JCPSLP Vol 20 No 2 July 2018

Clinical implications The ability to effectively collaborate with other professions and work within a transdisciplinary model may become increasingly important with recent changes in health funding in Australia, particularly with the introduction of the National Disability Insurance Scheme (NDIS). Through the NDIS, health professionals working with clients with a disability, including those who are D/HH, will be required to implement a practice model similar to transdisciplinary practice involving a primary service provider (Moore, 2013). An understanding of factors that contribute to effective interprofessional collaboration, barriers that are common and specific to particular clinical contexts, and the needs of different professions is essential in order to remain responsive and effective within an ever-changing service landscape. Limitations and future research This study was a small-scale study involving survey methdology. An inherent limitation of survey research is the risk of low numbers of respondents, as was experienced in this study. Consequently, results were analysed using descriptive statistics. Caution must therefore be exercised when interpreting and applying these findings as they may not be representative of the experiences of SLPs and audiologists in all contexts involving deaf or hard of hearing clients. The sample obtained in this study was essentially a convenience sample and as such there is no way to know whether differences exist between participants who chose to respond to the survey and those who did not. In addition to an overall small number of participants, there was also a lower response rate for the audiologists as compared to the speech-language pathologists. This may have affected the ability to make comparisons between the groups and draw conclusions about professional similarities and differences. Furthermore, this study did not differentiate between SLPs and audiologists who worked together within the same organisation or between those who collaborated across institutions. As a result, data could not demonstrate how intra-institution or inter-institution communication influenced the perceived value or effectiveness of IPC. Future research involving larger numbers of participants and inductive qualitative data collection and analysis methods would be beneficial to answer such questions. Conclusion This study provided preliminary data regarding the views of Australian SLPs and audiologists on IPC. It was generally reported that IPC was beneficial for the client and the clinician; however, there were several barriers to implementation within actual clinical contexts including difficulty following profession specified best-practice guidelines for communication and teamwork. Communication was identified as a key factor influencing the success or otherwise of IPC. It was reported as both a facilitator when implemented well, and a barrier when utilised poorly. The type of communication professionals engaged seemed to differ based on the IPC practice model used; multidisciplinary, interdisciplinary or transdisciplinary, although further research to examine the nature of this relationship is required. Education and training about the role of other professions may help improve IPC as results of this study showed that knowledge and understanding of what other professions contribute to holistic client care is expected and highly valued within interprofessional

The results of this study highlighted that IPC may be influenced by the practice model implemented as both communication before an assessment and interprofessional case discussions throughout service delivery were higher for clinicians working within a transdisciplinary model. This suggests that the transdisciplinary practice model may facilitate engagement and collaboration with other professions. However, the majority of responses for open-ended questions (including client and clinician benefits of IPC) did not vary based on the practice model implemented. Further research with a larger sample is required to determine if this is a true reflection of the effects of IPC. Both Speech Pathology Australia and Audiology Australia in their respective professional guidelines espouse effective teamwork and collaboration as a means of enhancing the efficiency of service provision and in some cases reducing the time the client spends with a number of different health professionals (Speech Pathology Australia, 2007). The findings of this study indicate that while both speech-language pathologists and audiologists recognise the value of IPC for streamlining client care, they are ambivalent about whether interprofessional collaboration does in fact reduce client contact with health services. This is but one example of a number of possible issues that influence translation of clinical recommendations into practice. Another example arising from this study relates to communication assessment. Audiology Australia (2013) states that an audiological assessment should include examination of communication skills; a core component of an SLP’s range of practice (Speech Pathology Australia, 2015). It would be reasonable to assume that this would be logical and necessary area of interprofessional collaboration between speech-language pathologists and audiologists. However, in this study only a small percentage of audiologists contacted the client’s SLP prior to their assessment. Similarly, only 17.4% of SLPs “always” contacted the audiologist after an assessment. This does not correspond with best practice assertions that assessments should involve the collection of information regarding the client’s involvement with other health professionals (Speech Pathology Australia, 2013). Further exploration of why these collaborations do not routinely occur would assist both professions to remedy this oversight. The results of this study identified perceived facilitators, barriers, and strategies to improve IPC in the Australian context. Consistent with previous research, facilitators of IPC identified in this study included good communication, clinician knowledge of the other profession, time, and common client goals. These factors were reitereated by participants in their open-ended responses, with particular emphasis on the importance of utilising a family-centred approach to work on common goals. Conversely, the barriers to IPC were identified as poor communication, lack of knowledge, time, and poor professional attitudes. These barriers have the potential to negatively impact client experience and outcomes, particularly if the professionals involved in their care have limited understanding of the holistic and interrelated nature of their needs. Strategies to improve IPC included increased utilisation of communication options, increased training for both professions, more time, and improved service provision regarding opportunities for joint sessions (e.g., co-location services).

87

JCPSLP Volume 20, Number 2 2018

www.speechpathologyaustralia.org.au