LAUSR

Over the last decade, the Triple Aim of improving population health, enhancing the patient experience, and reducing per capita cost has been an organizing framework in healthcare (Berwick et al., 2008). To achieve the Triple Aim, better interprofessional practice, defined as when health-care practitioners from two or more professions collaborate to improve health outcomes, has been identified as one of the key strategies (Earnest & Brandt, 2014; Friese, Lake, Aiken, Silber, & Sochalski, 2008; Gittell et al., 2000; Havens, Vasey, Gittell, & Lin, 2010; World Health Organization, 2010). Meanwhile, as practitioners have sought to achieve the Triple Aim, burnout and dissatisfaction among health-care practitioners have been increasingly recognized as a threat to these goals (Bodenheimer, 2014; Sikka, Morath, & Leape, 2015). Physician burnout, in particular, has been spotlighted (Shanafelt et al., 2015), including its possible link to high rates of physician suicide (Center et al., 2003). As a result, practitioner wellbeing has been suggested as an addition to the Triple Aim, creating the Quadruple Aim (Bodenheimer, 2014; Sikka et al., 2015). Better interprofessional practice has also been identified here as a possible solution (Smith et al., 2018). However, demonstrating an impact on health outcomes and the Triple Aim from interventions that increase or enhance interprofessional practice has been challenging (Reeves, Pelone, Harrison, Goldman, & Zwarenstein, 2017). Health outcomes are shaped by many interwoven factors and the impact of these factors or any intervention – interprofessional or otherwise – may take years to manifest (Schroeder, 2007). In contrast, if practitioner wellbeing is an important antecedent for health outcomes, it may be more amenable to interprofessional interventions and an improvement may be easier to detect. To examine practitioner wellbeing as an interprofessional construct, we explore some of the literature correlating interprofessional interactions and practitioner wellbeing. Then, we describe findings from the intensive care unit that compare and contrast the causes of practitioner distress by profession and how those findingsmay inform future work.We conclude by recommending three future directions: 1) incorporating interprofessional interactions as fundamental to practitioner wellbeing, 2) defining the appropriate unit of study for wellbeing research as the interprofessional unit, and 3) emphasizing the necessity for multi-pronged interventions to enhance interprofessional relationships in concert with refining our understanding of these concepts. Practitioner wellbeing as an interprofessional outcome