NURS 732 Week 1 Discussion Board Forum 1 on the Advanced Practice Nurse in Interprofessional Teams Example

Discussion Board Forum 1: The APN on the Interprofessional Team

NURS 732 Interprofessional Collaboration and Outcomes Management for Quality in Health Care, Discussion Board Forum 1

Thread by [Student Name]

The clinic, its team and the classmates replied to are composites written for a model discussion.

In our safety-net clinic, 58% of adults with hypertension had their blood pressure controlled below 140/90 at their last visit in the most recent reporting year. I practice there as a family nurse practitioner; the federally qualified health center serves about 9,000 patients, many uninsured or on Medicaid, and the control rate had been flat for three years. Last spring our medical director asked a group of us to form a hypertension team: two medical assistants, two registered nurses, our clinical pharmacist, a community health worker, two physicians and two nurse practitioners, including me. In the first meeting, several people looked at the providers as though we would tell them what to do. I have come to believe that my most useful role on that team is not captain but coach and connector.

Sollecito and Johnson (2013) describe continuous quality improvement as a philosophy in which processes, not individuals, are the main source of variation in quality, and in which the people who do the work are the ones best placed to improve it. If that is true, then the medical assistant who rooms patients knows more about our blood pressure measurement process than I do, and my job is to help her see that knowledge as valuable and to connect it to the pharmacist's knowledge of medication adherence and the community health worker's knowledge of why patients miss visits.

The Interprofessional Education Collaborative (2023) describes four core competencies for collaborative practice, and each showed up, or failed to, in our first months. Values and ethics: we agreed that the patient's goals, not our control rate, would guide our decisions, which mattered when a patient chose not to add a third medication and the team supported home monitoring and diet changes instead. Roles and responsibilities: we discovered that no one owned follow-up for patients with a high reading, so we assigned it to the registered nurses. Communication: our medical assistants had been reluctant to report problems with the cuffs because they assumed providers already knew; when one finally mentioned that two of our six cuffs were the wrong size for many of our patients, we replaced them within a week. Teams and teamwork: we had to learn to run a meeting in which a medical assistant's observation carried as much weight as a physician's. A team becomes interprofessional when the person with the least formal authority can change the process, not when every profession has a seat.

Evidence supports the value of this kind of team. A 2026 synthesis of 12 systematic reviews of team-based hypertension care in primary care found that, regardless of team composition, most reviews showed improvements in blood pressure and other outcomes, and that a greater number of team components was associated with better outcomes, although the optimal model remains unclear (Halcomb et al., 2026). For our clinic, that suggests the benefit comes not from one profession leading but from several contributing. In practice, my coaching role means asking questions in meetings more than answering them, sharing the monthly control data with everyone rather than only with providers, and making sure that when a change works, the person who proposed it is named.

Paul reminded the Corinthians that the parts of the body that seem weaker are indispensable, and that God arranged the members so that each cares for the others (English Standard Version Bible, 2001/2016, 1 Corinthians 12:22-25). A quality improvement team works the same way. My role as a nurse practitioner is to make sure the hand's contribution is seen.

Reply to Renee

Renee, you described your clinic's plan to start a nurse-led telehealth program for patients with uncontrolled blood pressure, and you sounded confident that the technology would carry it. A recent evaluation suggests the team will matter as much as the technology. In a mixed-methods study of a team-based telehealth hypertension program in two safety-net clinics, patients and clinic staff identified staffing barriers and the need for coordinated teamwork as a major theme, alongside the program's patient-centeredness, the ease of home monitoring, personalized self-management calls and social support (Chhetri et al., 2026). The program depended on people as much as devices. In IPEC terms, your team will need clear roles for who reviews home readings, who calls patients and who adjusts medications, and a way to communicate when a reading is dangerous (Interprofessional Education Collaborative, 2023). Sollecito and Johnson (2013) would add that you should map that process before launch, since gaps between roles are where improvement efforts often fail. Who on your team will own the readings that arrive on a Friday afternoon?

Reply to Victor

Victor, your point that your clinic's blood pressure numbers might be wrong rather than your patients' blood pressure was a good one. Measurement is part of the process. At one academic medical center, a department-wide improvement effort across 61 clinics aimed to repeat the blood pressure whenever the first reading was 140/90 or higher; the repeat rate rose from a mean of 41% to 61%, and the control rate rose from 74% to 78% (Murphy et al., 2026). When the reading was repeated, a median of 38% of encounters were reclassified from uncontrolled to controlled, which suggests that a large share of apparently uncontrolled patients simply had a high first reading. The authors noted that control was already improving before their interventions began, so not all of the gain can be attributed to them. Still, a repeat-measurement step is something medical assistants can own, which fits the IPEC emphasis on roles. Has your clinic looked at how often high readings are repeated now?

References

Chhetri, S., Manandhar, S., Seals, A. L., Kramer, J., & Pokharel, Y. (2026). Determinants of successful implementation: A mixed-methods evaluation of a team-based telehealth hypertension management program for underserved patients. Journal of the American Heart Association, 15(10), Article e047236. https://doi.org/10.1161/JAHA.125.047236

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Halcomb, E., Kuzmins, K., de Tourettes, E., & Stephen, C. (2026). Team-based hypertension management in primary care: A synthesis of systematic reviews. Heart, Lung and Circulation. Advance online publication. https://doi.org/10.1016/j.hlc.2026.05.020

Interprofessional Education Collaborative. (2023). IPEC core competencies for interprofessional collaborative practice: Version 3. Interprofessional Education Collaborative.

Murphy, K., Hood, C. J., Dirisala, K., Voit, J., Vigen, R., Bowen, M. E., & Bajaj, P. (2026). Impact of a centralized quality improvement initiative on repeat blood pressure measurement at an academic medical center. The Joint Commission Journal on Quality and Patient Safety. Advance online publication. https://doi.org/10.1016/j.jcjq.2026.08.008

Sollecito, W. A., & Johnson, J. K. (Eds.). (2013). McLaughlin and Kaluzny's continuous quality improvement in health care (4th ed.). Jones & Bartlett Learning.