McMaster University

McMaster University

History of the Development and Use of the TOSCE Tool

Why is the TOSCE toolkit needed in the primary healthcare setting?

Studies suggest that interprofessional collaboration (IPC) improves team cohesion, patient safety, and may improve health care providers’ job satisfaction and the efficiency of health care delivery (Bower et al, 2003; Lemieux-Charles, 2006; Shortell et al, 2003).  However, most current health professionals have not received training in this area.  It has been difficult in interprofessional education (IPE) efforts to produce changes in behaviour that are integrated into the work force.  Literature suggests that IPE activities should be interactive, and involve no more than 8 individuals representing at least 4 professions, (Russell & Hymans, 1999).  They are intended to promote individual and team development as well as facilitate communication skills, problem solving abilities, and conflict resolution strategies (Anderson et al, 2006). 

Team effectiveness in interprofessional primary health care teams has also been shown to be associated with higher quality of care (Lemieux-Charles, 2006; Shortell et al, 2003).  The current interest in IPE, IPC and patient-centred practice has raised the challenge of defining the necessary competencies for effective teamwork across different care settings, how to teach them, and how these competencies, once taught can be evaluated.  Although tools exist to measure attitudes of health professionals in teams (e.g., Heinemann et al, 1999; Parsell & Bligh, 1999), there is a lack of rigorously designed standardized measures to assess team-based competencies (Suter et al, 2009).

A parallel challenge in Ontario is the recent formation of primary care Family Health Teams (FHTs) in which different professionals work together in family practice, often without specific training and skills in providing collaborative care.  It is a challenge for teams to optimize their mix of skills to provide safe effective patient care without a clear understanding of each profession’s roles and how to work collaboratively rather than in a consultative model.  Development and implementation of tools to promote collaborative interprofessional care is currently a priority for FHTs.

See Guide to Collaborative Team Practice.

"This is a fairly 'young' FHT with a developing allied health component - as time progresses I believe it will able to know how to utilize my teammates for effectively."
Quote from team participant
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