To provide high-quality patient-centered services, a leader needs to ensure that the interprofessional collaboration in the given care setting is effective. The key concern lies in the readiness of nurses to change their attitudes and practices, which may be caused by multiple factors. Nevertheless, the pivotal goal of the leader is to build a team that is responsible, communicative, cooperative, and accountable. The application of the transtheoretical model (TTM) is likely to facilitate the change process.
TTM is an integrative model that posits on biological, social, and other dimensions of change. In their study, Keshmiri et al. (2017) examine an interprofessional education model (IPE) in the context of TTM and state that the mentioned model may significantly enhance interprofessional collaboration. In particular, the scholars revealed that training provided to caregivers proved to be successful since they translated obtained competencies into practice. Initially, Keshmiri et al. (2017) conducted the needs assessment and based their education on the instructional design offered by Prochaska. Accordingly, the leader may adopt a similar approach to improve collaboration in a team through better problem-solving and cooperative learning.
For a leader of a Home Health organization that offers care for older adults, it is critical to employ relevant strategies to manage nurses and meet patient needs. The use of TTM is studied by Ekberg, Grenness, and Hickson (2016), who assessed patients’ hearing rehabilitation readiness based on conversation analysis (CA). It is noted that those clients who specified themselves as being in a pre-contemplation stage tended to resistant to change, namely, 80 percent of participates (Ekberg et al., 2016).
On the contrary, those who were more open to hearing aids during the conversation with audiologists showed the willingness to listen to the recommendations. Thus, TTM seems to be effective to identify the psychological readiness of older adults to accept change, which is important for caregivers to individually adjust their recommendations and services.
While the behavior change intervention in terms of TTM has the potential to improve interprofessional collaboration, the leader should properly introduce and monitor it. According to Larsen et al. (2017), ontologies compose a relevant way to gather, organize, and implement expert knowledge. The mentioned authors emphasize that ontologies combine data from various sources and make it comprehensive. The leaders may benefit from them by adopting the models for behavior change to guide nurses and assist them in addressing occurring difficulties (Larsen et al., 2017). For example, in case one of the team members made an error, it is important to encourage others to help him or her. The so-called data harmonization allows the leaders to collect and use unambiguous and consistent data.
The utilization of TTM requires following such essentials of advanced nursing practice as scientific underpinnings for practice (I), leadership for quality improvement (II), and interprofessional cooperation (IV) (American Association of Colege of Nurses, 2006). The conceptual foundation of the nursing profession and nursing leadership should be incorporated into practice. Besides, a multi-tiered and interdisciplinary healthcare environment should be transparent and responsive to both personnel and patients.
The collaborative leader is expected to possess such characteristics as contextual intelligence, transferability of skills, conflict-solving competence, the ability to establish mutual trust, diversity promotion, proactivity, integrity, and inspiration to others. Thus, the leader who strives to implement TTM needs to evaluate patient or nurse needs, design education accordingly, and serve as an example of effective performance.
References
American Association of College of Nurses. (2006). The essentials of doctoral education for advanced nursing practice. Web.
Ekberg, K., Grenness, C., & Hickson, L. (2016). Application of the transtheoretical model of behaviour change for identifying older clients’ readiness for hearing rehabilitation during history-taking in audiology appointments. International Journal of Audiology, 55(3), 42-51.
Keshmiri, F., Rezai, M., Mosaddegh, R., Moradi, K., Hafezimoghadam, P., Zare, M. A.,… Shirazi, M. (2017). Effectiveness of an interprofessional education model based on the transtheoretical model of behaviour change to improve interprofessional collaboration. Journal of Interprofessional Care, 31(3), 307-316.
Larsen, K. R., Michie, S., Hekler, E. B., Gibson, B., Spruijt-Metz, D., Ahern, D.,… Yi, J. (2017). Behavior change interventions: The potential of ontologies for advancing science and practice. Journal of Behavioral Medicine, 40(1), 6-22.