Interprofessional teams and integrated care – Can they make a difference?

By | 27th July 2017

Healthcare is full of debatable definitions, creating dilemmas across departments and across the globe. One definition that may differ in its wording but not in its meaning and implications is ‘Integrated Care’. One such definition from the NHS in the UK, is: For health, care and support to be ‘integrated’, it must be person-centred, coordinated, and tailored to the needs and preferences of the individual, their carer and family. It means moving away from episodic care to a more holistic approach to health, care and support needs, that puts the needs and experience of people at the centre of how services are organised and delivered.

The principle of integrated care must be at the core of healthcare practice and education and it is clear that its adoption, albeit slow in varied geographies is having an impact. Superimposing the much needed adaptation of interprofessional education, integrated care is now having an impact on key health indicators such as hospitalizations and emergency department visits.

Recent work by Anne Gaglioti et al, published this month has shown that by developing an interprofessional, integrated approach to mental health, ED visits and hospitalizations dropped over a 12 month period. Using an integrated, interprofessional training model, teams that composed of resident and faculty family physicians, care managers, resident and faculty psychiatrists, pharmacists, clinical social workers, substance abuse counsellors, and a psychologist were the point of call for all patients.

Findings were also noted at the 6 month mark, with hospitalisations in the 6-month pre–post comparison group representing 5.4% of all before enrolment encounters, while they only represented 2.6% of post-enrolment encounters. Additionally, the proportion of primary care and psychiatry clinic visits accounted for a larger proportion of visits after enrolment when compared to before enrolment visits. This clearly indicated that patients within an interprofessional, integrated care management programme had lower odds of an emergency room visit or hospitalisation, and greater likelihood of attendance at an outpatient psychiatry visit or primary care visit after enrolment compared to prior to enrolment.

This clearly shows the benefits of interprofessional, integrated care, however, as the authors have stated, replication is essential, especially at a larger scale. How would this methodology work at regional, national or even global levels? There is no doubt more work is needed, however, this work is an example of creating foundations for the health and education community to build and develop from.