Complex Care and the Need for Collaborative Brains*

With the rising complexity of patient care comes a rising need for collaborative work. The articles in JRIPE’s sixth issue (www.jripe.org) explore two important questions in this regard: How should we organize collaborative work? And how should we prepare future generations for it?

Packard et al. [1] test whether students’ performance working up a case and perceptions of interprofessional skills would improve if they are given modeled examples of interprofessional communication and a team reasoning framework.

Holmqvist et al. [2] highlight the need for co-ordinated research efforts to determine the usefulness of student-run clinics as ideal sites to advance learning in teamwork and social accountability.

Newhouse et al. [3] add to our understanding of how to design effective heart failure management programs. Using a Delphi process, they report data from a series of consultations among health professionals, patients, and family caregivers.

Hutchison et al. [4] test the hypothesis that clinical pharmacists, physicians, and other healthcare professionals providing medication therapy management can improve outcomes and reduce costs among patients at high risk of adverse reactions from medication.

Arar et al. [5] provide insights into the cycles of growth through which multidisciplinary research teams operate. And finally, Butson et al. [6] examine the problems that can affect the creation of interprofessional virtual communities of practice.

All of these studies reflect variations on the theme of care complexity and the need for multidimensional platforms to address that complexity. These studies also highlight the kinds of skills we need to hone—dialogue, compassion, attention to the other, extending loyalties, and social interdependencies.

Indeed, when care is complex, when interactions among health professionals and patient become intricate, with the need to process higher amounts of information, it pays to hone our collaborative brains to broaden our perspective, widen our insights, and extend our predictive abilities. Such collaborative brains would work their way, through successive approximations, toward a better understanding of interprofessional practice. Armed with ideas, tools, and vocabulary, they would elevate their approaches to problems—each new understanding building on another, each new insight the source of a productive vitality that can carry the group for a while, until the next problem, the next challenge to its imagination, the next insight.

* Published as editorial for JRIPE, Vol 2 (3), 2012.  http://www.jripe.org/index.php/journal/issue/current

References (available as pdf at http://www.jripe.org/index.php/journal/issue/current)

1. Packard, K., Chehal, H., Maio, A., Doll, J., Furze, J. Huggett, K, Jensen, G., Jorgensen, D., Wilken, M., & Qi, Y. (2012). Interprofessional Team Reasoning Framework as a Tool for Case Study Analysis with Health Professions Students: A Randomized Study. Journal of Research in Interprofessional Practice and Education 2(3), 250-263.

2. Holmqvist, J., Courtney, C., Meili, R., & Dick, A. (2012). Student-Run Clinics: Opportunities for Interprofessional Education and Increasing Social Accountability. Journal of Research in Interprofessional Practice and Education 2(3), 264-277.

3. Newhouse, I., Heckman, G., Harrison, D., D’Elia, T., Kaasalainen, S., Strachan, P.H., & Demers, C. (2012). Barriers to the Management of Heart Failure in Ontario Long-Term Care Homes: An Interprofessional Care Perspective. Journal of Research in Interprofessional Practice and Education 2(3), 278-295.

4. Hutchison Jr., R.W., Hash, R.B., & Nault, E.C. (2012). Multidisciplinary Team of a Physician and Clinical Pharmacists Managing Hypertension. Journal of Research in Interprofessional Practice and Education 2(3), 296-302.

5. Arar, N.H., & Nandamudi, D. (2012). Advancing Translational Research by Enabling Collaborative Teamwork: The TRACT Approach. Journal of Research in Interprofessional Practice and Education 2(3), 303-319.

6. Butson, R., Hendrick, P., Kidd, M., Brannstrom, M., & Medberg, M. (2012). Developing a Virtual Interdisciplinary Research Community in Clinical Education: Enticing People to the “Tea-Room.” Journal of Research in Interprofessional Practice and Education 2(3), 320-338.

5 thoughts on “Complex Care and the Need for Collaborative Brains*

  1. Wow great article and if you don’t mind me saying, a step up in IPE thinking. Must be something you’re passionate about, or you’ve discovered a new muse!

    Looking forward to more about complexity, so I hope you don’t mind the tip, there is a small hint in your narrative, of confusing complexity (retrospective coherence) with complicatedness (navigating volume).

    Altogether an excellent and interesting line of inquiry. Of course Bertalanffy, father of the systems science that spawned complexity, believed in an interdisciplinary approach as the ultimate answer to all scientific inquiry.

    • Thank you. I hope it is a step up. And yes, it’s nice to keep in mind that distinction between complexity and complicatedness. But in practice, the difference may have no import on how we organize the work; in all human endeavors, coordination, cooperation, collaboration are always present albeit at different degrees at the collective or the individual level (yes sometimes I collaborate with myself, sometimes I don’t 🙂

      • You’ve hit the nail right on the head!

        Organising the work is all about complicatedness, complexity is always self regulating. The import is instead of insisting that a group conform to a preconceived set of socially constructed structures or rules like for example ‘be a team’, the group is supported to do what they are good at first and to let their own rules emerge. All interesting stuff!

        I call all this word play ‘epistemantics’ using slightly more fashionable words to talk about old ideas without sounding dull. I have to say that you’ve named my favourite, in the current popular obsession with ‘collaboration’, it used to mean working with the enemy. Got to love the ironic dissonance or is it just a Freudian slip?

        Thanks for the response.

      • Interesting. A small number of people collaborate with the enemy = Bad. Now, if everybody does it, it is good. It is no longer “collaborating (sleeping?) with the enemy”, but normal behavior, and benefit and prosperity for all!

        I guess moral forces intervene in the background. We tend to forget those forces, but thanks to millennia of evolutionary build-up, we remain moral creatures. Consider the following:
        Situation 1: Loyalty toward members of your group + collaboration with your group = Complexity + Fair Competition.
        Situation 2: No Loyalty toward members of your group + collaboration with the enemy = Complicatedness + Unfair Competition.
        Situation 1 is self-regulating and conditional on the store of common resources the groups use.
        Situation 2 is doomed regardless of the store of resources. Moral forces tip the balance sooner or later. I don’t know if it is survival of the fittest or the most moral, but goodness (or fairness?) always wins. Humanity survives as long as the store of common resources is renewed (soon we’ll probably have to look for resources in other planets).

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