Creating the Health Care Team of the Future: The Toronto Model for Interprofessional Education and Practice

Abstract

That our health care system could do better is hardly a controversial idea. The authors of this book cite several reports, including the Institute of Medicine's To Err Is Human: Building a Safer Health System [1], to explain the need for a different approach to health care in the twenty-first century. Our modern health care system, while wonderfully effective, is also dangerous, each year harming thousands of the people it is trying to help. The complexity of health care poses a formidable challenge to change, yet change is sorely needed to make the system safer, more efficient, and more cost effective. The solution, this book proposes, is to create a truly integrated system in which all of the various health professions collaborate. The system must be patient centered. The health care team must function as a team and not just a collection of professionals pursuing their particular goals. Most important, the key to changing health care practice is to change health care education. Traditional curricula in medicine, nursing, pharmacy, and other health professions tend to perpetuate barriers to collaboration among practitioners. This book provides a model for interprofessional education in which students learn to understand and appreciate each other and to work together in providing better patient care. The model outlined in Creating the Health Care Team of the Future: The Toronto Model for Interprofessional Education and Practice was developed at the University of Toronto and the fourteen teaching hospitals that constitute the Toronto Academic Health Science Network. Toronto did not invent interprofessional education and care (IPE/C). The Journal of Interprofessional Care began publication in 1986. But around 2000—fueled by a growing body of literature on team-oriented care, the deficiencies that the Institute of Medicine and others identified, and government policies and incentives—key leaders at Toronto launched the program that would become a world-renowned demonstration of the concept's application. The first of the book's five chapters reviews the history and development of IPE/C at Toronto. The second chapter covers the organizational structures, leadership, and financial aspects of the program. Chapter three explains how Toronto overcame the formidable challenge of finding room for interprofessional education in already full curricula. Chapter four discusses the project in the clinical setting, focusing on the importance of top-management support and leadership champions, and outlining the key roles required for success. The last chapter looks at the impact and sustainability of interprofessional education and practice in terms of accreditation requirements, outcomes evaluation, and funding strategies. The authors of Creating the Health Care Team of the Future present this volume as a resource and guide for organizations that are interested in implementing interprofessional practice. Recognizing that one size does not fit all, they never say, “Ours is the only way.” They share their experiences, insights, and lessons learned. Each chapter ends with a list of questions for reflection to help readers think about applying the principles discussed in their own settings. Chapters three and four include illuminating case study examples of various aspects of the program. Links to abundant additional resources at the University of Toronto Centre for Interprofessional Education and other websites are provided via quick response (QR) codes at several points in the book. Unfortunately, one of these leads to a “page not found” error, and two of them repeat the previous codes instead of linking to the listed sites. In keeping with the book's focus on the Toronto model, the annotated bibliography of papers with which it concludes were published from 2005 to 2013 and with University of Toronto faculty or students listed as first or second authors. The authors of Creating the Health Care Team of the Future are intimately involved in the work at Toronto. Sioban Nelson is vice provost, Academic Programs, University of Toronto; Maria Tassone is director of the Centre for Interprofessional Education; and Brian Hodges is vice president, Education, at the University Health Network. Together, they bring a wealth of experience and a thorough understanding of the opportunities and challenges of IPE/C. Their book is an excellent introduction to the topic, an inside look at the translation of theory into practice, and an encouraging view of better health care for the future. Health care educators and leaders at all levels will benefit from reading this book and exploring the online resources at the Centre for Interprofessional Education. Even a teacher or practitioner who is not in a position to introduce such radical change as was implemented at Toronto will find practical ideas in the case studies included in the book and inspiration in the quotes that are liberally sprinkled through its pages from faculty, students, and patients. Creating the Health Care Team of the Future deserves a wide readership.