HLTH 3105 Week 7 IPEC Competency Application Example

Applying the IPEC Competencies to the Delayed Oxygen Discharge: The Two Domains That Bite, the Evidence for Each and the Two That Do Not

Student Name

Walden University

HLTH 3105: Interprofessional Teamwork in Healthcare

Instructor Name

Month Day, Year

Applying the IPEC Competencies to the Delayed Oxygen Discharge: The Two Domains That Bite, the Evidence for Each and the Two That Do Not

The Framework and the Case

The national competency set for collaboration across professions groups its expectations under four headings, which cover shared values, knowing each role, how information is exchanged and how teams function (Interprofessional Education Collaborative, 2023). Each domain contains specific competencies. Listing the four domains is easy. Applying them means asking which ones actually explain what went wrong, or right, in a specific case and producing evidence for each.

The case is the delayed discharge analyzed in Week 4. A patient recovering from pneumonia was expected home at 1100 and left at 1940, because her qualifying oxygen test result stayed on a paper worksheet in the respiratory department overnight while the case manager, physician and vendor acted on an order without it. This paper applies the framework to that case. It finds that two domains bite hard, roles and responsibilities and communication, and gives evidence for each. The other two are named briefly, with a sentence on why they matter less here.

Domain That Bites: Roles and Responsibilities

This domain asks team members to understand their own roles and the roles of others and to use that knowledge to meet patients' needs. Its competencies include communicating one's own role clearly to other team members and recognizing how one's work depends on others.

Evidence from the case. The respiratory therapist understood her own role well: perform the test, report it, chart it before the shift ends if possible. What she did not know was that the case manager's role depended on her result being in the record that evening. Her decision to chart the result the next morning was reasonable from inside respiratory therapy. The case manager, for her part, understood that home oxygen needs a qualifying test but did not know that respiratory therapists sometimes chart these tests the next day. Each understood her own role; neither understood how it connected to the other's. When I asked each of them afterward, both said they had never discussed home oxygen with someone from the other department.

What the competency would have changed. If each role understood the other's dependency, the therapist would have charted immediately for a patient going home the next day, or the case manager would have checked whether the result was charted before sending the order. Either would have closed the gap.

Domain That Bites: Communication

This domain asks team members to communicate with patients, families and other professionals in a responsive and responsible way that supports a team approach. Its competencies include choosing communication tools and techniques that make information available to those who need it.

Evidence from the case. Communication by voice worked well. The therapist told the nurse the patient qualified, and the nurse passed that on at evening handover. The communication that failed was written, into the shared record that the case manager, physician and vendor rely on. The team had chosen, by habit, a tool, verbal reporting, that served people on the unit that evening but not people acting the next morning or outside the hospital. Research on information transfer at discharge shows that missing results in the documents the next provider relies on are a common cause of problems after discharge (Kripalani et al., 2007).

What the competency would have changed. Choosing the record as the communication tool for a value that a vendor and a payer would need, and confirming at handover that the value was there, would have made the information available to everyone who needed it.

The Domains That Matter Less Here

Values and ethics. Nobody in this case acted against the patient's interests, disrespected another profession or ignored the patient's preferences. The domain matters for teamwork generally, but it does not explain this delay.

Teams and teamwork. This domain covers team processes, such as shared problem-solving and reflection. It is relevant to how the unit should respond, through the huddle and escalation plans of later weeks, but the delay itself is explained by the first two domains.

What the Framework Adds Beyond the Timeline

The Week 4 timeline located the hop where information stopped. The framework adds a different kind of explanation: it names the capacities the team lacked, not just the moment it failed. That matters because the same gap in role understanding between respiratory therapy and case management will show up in other forms, for example with mobility equipment ordered after a physical therapy evaluation, or with sleep apnea devices after an overnight study. A timeline explains one delay; a competency gap predicts the next ones.

The framework also gives the team shared language. Saying that the departments lack role understanding about home oxygen is more useful in a meeting than saying the therapist should have charted sooner, because it describes a gap the departments can close together rather than a lapse by one person. In my experience on the unit, conversations that start with shared language end in plans; conversations that start with a name end in defensiveness.

Using the Framework to Plan Training

Applying the framework this way points to targeted training rather than a general teamwork course. The roles domain suggests a short joint session between respiratory therapy and case management, perhaps 20 minutes at a department meeting, where each explains what it needs from the other for home oxygen discharges and when. The communication domain suggests one rule, written into both departments' practices: any result that decides whether a patient can go home is charted before the end of the shift in which it is obtained. Reviews of interprofessional interventions find that the evidence for broad collaboration programs is limited, while practice-based changes to specific routines show more promise (Reeves et al., 2017). A framework applied to a real case tells a team which routine to change.

The framework also has limits here. It describes what competent collaboration looks like, but it does not tell a hospital how to assign charting priorities across departments with different workloads. That is a management decision the framework informs but cannot make.

References

Interprofessional Education Collaborative. (2023). IPEC core competencies for interprofessional collaboration: Version 3. https://www.ipecollaborative.org/ipec-core-competencies

Kripalani, S., LeFevre, F., Phillips, C. O., Williams, M. V., Basaviah, P., & Baker, D. W. (2007). Deficits in communication and information transfer between hospital-based and primary care physicians: Implications for patient safety and continuity of care. JAMA, 297(8), 831-841. https://doi.org/10.1001/jama.297.8.831

Reeves, S., Pelone, F., Harrison, R., Goldman, J., & Zwarenstein, M. (2017). Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, 2017(6), Article CD000072. https://doi.org/10.1002/14651858.CD000072.pub3