Nexus Distinguished Scholars Blogs

Observations on the Nexus Summit – Directions for What’s Next

Gerri Lamb and Mary Mauldin, Nexus Distinguished Scholars

We admit it. We’re impatient for interprofessional practice and education to move ahead and take its essential role in improving quality care and workforce resilience. We thought Summit participants reached a new level of insight together about the barriers to moving ahead. There were so many rich discussions about difficult topics – some of which we and our predecessors have been grappling with for years. From our armchair seats, we believe it’s an important time to learn from our history, identify priorities for action, and act together. The health care system moves forward and times awasting! We wanted to share a little of our take on history, priorities, and action – and invite your thoughts.

We’ve learned at the Summit that IPE has experienced many cycles usually driven by current context and need for teamwork and collaboration to solve critical problems. It’s not a coincidence that teamwork and collaboration have been heralded in response to crises in health care – unacceptable levels of medical error, COVID, provider-burnout and the like. And history tells us that memories are short. People tend to overestimate how well they understand and practice evidence-based high performance teamwork – and as we heard during the Summit, many are exhausted with trying to keep up with the many sets of teamwork competencies they’re expected to incorporate in curricula and implement in practice

Our first observation is that it’s time to USE our history. We’re very fortunate to have historians like Barbara Brandt, Bud Baldwin, Mattie Schmitt, John Gilbert and others to help us make sense of how and why things happened and the lessons we need to take seriously – mostly to avoid having the exact same things happen again. We have newer people on the scene who are driving today’s lessons – about the role of academic-clinical partnerships in embedding IPE into the heart of today’s incentives in health care, about the strengths and drawbacks of what we’re currently doing to realize the goal of having patients as engaged team members. The Summit also held up a mirror to our continuing discomfort with power dynamics in teamwork and why it’s important to have physicians engaged in IPE.

Our second observation and a few questions. We think that we (the collective “we”) have a decent handle on the fundamentals. We’ve got written history, several excellent journals, and lots of people working very hard to move the needle. We saw evidence of these things over and over at the Summit. So – how do we move to the next step and begin to ask, and answer, some of the uncomfortable questions that are holding us up. For instance, what are the key priorities for the interprofessional practice and education community to be focusing on to meet today’s challenges? What are the tables we, as IPE experts, need to be at, and how do we frame the case for IPE in the ways that will resonate for health system leaders and others? How do we overcome (in some case centuries-old) cultural barriers within and across our profession that create barriers to achieving our fundamental goal of improving health?

Some observations on priorities. In our view, advocates of interprofessional practice and education have been extremely clear on the end-game – it’s about patients and quality care. The goals of teamwork and collaboration for practitioners and educators alike always have been about improving health and healthcare – whether we refer to them as quality care, the Triple Aim, the Quadruple Aim, the Quintuple Aim or whatever the next waves of labels brings. The tables we think we need to get to are the ones that have profound effect on how health care is practiced and taught, the drivers of incentives – policy-makers, top healthcare administrators, payors, accreditors. The Summit showed us examples of colleagues doing an amazing job in making the case for IPE – a skill set we think ALL of us need. We need clear and compelling elevator speeches to get to the tables and have an impact. Let’s help each other do that.

We also think it’s a priority to get a handle on how patients may be fully integrated into team models – not at the edges, not as observers and not as afterthoughts – fully integrated. The current initiatives – such as the ones at PCORI to measure patient engagement – should help us. Feedback from the many patient observers at this year’s Summit will help guide us. We suspect that shifting to a fully integrated patient practice model will be risky and probably uncomfortable. Who better to walk this talk than our community? We’d love to see members of our IPE community collaborate with patients/consumers, propose better models and write about this.

Another priority is to gain a better understanding – including the historical roots – of the cultures of and power dynamics between professions and learn how to deal with them effectively. For this, we would like to see us engage the social scientists in our community to provide us with insights and strategies.

We think the 2023 Summit did an outstanding job providing focus, context, and direction. Let’s put them together – with the examples of innovation and risk taking we heard in the panels and presentations - and MOVE!

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