Interprofessional collaboration in early childhood education and care: Working Together to Include All Children in Their Early Years

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Amsterdam University of Applied Sciences

Interprofessional collaboration in early childhood education and care

Working Together to Include All Children in Their Early Years Fukkink, Ruben

DOI

10.13140/RG.2.2.20039.14241 Publication date

2019

Document Version Final published version Published in

Social Inclusion, Education and Urban Policy for Young Children

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Citation for published version (APA):

Fukkink, R. (2019). Interprofessional collaboration in early childhood education and care:

Working Together to Include All Children in Their Early Years. In Social Inclusion, Education and Urban Policy for Young Children Hogeschool van Amsterdam, Kenniscentrum Onderwijs en Opvoeding. https://doi.org/10.13140/RG.2.2.20039.14241

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Interprofessional collaboration in early childhood education and care

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DOI: 10.13140/RG.2.2.20039.14241

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WORKING TOGETHER TO INCLUDE ALL CHILDREN IN THEIR EARLY YEARS

RUBEN FUKKINK – WORKSHOP 8

1

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EUROPEAN COMMISSION/EACEA/EURYDICE/EUROSTAT, 2014;

INSTITUTE OF MEDICINE AND NATIONAL RESEARCH COUNCIL, 2015;

WORLD HEALTH ORGANISATION

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Transforming autonomous and often fragmented children’s services into an integrated service is a typical issue in several countries. The advent and growth of inclusive early childhood care and education (ECEC) for young children has also made the interprofessional

collaboration (IPC) between childcare, primary education and youth care an important theme.

 growing interest in role of multidisciplinary teams in community-

based settings for young children

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Individual staff and/or team perspective

individual staff team

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THIS WORKSHOP: 3 RELATED PARTS

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Introducing Inter-Professional Collaboration (IPC) 1. Your professional development & profile: IPC 2. Your team: IPC

3. Ongoing literature review: Effective ingredients for IPC

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5

PROFESSIONAL DEVELOPMENT

AND PERSONAL IPC PROFILE

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Selection of 5 items IIC measure

Strongly

disagree Disagree Neutral Agree Strongly agree

My colleagues from other disciplines believe that they could not do their jobs as well without the assistance of social workers.

Working with colleagues from other disciplines leads to outcomes that we could not achieve alone.

My colleagues from other disciplines and I collaborate in various ways.

Colleagues from all professional disciplines take responsibility for developing treatment plans.

I discuss with professionals from other disciplines the degree to which each of us should be involved in a particular case.

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5 items selected from 5 IIC subscales:

• Interdependency

My colleagues from other disciplines believe that they could not do their jobs as well without the assistance of social workers.

• Newly created professional activities

Working with colleagues from other disciplines leads to outcomes that we could not achieve alone.

• Flexibility

My colleagues from other disciplines and I collaborate in various ways.

• Collective ownership of goals

Colleagues from all professional disciplines take responsibility for developing treatment plans.

• Reflection on process

I discuss with professionals from other disciplines the degree to which each of us should be involved in a particular case.

Index Interdisciplinary Collaboration

Bronstein, 2002 - https://nexusipe.org/informing/resource-center/iic-index-interdisciplinary-collaboration

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Growth during PACT project: IIC measure

(18-24 months)

1 2 3 4 5

Interdependence New activities Flexibility Collective

ownership Reflection Total ICC Start Intermediate End

See Balledux, Doornenbal, Fukkink, Spoelstra, van Verseveld & van Yperen (2017). Inclusie door interprofessionele 8

samenwerking; Resultaten van de proeftuinen van PACT samen werken voor jonge kinderen. Utrecht/Groningen/Amsterdam:

PACT; See Fukkink & Van Verseveld (submitted)

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9

INTERPROFESSIONAL TEAMS

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From Stepans, Thompson, & Buchanan (2002)

Team building

Transdisciplinary team building through role release and collaboration

https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1525-1446.2002.19403.x 10

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The Hague, NL

Aarhus, DK Stockholm, S

Berlin, D 4 ECEC centres in 4 European cities

What does your team look like?

Ploeger & Fukkink (2013). Interprofessionele samenwerking tussen kinderopvang en onderwijs in vier Europese steden. Pedagogiek, 33(3), 209-226.

Ploeger & Fukkink (2018). Interprofessionele samenwerking tussen kinderopvang en onderwijs in vier Europese steden. In V. de Waal (red.), Interprofessioneel werken en innoveren in teams. Bussum: Coutinho.

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7 integrative

= Stockholm center 6 interdisciplinair 5 multi-disciplinary =

Berlin center 4 coordinated

3 collaborative = Aarhus center 2 consultative

1 parallel = The Hague center

IPC typology of Boon et al. (2004)

Process:

More

collaboration and interactions

Philosophy:

From specialist  to holistic

Structure:

Less

hierarchical from 1  7

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Type the footer here 13

WHAT DOES YOUR IPC TEAM LOOK LIKE?

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PEDAGOGISCH PACT IS EEN INITIATIEF VAN

Pilots from Dutch PACT project

Groningen Almere Amsterdam

Middelburg Apeldoorn

Eersel Lent

https://www.researchgate.net/publication/317664333_Inclusie_door_

interprofessionele_samenwerking_Resultaten_van_de_proeftuinen_va n_PACT

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Position

Centre for Youth and Family staff member Youth care staff member

Child protection staff member Social nurse

Remedial educationalist

Youth health care staff member Director of special education school Position

Caregiver (day-care)

Caregiver (afterschool care)

Special educational needs coordinator – (childcare) Manager of childcare centre

Primary school teacher Remedial teacher

Special educational needs coordinator – (school) Primary school director

Social worker

Special education teacher Special care coach

Parental coach

Upper school coordinator care and advisory team

Positions in Dutch ECEC teams (0-6 yrs)

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IPC sociogram for pilot Eersel (start of project)

See Balledux, Doornenbal, Fukkink, Spoelstra, van Verseveld & van Yperen (2017). Inclusie door interprofessionele 16

PACT.

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IPC sociogram Apeldoorn (start of project)

See Balledux, Doornenbal, Fukkink, Spoelstra, van Verseveld & van Yperen (2017). Inclusie door interprofessionele

PACT.

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Sociogram Middelburg pilot (end of project)

See Fukkink & Van Verseveld (submitted), Inclusive Early Childhood Education and Care: A Longitudinal Study into the Growth of Interprofessional Collaboration

Note. Red squares represent actors from child care, purple squares represent actors from primary schools; green squares represent actors from youth care; blue represents the manager of the ECEC (not sector-related);

Arrow indicates directional (→) or

(bi)directional path (↔) between professionals;

Core with selection of key figures is highlighted with circle.

Functions are indicated with numbers: 1 = Caregiver day-care; 2 = Caregiver afterschool care; 3 = Special educational needs

coordinator childcare; 4 = Manager of childcare centre; 5 = Primary school teacher; 6 =

Remedial teacher; 7 = Special educational needs coordinator school; 8 = Coordinator of the lower primary grades; 9 = Primary school director; 10 = Special education teacher; 11 = Special care coach; 12 = Parental coach; 13 = Upper school coordinator care and advisory team; 14 = Centre for Youth and Family staff member; 15 = Youth care staff member; 16 = Child protection staff member; 17 = Social nurse; 18 = Remedial educationalist; 19 = Youth health care staff member; 20 = Social worker; 21 = Director of special education school; 12, 13 and 14 were not included in this ECEC team.

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Effective & efficient structure in community service ECEC

Example from PACT project:

Middelburg (end of project) Core-periphery structure

https://en.wikipedia.org/wiki/Core%E2%80%93periphery_structure

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SOME CONCLUSIONS PACT PROJECT

Network  participant-governed networks

 with modest level of density: about 15% of all possible ties

 With relatively small distances: maximum distance (diameter) is <4 persons

 reciprocated dyadic relationships: ≈ 80% ”two-way relationships”

 With outdegree centrality: ≈ average .50

 Close collaboration between professionals from different sectors (‘care axis’) with relatively high IIC levels

For example: close collaboration between

Special educational needs coordinator from childcare &

Special educational needs coordinator from primary school &

Remedial educationalist from youthcare

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ONGOING RESEARCH:

FIRST REPORT ON REVIEW OF SCIENTIFIC STUDIES INTO INTERPROFESSIONAL COLLABORATION

IN EARLY CHILDHOOD EDUCATION AND CARE

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CATEGORIES OF BARRIERS/FACILITATORS IPC

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Your personal IPC experience Roles

Power

Communication

Professional development

Other

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SOME EVIDENCE-BASED MECHANISMS

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Negative mechanisms Positive mechanisms

Lack of trust, negativity Trust, positivity

Lack of support Adequate support

Lack of leadership Leadership

Low levels professional development / IPC skills High levels of PD / IPC Different opinions about professional role Agreement about professional role Ambiguity about roles/tasks: Who Clarity about roles/tasks: Who Ambiguity about roles/tasks: What Clarity about roles/tasks: What

Lack of job autonomy Job autonomy

Job demands high, resources: Low Job demands OK, resources: adequate

Job stress high Job stress adequate

Interprofessional education (IPE) : low/none Interprofessional education (IPE): adequate

Lack of communication Communication: adequate

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ROLE AMBIGUITY/DEFERRAL/DISCREPANCY

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‘Social workers indicated a desire for greater clarity in their roles.’

‘Role ambiguity is indeed a grand challenge for social workers.’

Bolin, Rueda, & Linton (2017)

to minimize professional role discrepancy and to foster the development of positive interprofessional relationships Agresta (2006)

unrealistic expectations and perceptions of the other professional grouping and its facilities to support children Timonen-Kallio et al. (2017)

mental health practitioners’ attitude in collaboration focuses slightly on delivering psychiatric

knowledge and expertise into residential child care work rather than sharing professional responsibility

Timonen-Kallio et al. (2017)

Transdisciplinary team building through role release and collaboration Stepans et al. (2007)

‘boundary crossing’: Social workers can act as mediators and consultants “on the borders” between two systems Timonen-Kallio, Juha Hämäläinen & Eila Laukkanen (2017)

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POWER DISCREPANCY & STATUS

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‘Individuals’ perceptions of greater power disparity were correlated with lower ratings of interprofessional collaboration’

Cole (2018)

‘When asked whether there was a hierarchy in the SART, a small number of participants referred to professionals devaluing the contributions of volunteer advocates’

Cole (2018)

‘The code of status included comments around high-status jobs and

lower-status jobs. In particular , the difficulties of having a high status

within a when team members appeared to value someone’s expertise

over their own’

Rose (2011)

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COMMUNICATION & RELATIONS

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‘It is becoming quite apparent that in terms of relationships with other professionals, one of the key areas of focus for the child and youth worker discipline is communication and reporting skills’

Gharabaghi (2008)

‘Communication between professionals is also a prominent factor that impacted collaboration’ Weglarz- Ward (2016)

‘Ineffective communication strategies hinders collaboration among professionals’ Weglarz-Ward (2016)

‘communication between different child protection agencies is essential for collaborative practice but often difficult to navigate’ O’Reilly (2011)

‘Time to build a culture of trust in transdisciplinary consultation is a “behind the scene” activity that organisations may be reluctant to fund outside of consumer-paid direct service provision time’ ^Evans

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‘Develop formal and informal relationships between agencies and across service systemsMorland et al. (2005)

conflict resolution skills’Cole (2018)

‘conflict between professional cultures, reinforcing an ‘us and them’ culture … bureaucracy was in effect a catalyst for conflict’Simpson et al. (2017⁾

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PROFESSIONAL DEVELOPMENT

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‘showcase specific collaboration strategies to implement in order to improve service delivery’

He & Phillips (2017)

‘importance of providing interdisciplinary training’

Bressem et al. (2016)

‘good supervision, adequate time for preparation’

Banach & Couse (2012)

‘blend of formal and experiential knowledge in relation to

interprofessional practice’

Hood et al. (2016)

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OTHER: SELECTION OF THEMES

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co-location of staff He & Phillips (2017)

everyone in the same region, who also works with children, is so familiar with the professional, that they will not hesitate to call when they suspect maltreatment Visscher & van Stel (2017)

participation of data managers and medical informaticians is also of critical importance Gilbert & Downs (2015)

… and coordination of services has played a vital role in the health promotion, health protection, and disease prevention in this group of socially complex and vulnerable children Katz et al. (2007)

Desirable horizontal and less desirable vertical task transfer elements ^Evans

(2017)

to communicate the limits of their service provision to prospective service users Evans (2017)

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SELECTION OF REFERENCES: IPC IN ECEC CONTEXT

29 Bollin, S. J., Rueda, H. A., Linton, K. F. (2017). Grand challenges in school social work: Collaboration and constraint in school social workers’ sexuality support for children with disabilities. Children & Schools, 40, 25-33. doi:10.1093/cs/cdx027

Bronnstein, L. R. (2002). Index of interdisciplinary collaboration. Social Work Research, 26(2), 113-126. doi:10.1093/swr/26.2.113

Cashman, S. B., Reidy, P., Cody, K., & Lemay, C. A. (2004). Developing and measuring progress toward collaborative, integrated, interdisciplinary health care teams. Journal of Interprofessional Care, 18, 183-196. doi:10.1080/13561820410001686936

Cole, J. (2018). Structural, organizational,  and interpersonal factors influencing interprofessional collaboration on sexual assault response teams. Journal of Interpersonal Violence, 33, 2682-2703. doi:10.1177/0886260516628809

Curran, T., Olver, B., & Benjamin, C. (2014). A critical analysis of workforce development research use in the transformation of children's services. Journal of Social Work, 14(4), 360-379. doi:10.1177/1468017313477977

Daly, A. J. (2015). Refocusing the lens: Educational research in an era of relationships. Journal of Educational Administration, 53(1). doi:10.1017/CBO9781107415324.004 European Commission/EACEA/Eurydice/Eurostat (2014). Key Data on Early Childhood Education and Care in Europe. Luxembourg: Publications Office of the European Union.

Retrieved from http://eacea.ec.europa.eu/education/eurydice.

Forbes, J., & Watson, C. (2012). The Transformation of Children’s Services: Examining and debating the complexities of interprofessional working. London, UK: Routledge.

Gharabaghi, K. (2008). Relationships within and outside of the discipline of child and youth care. Child & Youth Services, 30, 235-255. doi:10.1080/01459350903107376 Institute of Medicine (IOM) and National Research Council (NRC) (2015). Transforming the workforce for children birth through age 8: A unifying foundation. Washington, DC: The National Academies Press.

Littlechild, B., & Smith, R. (2012). A Handbook for Interprofessional Practice in the Human Services. Harlow, UK: Pearson.

Nores, M., & Fernandez, C. (2018). Building capacity in health and education systems to deliver interventions that strengthen early child development. Annals of New York Academy of Sciences, 1419(1), 53-73. doi:10.1111/nyas.13682

Nurius, P., Coffey, D., Fong, R., Korr, W., & McRoy, R. (2017). Preparing professional degree students to tackle grand challenges: A framework for aligning social work curricula.

Journal of the Society for Social Work Research, 8(1), 99–118.

Rose, J. (2011). Dilemmas of inter-professional collaboration: Can they be resolved? Children & Society, 25, 151-163. doi:10.1111/j.1099-0860.2009.00268.x Saint-Pierrea, C., Herskovic, V., & Sepulveda, M. (2018). Multidisciplinary collaboration in primary care: A systematic review. Family Practice, 35(2), 132-141.

doi:10.1093/fampra/cmx085

Schoyerer, G., & van Santen, E. (2016). Early childhood education and care in a context of social heterogeneity and inequality; Empirical notes on an interdisciplinary challenge.

Early Years, 36(1), 51-65. doi:10.1080/09575146.2015.1075966

Sloper, P. (2004). Facilitators and barriers for co-ordinated multi-agency services. Child: Care, Health & Development, 30(6), 571-580. doi: 10.1111/j.1365-2214.2004.00468.x Weglarz-Ward, J. M., (2016). Project collaborative care: Experiences of child care and early intervention providers. Dissertation.

Xyrichis, A., & Lowton, K. (2008). What fosters or prevents interprofessional teamworking in primary and community care? A literature review. International Journal of Nursing Studies, 45, 140–153. doi:10.1016/j.ijnurstu.2007.01.015

See also https://www.researchgate.net/profile/Ruben_Fukkink

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