Data collection occurred from December 2010 to February 2011. Results: Survey results (n=66) indicate that the majority of healthcare workers on the NICU support IPC. However, the interview data demonstrated that problems arose during an emergency discharge. An emergency discharge occurs when an existing patient on the NICU needs to be discharged to another unit in order to provide a bed for a new admission. The lack of effective communication, role clarity issues, and a need for mutual respect act as barriers to the full participation of all members of the interprofessional team in an emergency discharge. Conclusions: Defining the context is important; IPC works well in a non-emergency situation on the NICU. The level of involvement of the healthcare workers in IPC varies due to previous experience working on interprofessional teams (IPT). The medical lead is responsible for making the decision about a discharge. However, what has been identified as important is an IPC leader who is responsible for ensuring that all information from the IPT members is accessible to inform the medical lead