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If You Want to Go Far, Go Together: Collaboration as an Essential Component of EBP

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Healthcare professionals are first called to do no harm. We also have an inherent obligation to act in our patients’ best interests, which compels us to continuously evaluate, enhance, and re-evaluate our systems of care to ensure we do the best we can, as often as we can, for every baby we can. This is the foundation of evidence-based practice (EBP). “We learned more, and then we did better.”  

As clinical practice evolves, we aim to integrate and sustain change. Each discipline contributes unique expertise to EBP, and maximizing these strengths requires ongoing collaboration across all aspects of care. The World Health Organization (WHO) has used the term Interprofessional Collaborative Practice (IPCP) to describe what could be regarded as an ideal state: collective willingness to teach and learn from one another as experts in respective fields, with the overarching goal of providing the highest quality care (1,2). One might say that participation in IPCP occurs through conscious behavior, rather than occurring without effort.

Interprofessional Collaborative Practice (IPCP) Improves Outcomes

Interprofessional collaboration benefits patients and care systems. Examples of successful IPCP are evident across available scientific literature, including: 

  • Complex case reports, such as care of conjoined twins (3) 
  • Studies describing outcomes from population-specific patient care teams, such as Small Baby or Bronchopulmonary Dysplasia Units (4,5)
  • Harm-reduction project teams, such as those targeting Hospital-Acquired Pressure Injuries6 and Central Line-Associated Blood Stream Infections (7)

IPCP Facilitates Change

Managing and sustaining large-scale clinical practice improvements is complex and time-consuming. Education of front-line providers is essential to driving successful change.  IPCP should be a cornerstone of clinical education from the outset, engaging multiple clinical disciplines in its design and execution.

Developmental care and positioning are subject to continuous improvement as new research emerges. Neonatal Therapists and Neonatal Nurses are instrumental in driving such changes, and collaboration between these two disciplines is as essential as the changes themselves. Each discipline brings a unique set of knowledge and skills that work synergistically to address the needs of babies and their clinical teams. 

Engaging frontline Neonatal Therapists and Neonatal Nurses in partnership as subject matter experts is an effective way to share essential knowledge about new products and practices at the point of care. Bedside education through peer-to-peer trainers, or “Super Users,” makes training more accessible at the start of a change initiative and supports timely, just-in-time troubleshooting as needs arise. This model strengthens both Super Users and frontline clinicians, fostering autonomy and improving satisfaction with EBP initiatives.

IPCP Improves Workplace Safety Culture 

Collaboration is an integral part of unit teamwork and promoting a culture of safety. The Safety Attitudes Questionnaire (SAQ) provides a reliable and meaningful way to measure perceptions and attitudes of healthcare providers relevant to healthcare safety. Collaboration is assessed through subjective metrics, including how easy it is to speak up, how well disciplines work together, and how disagreements are handled at the point of care. Higher scores on the SAQ indicate a stronger culture of safety. (8)  

Notably, a 2020 study also showed that high scores on certain SAQ metrics were correlated with lower rates of infection in NICUs. Interestingly, the inverse correlation was also true— lower scores on certain SAQ metrics tended to be present in NICUs with higher infection rates.9 

A Powerful Tool

IPCP supports EBP integration by engaging interprofessional teams in EBP-focused education, improving the quality and sustainability of practice and product changes. Collaborative teams are more likely to speak up, ask questions, seek feedback, and improve care.

References

  1. Gilbert JH, Yan J, Hoffman SJ. A WHO report: framework for action on interprofessional education and collaborative practice. J Allied Health. 2010 Fall;39 Suppl 1:196-7. PMID: 21174039.
  2. Mohammed CA, Anand R, Saleena Ummer V. Interprofessional Education (IPE): A framework for introducing teamwork and collaboration in health professions curriculum. Med J Armed Forces India. 2021 Feb;77(Suppl 1):S16-S21. doi: 10.1016/j.mjafi.2021.01.012. Epub 2021 Feb 2. PMID: 33612927; PMCID: PMC7873741.
  3. Luton A, Estrada N, Barrientez K, McGinnis J, Pitlik J, Carter A, Davenport L, Davies J. Nursing considerations and interdisciplinary coordination in the care of conjoined twins. Semin Perinatol. 2018 Oct;42(6):340-349. doi: 10.1053/j.semperi.2018.07.012. Epub 2018 Jul 27. PMID: 30185382.
  4. Fathi O, Nelin LD, Shepherd EG, Reber KM. Development of a small baby unit to improve outcomes for the extremely premature infant. J Perinatol. 2022 Feb;42(2):157-164. doi: 10.1038/s41372-021-00984-0. Epub 2021 Mar 12. PMID: 33712714; PMCID: PMC7952830.
  5. Kielt MJ, Sanlorenzo LA. Interdisciplinary collaboration and innovation in established bronchopulmonary dysplasia. Semin Perinatol. 2025 Sep 18:152148. doi: 10.1016/j.semperi.2025.152148. Epub ahead of print. PMID: 40973563.
  6. Moyer LB, Lauderbaugh DL, Worten K, Carter C, Holub P, Santos Manrique RA, Bergman JH, Dilloway MA, Hamid M, Glenn L. High-stage Device-related Pressure Injury Reduction in a Neonatal Intensive Care Unit: A Quality Improvement Project. Pediatr Qual Saf. 2022 Jun 14;7(3):e554. doi: 10.1097/pq9.0000000000000554. PMID: 35720865; PMCID: PMC9197377.
  7. Linam M, Wannemacher L, Hawthorne A, Calamaro C, Spafford P, Walson K. Initiation of interdisciplinary prevention rounds: decreasing CLABSIs in critically ill children. Antimicrob Steward Healthc Epidemiol. 2024 May 8;4(1):e80. doi: 10.1017/ash.2024.55. PMID: 38721488; PMCID: PMC11077607.
  8. Sexton JB, Helmreich RL, Neilands TB, Rowan K, Vella K, Boyden J, Roberts PR, Thomas EJ. The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research. BMC Health Serv Res. 2006 Apr 3;6:44. doi: 10.1186/1472-6963-6-44. PMID: 16584553; PMCID: PMC1481614.
  9. Profit J, Sharek PJ, Cui X, Nisbet CC, Thomas EJ, Tawfik DS, Lee HC, Draper D, Sexton JB. The Correlation Between Neonatal Intensive Care Unit Safety Culture and Quality of Care. J Patient Saf. 2020 Dec;16(4):e310-e316. doi: 10.1097/PTS.0000000000000546. PMID: 30407963; PMCID: PMC6504623.
  10. Aljawad B, Miraj SA, Alameri F, Alzayer H. Family-centered care in neonatal and pediatric critical care units: a scoping review of interventions, barriers, and facilitators. BMC Pediatr. 2025 Apr 14;25(1):291. doi: 10.1186/s12887-025-05620-w. PMID: 40223058; PMCID: PMC11995472.