As the healthcare landscape in Ontario continues to move towards a more integrated system, interprofessional collaboration (IPC) has become increasingly vital to delivering high-quality, person-centred care. This is especially important in home healthcare where providers often work independently. In support of this need, researchers and clinical leaders at VHA Home HealthCare (VHA) developed the Interprofessional Collaboration Competency (IPCC) Framework. The framework offers a clear model for others in the sector that highlights what is required for care providers to work effectively together.

What is Interprofessional Collaboration?

Interprofessional collaboration occurs when healthcare professionals from different disciplines work together, along with clients, families, and communities, to deliver high quality care. Effective collaboration requires clear, efficient communication between healthcare providers as they care for shared clients. Without this collaboration, clients and families are burdened with the task of sharing medical information multiple times with different providers. This increases the risk of errors, reduces chances for providers to clarify or follow up, and adds extra stress to the client or caregiver.

In Ontario, publicly funded home healthcare is coordinated by a provincial agency that contracts services to multiple organizations. As a result, clients may receive care from providers who do not work in the same regions, have different schedules, and may also have limited time for indirect care. While IPC frameworks exist for the hospital and primary care sectors, the unique structure of home healthcare can benefit from a more tailored approach. VHA’s IPCC Framework was developed through a collaborative cross-departmental quality improvement initiative grounded in published research and with input from a wide range of stakeholders including clients, point-of-care providers, and clinical leaders.

Framework and Development

The VHA IPCC Framework was created as part of the “One Team Project”, which was aimed at improving client and service provider experiences through greater interprofessional collaboration. , and engaged office staff and service providers from across the organization in a participatory co-design process.

Between July 2022 and August 2023, the team followed a five-step process:

Step 1: Rapid Literature Review

The team began by reviewing the existing literature on alternative models and relevant competencies and frameworks. Their findings provided the evidence for the next steps and identified two relevant models from the local context.

Step 2: “Design Day”

A full-day co-design session engaged 94 stakeholders, including clients, PSWs, nurses, allied health professionals, leaders, and administrative staff. Participants discussed values, competencies, and practices needed for effective IPC. Thirteen priority areas emerged, including team development, person-centred care, interdepartmental collaboration, role clarity, and communication.

Step 3: Iterative Development

The 12-member “Design Workstream” team refined the priorities into a draft framework through five virtual meetings. Using group discussion, ranking exercises, and reference to existing frameworks, they mapped key behaviours, skills, and structures needed at the individual, team, and organizational levels.

Step 4: Shareback Meetings

Drafts were shared with 60 clinical leaders and other stakeholders, as well as point-of-care providers and client partners, to test the framework’s clarity and relevance. Feedback led to the addition of four guiding principles.

Step 5: Final Refinement

The final framework was approved by project leaders and senior sponsors, with competencies and definitions polished for clarity.

The VHA IPCC Framework

At its centre, the framework places person-centred care as the core value.

Four guiding principles shape its application:

1. Creativity and Innovation: encouraging flexible, problem-solving approaches
2. Quintuple Aim improving patient experience, population health, provider well-being, equity, and reducing costs
3. Diversity, Equity, and Inclusion: ensuring all voices and perspectives are respected
4. Best Practice, Research, and Education: grounding decisions in evidence and continuous learning

Seven competencies define effective IPC in home healthcare:

1. Team Development and Empowerment: building trust, inclusion, and shared accountability; advocating for supports that enable collaboration.
2. Collaborative Decision-Making: ensuring care plans reflect the perspectives of the client, family, and all relevant team members supporting care.
3. Organizational Consistency: embedding IPC into policies, procedures, and organizational culture.
4. Collaborative Leadership: leaders modelling teamwork, addressing power imbalances, and fostering psychologically safe spaces.
5. Interprofessional Communication: ensuring a common understanding by engaging in reciprocal knowledge exchange, leveraging interprofessional/diverse perspectives, and using clear, timely, and respectful communication within and across teams, supported by appropriate processes and tools.
6. Interprofessional Conflict Resolution: applying proactive, ethical approaches to address disagreements constructively.
7. Role Clarity: understanding and respecting one’s own and others’ professional scopes/expertise, acknowledging role interdependencies to optimize each member’s scope within integrated models of care.

Each competency includes detailed expectations at the individual, team, and organizational levels.

Implementation Study

To prepare for organization-wide implementation of the IPCC Framework, clinical leaders were provided with comprehensive training and education. To assess practice readiness and identify barriers and enablers of framework implementation, these clinical leaders were surveyed immediately after the training to rate the expected ease of implementing each competency, using questions adapted from the Collaborative Practice Assessment Tool. Three months later, follow-up workshops gathered insights into teams’ existing capabilities, opportunities, and motivation for implementation.

Leaders indicated that they generally anticipated most competencies would be easy to integrate into team practice. The most challenging areas included ensuring organizational consistency and interprofessional conflict resolution, which often require structural or cultural change. The feedback also included these insights:

• Capabilities: Leaders described using the framework to build capacity within their point-of-care teams, applying competencies like collaborative leadership, interprofessional communication, and role clarity through regular team and leadership meetings where members shared learnings and providers from different professions discussed their roles.
• Opportunities: There were more opportunities to collaborate in integrated care models. The framework also validated many IPC clinical practices seen as innate and already built into clinical care.
• Barriers: Structural barriers were identified, including time limits for visits, working in different locations, limited funding for team meetings, staff , and potential coordination challenges when a client’s care is provided by multiple service provider organizations.
• Motivation: Motivation to work collaboratively was high, driven by recognition of IPC’s benefits for client outcomes and staff satisfaction. However, competing priorities and operational pressure could interfere.

The Future of Interprofessional Collaboration in Home Care

VHA is working to embed the IPCC Framework across its organizational culture and operations. Pilot projects are underway to test key change ideas such as integrated care models, interprofessional rounds, shared scheduling, and coordinated care plans, with a vision to scale and sustain across operations.

VHA’s IPCC framework offers homecare organizations a guide for strengthening collaboration at the individual, team, and organizational levels by defining seven key competencies. With healthcare reforms calling for interprofessional care models to support increasingly complex clients needing care at home, VHA’s IPCC framework can assist homecare organizations to develop and promote interprofessional collaborative care.

To learn more about how this framework was developed and what’s required to put it into practice, read the full peer-reviewed article here.