Core Competencies for Interprofessional Collaborative Practice

In May of 2011, the Interprofessional Education Collaborative, a panel of experts representing the American Association of Colleges of Nursing, American Association of Colleges of Osteopathic Medicine, American Association of Colleges of Pharmacy, American Dental Education Association, Association of American Medical Colleges and the Association of Schools of Public Health convened to develop a set of competencies for ICP.² The panel identified four Core Competencies for Interprofessional Collaborative Practice (CCIPCP). The focus of these competencies was to develop guidelines for preparing health professionals to provide quality patient-centered care and population health in evolving health care systems in which team-based care is necessary. The competencies act as one potential strategy for addressing issues in healthcare related to the rising cost of healthcare, improving access to care for underserved populations and providing quality care. This concept is in keeping with the Triple Aim framework as an approach described by the Institute for Healthcare Improvement (IHI) to optimize the delivery of healthcare, by improving the patients experience, improving population health and reducing the per capita cost of requiring a collaborative approach to the complex health conditions that are increasingly more common in the populations we serve. The Triple Aim framework was designed to improve health, which requires the engagement of stakeholders with a community to speak to broad determinants of health and not one single dimension. In this regard, true health is not realized at the individual level, but at the community level. The triple aim creates a metric that allows the healthcare system to partner with providers to improve the health of the population,³ improve medical management,⁴ and transform healthcare reimbursement models.⁵

IPEC identified four core competencies, which could be implemented as common core concepts in health profession educational programs that would be broad enough to encompass multiple professions but be flexible enough to account for the uniqueness that exists between professions. The CCIPCP are framed in such a way that collaborative teams can be evaluated on the effectiveness of team-based care for those complex patients that require care from multiple providers.

In 2016, the CCIPCP updated the Core Competencies to focus on a single domain, Interprofessional Collaboration. The core concept of the four competencies is collaboration.⁶ According to the CCIPCP, the updated competencies provide more integration of population health and have a greater focus on population health, which is consistent with the Triple Aim. The updated competencies include sub-competencies that further elaborate each of the core competencies’ aim to utilize measurable learner objectives that allow different professions to track outcomes.

The IPEC Core Competencies were reviewed and updated again in 2023. Each of the four CCIPCP emphasize team and reflect concepts of safety, high-quality outcomes, accessibility, equitability, patient/client centered care and enhanced population health outcomes.⁷ In addition, to a reduction in the number of sub-competencies from thirty-nine to thirty-three there is also a focus on team and teamwork.

The updated CCIPCP are as follows.

• Values and Ethics: Work with team members to maintain a climate of shared values, ethical conduct, and mutual respect.

• Roles and Responsibilities: Use the knowledge of one’s own role and team members’ expertise to address individual and population health outcomes.

• Communication: Communicate in a responsive, responsible, respectful, and compassionate manner with team members.

• Teams and Teamwork: Apply values and principles of the science of teamwork to adapt one’s own role in a variety of team settings.

The updated CCIPCP similarly highlight some foundational characteristics necessary for oral healthcare professionals that encompass shared values relevant across other health professions. Concepts represented in the CCIPCP are typified in some statements that appear in the ADA Principles of Ethics and Professionalism as well as the Code of Ethics for Dental Hygienists and are part of the day-to-day practice of an oral healthcare provider. For example, the Dental Hygiene code states “develop collaborative professional relationships and exchange knowledge to enhance our own lifelong professional development,” while the ADA code says “…the dentist’s primary obligations include keeping knowledge and skills current, knowing one’s own limitations and when to refer to a specialist or other professional…” As new practice models are evolving, oral healthcare providers are practicing in rural settings, urban settings, in community health centers, etc., and they will need to acquire the skills needed to work with an interprofessional collaborative team to help promote oral health and treat the growing number of patients with complex medical and mental conditions.

In addition, the CCIPCP integrated the concepts of the Quadruple and Quintuple Aims. While the Triple Aim focused on three concepts, it did not include healthcare provider well-being and healthy equality which are illuminated in the Quadruple and Quintuple Aim, respectively.⁸

Bodenheimer and Sinsky noted the health and well-being of the provider is a crucial component in achieving the overall goal.⁹ They noted that provider burnout has increased and may be linked to future shortages in primary care physicians and other healthcare workers. A similarly finding was noted for dental graduates related to the working environment that could impact ones professional and personal life. The impact of healthcare provider burnout may lead to further workforce challenges and compromise care, making the Quadruple Aim an important component of maximizing care.^8,10

Furthermore, vulnerable populations who are uninsured, underinsured or who have limited access to medical and dental service healthcare services have a challenges making it difficult to address the needs of all populations. It has been noted that certain marginalized populations, such as those with low social economic status, historically underrepresented groups, and the elderly even prior to the COVID-pandemic experienced health inequities and lack of access to care. These trends were magnified during the COVID-19 pandemic. Farrell et al noted in a perspective that health inequities should be highlighted as a discrete concept as noted by the Quintuple Aim if they are to be addressed.¹¹