Community of Practice
A Nurse Practitioner Collaborative Model Linda Sawchenko, RN MSHA & Judith Burgess, RN PhD
Purpose
To explore what characteristics contributed to the success of the Interior Health Authority (IHA) Nurse Practitioner (NP) Community of Practice (CoP) and how health care leaders fostered a collaborative approach (Burgess & Sawchenko, 2011).
Context
NPs were formally introduced in British Columbia in 2005 through enabling legislation and regulation. A study was undertaken in 2008-2009 to examine NP role development. A significant finding was the Interior Health NP CoP established in collaboration with nursing leaders and newly hired NPs, which we report on here.
“It would have been a perfect storm for an alone, new NP, not all that clear on her role. The CoP model provided a great link to all these new professionals so they had a peer network and some support…This was very strategic and very intentional, and became a really important strategy for role success.” -Healthcare Leader
Methods Participatory action research was employed, and Hall‟s (2001) definition of “social investigation, education and action to support those with less power in their organization or community setting” guided the inquiry. With ethics approved, we used strategic sampling to invite all NP employees to participate as coresearchers. Their CoP became a „community of inquiry‟, where an evolving collective dialogue about collaborative practice ensued. The social investigation stage of the inquiry entailed developing community of inquiry principles, sharing journal articles, and clarifying inquiry interactions for fostering group trust. The education stage focused on inquiry discussion of everyday practice patterns of NPs, role development progress and factors contributing to collaboration and role integration. The action stage unfolded into two strategies: first, IHA leaders were invited to an action interview; and second, was hosting a research action day.
Table 1: How can leaders support a Community of Practice? Ten Principles for Cultivating Collaboration Recognize and acknowledge urgent issues about client-related practice and care. Identify relevance within the context of management operations and goals. Create a shared and evolving vision for participants and health leaders. Articulate collective aims and goals, while respecting individual participants’ needs. Encourage and mentor shared leadership. Foster internal dialogue, and extend outward through the organization. Identify and strategize on barriers and challenges that threaten sustainability . Set targets and celebrate successes.
Findings
The IHA CoP was revealed as a significant factor to the success of NP role integration, and is described by five characteristics.
Refresh and revisit your vision, values and ethics of practice. Report progress and accountability of client care and healthcare improvements.
Conclusions Sanctioned Social Structure
Knowledge Exchange Network
Stewards Strategic Improvement
Generates Discovery & Innovation
Engenders Meaning & Value
“We just help one another be successful!” -Nurse Practitioner
A collaborative COP model is a valuable strategy to foster NP role development, by addressing internal members‟ needs, while attending to external organization concerns. Leader mentorship accelerates the maturity and capacity of the COP. “NPs, in our view, are a key piece of the solution to the challenges we have around access, continuity and coordination of care…the NP role is much more than a resource; it’s a whole different philosophical orientation and way of providing care” -Healthcare Leader
References
Burgess, J. and L. Sawchenko. 2011. “Community of Practice: A Nurse Practitioner Collaborative Model”. Journal of Nursing Leadership, 24(2): 99-112.
“I see the CoP as an integral part of our success in terms of setting and achieving goals and integrating ourselves into the current healthcare system.” -Nurse Practitioner
Figure 1: Five Characteristics of a Collaborative CoP
Note of thanks to Katrina Plamondon, IH Nursing Research Facilitator for her support in preparing this poster.
Hall, B. 2001. “I Wish This were a Poem of Practices of Participatory Research”. In P. Reason and H. Bradbury (Eds.), In P. Reason and H. Bradbury, eds, “Handbook of Action Research: Participative Inquiry and Practice”. London: Sage Publications.