Interprofessional practice: magic at the intersection.

Abstract

Reflecting back on my career as a nurse, I am amazed at how the various positions I have held have shaped my perspectives on so many issues. After a great career in clinical nursing and hospital management, with involvement in the planning and design of a large specialty hospital, I was invited to join an architectural firm as a nurse consultant. The role included teaching less experienced architects about healthcare operations, care delivery processes, and patient and staff needs that might influence design decisions, and to accompany the design team when interfacing with the healthcare clients. In essence, I was an interpreter between the two languages in the worlds of healthcare and architecture. I must confess that the first few months in the architectural firm were a bit rugged for me. I was a pioneer in a new role with minimal skills, little orientation to the architects' world of thinking, and toolkit full of the wrong tools... or so I thought. Feeling like a fish out of water, I decided to surround myself with nursing memorabilia in my new avant-garde design office (what was a nurse doing in an office like this?). Still not comfortable in my new role, I re-read Florence Nightingale's Notes on Nursing, and then I knew why I was embedded in an architectural firm. Florence Nightingale was not only a nurse, but the first to bring attention to the need for changes in the design of healthcare facilities to ensure an environment that facilitated healing.After the first few client visits and work sessions, the importance of a nurse embedded in the design world was very apparent. Nurses and physicians could relate to me in ways that they could not relate to architects. They trusted me, because I was one of their own, and they were certain that architects didn't understand them or know how they were from all other hospitals in the world. Hospital leaders also trusted me, because I was experienced in hospital operations, finance, and patient care-what do architects know about that? was the general question. In hospital meetings, I was in my comfort zone, but back in the office, it took some time for me not to feel that I was in foreign ter- ritory. I made it my personal goal to prove my worth and to be a value-added asset to the firm.There is a purpose for my revealing such personal information. I hope to demonstrate in this editorial that there is magic at the intersection, where true interprofessional practice intersects and positive outcomes can be achieved as a result of the synergy that occurs among different professionals who come together with a common purpose and goal.Recognizing the Intersections in Healthcare DesignEven the term healthcare design indicates the intersection of two different disciplines that have merged into a new discipline with its own language, guidelines, and standards; science with rigorous research to guide practice decisions; and even certification examinations to recognize individuals who have mastered a body of knowledge that can be translated to quality decisions, service, and outcomes in healthcare design. All of these have come together at the intersection of two worlds; however, each of these distinctly different worlds has subsets of disciplines within them, making the intersection all the more complex. As an example, in healthcare the subsets of disciplines include healthcare administration, nursing, medicine, all the therapies, and numerous other disciplines that shape and support patient care. On the other hand, the design discipline also comprises subsets, including architecture; interior design; environmental psychology; structural, electrical, and mechanical engineering; and a host of other disciplines that support the planning, design, and construction of healthcare facilities. Clearly the healthcare design discipline is a complex system and can be best understood and explained using the theory of quantum science and complexity theory, which describe the world as one of complexity and chaos with multiple constantly moving and often unpredictable parts that comprise the structure of a whole system (Plsek & Greenhalgh, 2001). …