In Crisis? 
At Klinic, like in many community health centres, there is a strong history of innovation and a focus on collaborative care. It is evident that to support client-centred care, particularly for the most marginalized people, we have to support strong teams who collaborate. This year, Klinic has been working one process to establish our new five-year strategic plan. The Board of Directors identified early on that they felt our current mission, vision and values continue to hold true, particularly in their emphasis on areas like collaboration, social justice and accessible care. However, they also identified that it was time for some new key strategic directions to move us forward in the next few years (I mentioned this is a previous blog I wrote about change last month). In fall of 2016, we conducted a variety of surveys with staff, clients and community to help shape our new strategic directions. These four draft strategic directions were presented at our annual all-staff meeting a few weeks ago in order to facilitate conversations as program teams and Klinic overall- specifically, how would we put these concepts into actions?
The directions are still in a draft format as we finalize feedback from staff and prepare to bring a proposed operational plan to the Board in March. I would like to highlight one of these draft statements specifically; not only because of its importance (not surprisingly it is the first in the list) but because of how it ties to the work of last year’s all-staff meeting and the importance of collaborative care at Klinic. Our first draft strategic direction includes these terms (we are currently still finalizing wording based on feedback):
Klinic is a healthy, respectful and collaborative workplace.
At last year’s all-staff meeting we focused on interprofessional collaboration with the goal of developing a position paper for the organization. At the end of the day, we developed seven Klinic-specific principles that would make up the basis of the paper. I wrote about this in my blog shortly after, which you can read here. Over last fall and winter, we took the principles and feedback from the planning session and combined it with a review of evidence-based literature on interprofessional collaboration, to develop our position paper (you can read it here). The paper was shared at team meetings for feedback, finalized, and approved by our Board in December 2016. Though you can review the paper in its entirety on our website, I would like to share the Klinic staff-identified principles specifically as I believe these are the core of the paper:
Respect – Mutual respect and trust are foundational to effective interprofessional working relationships across the agency. Interprofessional collaboration honours the diversity reflected in the individual expertise that each profession brings to care delivery.
Shared understanding, values and goals – Health care professionals interact on behalf of shared goals for care with patients or communities, shared problem solving and shared decision making, especially in circumstances of uncertainty, leads to a stronger team. The interprofessional dynamic in an organization influences new program development and organizational decision making based on a shared understanding of what is important.
Healthy and positive work environment – Creating healthy work environments is both an individual and collective responsibility. Healthy work environments are safe, collaborative and diverse, and offer reasonable workloads, with many benefits to the organization, employees, and clients.
Teamwork – whether a team is formal or informal, there is an opportunity for health care professionals to work together in a way that ultimately benefits all. Teams are developed by establishing and maintaining effective working relationships, applying team practice processes to informal working groups, and understanding the process and dynamics of team development.
Communication – Creating a culture that promotes respectful and regular communication through active listening of verbal and non-verbal cues, standardizing documentation, using common vocabulary, and encouraging information sharing will facilitate both knowledge sharing and decision-making.
Client-centered care – requires collaboration among clients and health professionals who work together at the individual, organizational and health-care system levels to optimize the health and wellness of clients and involve the client in decision-making. Clients are actively engaged in the prevention, promotion and management of their health.
Social justice – people are entitled to a health system that has the capacity to keep them well by linking interprofessional collaborative care to social justice, equity and determinants of health; supporting health promotion; and promoting community-based care as well as acute illness care
I am personally excited by this work and the principles that have been developed and articulated to guide us in our next steps; the way it seamlessly comes together in our new strategic directions. I am also aware that these are words, and our actions are what are important if we want to truly live these values in our workplace.
The reality is that although Klinic has a strong history and a vested interest in this work, like any workplace, we still have work to do if we want to demonstrate that we are fully working together in collaboration. Creating and supporting interprofessional work is something that can only be done if every team member, including the organizational leadership, embraces the importance of collaboration in all aspects of our work. This can mean real self-reflection and consideration of things like historical power structures, particularly those that exist in healthcare environments, and that can impede or stand in the way of true collaboration.
This is not easy work, but I believe that we are very lucky to be starting from a place of real understanding of the why and the what of interprofessional work- now it’s time for the how, in particular, how we expand the great interprofessional work we are already doing to ensure that our core principles are lived every day at Klinic.