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North Star: Leading the Way Forward

Nurse Practitioners as Leaders in Interprofessional Practice

This is a season of promises made, promises kept, and of revisiting promises yet to be enacted.  There is the promise of rebirth signified by the holiday season. There are New Year’s resolutions as we strive to do better.  And it also a time to acknowledge what we do well and what we can build upon for the future.

Repeatedly over several months, I have heard, seen, read or spoken the phrase “North Star”.  Perhaps you have too.  Maybe it is the time of the year.  Witness the North Star shining brightly on a frigid, moonless winter night.  Find the North Star underscored by the aurora borealis and anchored by the Big Dipper in Amanda Lupes Ford’s compelling digital illustration above.  Read about it in Margaret Flinter’s Opening letter in the Consortium’s 2017 Annual Report: ”as we follow our ‘north star’ of believing healthcare is indeed a right, not a privilege” describing nurse practitioners unshakable focus on providing high quality healthcare.

Literally and figuratively, the North Star is associated with reliable navigation. In the northern hemisphere, the North Star has guided seafarers across unimaginable oceans, inspired songs and literature, and been the compass for ancient and current adventurers.  The North Star is only the 5th brightest star in the night sky, but it is the constant star in the night sky.  The earth spins on its axis, and the North Star stays steady.  It is an unerring guide for travelers.

With the winter solstice we look forward to daylight increasing by predictable increments.  Concurrent religious holidays symbolize rebirth.  On long winter nights, the North Star is visible for many hours, pointing the way forward.  The North Star is an anchor in a revolving sky.  Seeking the way forward, whether at a way-stop or the final destination, we look for markers and guidance.  Explorers of all kinds follow their North Star and lead the way forward. There is a North Star to guide activists, equally important North Stars guiding leaders, and essential North Stars guiding individuals on their life path.

In thinking about the North Star as a guiding light, a beacon to lead us forward, it occurred to me that the North Star is present in two guises: as a collective guiding vision and as a personal oracle. The collective North Star is visionary and inspirational on a grand scale.  Maybe a philosophy, a belief or a transformational leader that motivates groups to act, directly or indirectly causing changes that make a perceptible impact on a large scale.  Then there is the personal North Star; perhaps a book, a friend, a talent or a goal that by influencing individual life choices, ultimately creates a personal future.

Recently, I’ve also had multiple encounters with interprofessional practice, education and collaboration.  It has happened in a variety of unrelated settings – scholarly articles on accreditation, local community blogs, personal conversations, professional consultation, and in designing postgraduate training programs. The unexpected intersection of the manifestations of the North Star and frequent encounters with interprofessional practice has captured my attention and inspired me as I wrote this month’s blog.

Nurse practitioners and other health care professionals navigate the implementation of healthcare by adhering to the North Star of interprofessionalism.  As with the North Star, Nurse Practitioners may not be the biggest or most noticeable “star in the night sky”, but Nurse Practitioners are anchors in delivering interprofessional, evidence-based and high-quality care that is culturally sensitive.  Interprofessional care is a hallmark of their practice.  It’s a mandate to offer patient-centered, comprehensive care to the most vulnerable among us.  If you have a chance, do read Margaret’s letter mentioned in the opening of this post.  It is inspirational and captures past progress, current challenges, and future opportunities for nurse practitioners in delivering quality healthcare to all.  (Full disclosure: as indicated, Margaret is Chair of the Consortium’s Board.  In my role as the Executive Director, I report to the Board.  That notwithstanding, I hold to my assertion – truly, Margaret’s letter is inspiring!)

As I thought about the characteristics of transformational healthcare leaders from all professions that I’ve met across the country, it occurred to me that individually and as a group they are the singular and collective North Star for the future of healthcare and excellence in practice.  Each of them embodies the characteristic of successful Interprofessional practice – empathy, cultural intelligence, active listening, respect, collegiality, grace under pressure, and a commitment to serving the most vulnerable among us.  As a group, they are a powerful force for transformative change.

And now to link all this with accreditation…

The Quality Assurance Commons for Higher Education and Postsecondary Education is exploring innovative approaches to accreditation.  Paul Fain, of InsideHigherEd.com, authored a “Quick Take”: “Group Attempts New Twist on Accreditation”, describing one of the Quality Assurance Commons’ initiatives – understanding the drivers for accreditors to evaluate how programs address learners’ acquisition of interpersonal skills, which the authors called “employability skills”.  These employability skills are thought to be major contributors to the success of graduates from accredited training programs.

“Essential employment qualities the group will seek to gauge include:

  • People skills such as collaboration, teamwork and cross-cultural competence;
  • Problem-solving abilities such as inquiry, critical thinking and creativity;
  • Professional strengths such as communication, work ethic and technological agility”.

Exactly one week earlier, on Oct 2, the National Academies of Medicine published a discussion paper: The Role of Accreditation in Achieving the Quadruple Aim by Malcolm Cox, Ann Scott Blouin, Patricia Cuff, Miguel Paniagua, Susan Phillips, and Peter H. Vlasses. The article opens with this statement:

“Interprofessional education (IPE) and collaborative practice continue to gain momentum within the health sector. Recently, accreditors from multiple health professions have joined together to discuss their role and to set continuing education standards for IPE and guidance for interprofessional foundational education. And although models for IPE exist to guide the learning process from education to practice, there are few guides for the historic work of accreditors to promote interprofessional collaboration across education and practice.”

The North Star of interprofessional education and practice can be defined as ‘employability skills’ or as a caring, patient-centered, consistently collaborative approach to health care. Through rigorous accreditation we can promote high quality training of interprofessional education and practice. The Consortium’s accreditation standards explicitly require that a training program’s curriculum and evaluation have a systematic focus and clear documentation of a trainee’s observable interprofessional competence in patient care and in collegial interactions. The important message is the potential for a transformative impact on training, service, practice, and the discovery and application of knowledge.

Postgraduate training for fully qualified and credentialed novice nurse practitioners is already on the frontier of career development. As we consider life-long learning and career trajectories spanning decades, the implications and opportunities provided by interprofessional education and practice are breathtaking.  It is our challenge and our honor to embrace the possibilities as we continue to be on the cusp of innovative postgraduate training and career development.  Our future leaders of innovative, patient-centered, collaborative healthcare are depending on it.

Wishing everyone a healthy and rewarding New Year, filled with good tidings and good times!