Interprofessional Education for Collaboration Learning How to Improve Health from Interprofessional Models Across the Continuum of Education to Practice: Workshop Summary (2013) / Chapter Skim
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5 Interprofessional Education Within the Health System
5 Interprofessional Education Within the Health System
Pages 55-74
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From page 55... ...
Following this description, there is a discussion of impor tant health care issues involving workforce development and the expansion of the ethnic and cultural diversity of health providers and workers through IPE. The chapter closes with a discussion on the effective use of funds in IPE and in health care to lower costs while improving the value and the quality of care for patients and their caretakers, who are at the center of the health care system.
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From page 56... ...
This networked system of education and practice was the focus of many presenters at the workshop. One such presenter was Kathryn Rugen from the VA, who reported that the goal of the VA's centers of excellence in primary care education is to develop and test innovative structural and curriculum models that foster the transformation of health care training from the professional silos to interprofessional team-based education and clinical care delivery.
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From page 57... ...
The core requirements for these centers include co-direction by a physician and a nurse practitioner; joint sponsorship and engagement with academic affiliates; integrated, interprofessional teams in the workplace; and a commitment from trainees that 30 percent of their academic clinical training will be at the centers of excellence. Rugen provided the following list of primary learners: • Physician resident trainees: internal medicine PGY 1, 2, 3, chief resident; family medicine PGY1; psychiatry • Nurse practitioner trainees: pre-master's, pre-doctorate of nursing practice, post-master's fellows • Postdoctorate pharmacy residents • Postdoctorate psychology fellows and psychology interns Besides these primary learners, there is also some engagement from the social work and nutrition areas, bachelor's degree nursing students, medical students, podiatry, and physician assistants.
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From page 58... ...
• Learner Perception Survey– Primary Care • PACT continuity encounter Interprofessional collaboration Care is team-based, efficient, and • University of Toronto Centre • Longitudinal semi-structured coordinated; curricula focus on for IPE interviews developing trustful, collaborative • Huddle-Coaching Program • Team Development Measure relationships. • Readiness for Interprofessional Learning Scale Performance improvement Care is designed to optimize the • Curriculum of Inquiry • Clinical outcomes health of populations; curricula • Panel Management • Quality Improvement Knowledge focus on using the methodology • All sites looking at emergency Application Tool (QIKAT)
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From page 59... ...
The advantages to using this method, she said, are that it provides very specific and measurable learning objectives to work with, it integrates profession-specific skills with interprofessional learning so that students do not see a divide between what they need to know and how they need to deliver that care, and it establishes IPE as a core element of the clinical and clerkship experiences of students. Although both UVA and the VA provide good examples of the continuum between education and practice, workshop speaker Dennis Helling from Kaiser Permanente Colorado Region drew the audience's attention to the second workshop objective: "identify and examine academic/practice partnerships that demonstrate purposeful modeling to advance team-based education and collaborative practice." After reading this objective, Helling said, "I think that statement and objective makes a huge assumption that there are critical numbers and access by universities to high-performing, interprofessional teams delivering interprofessional health care." But, he said, that is not always the case.
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From page 60... ...
It was then that Helling made a personal career decision to, as he said, "walk the talk." IPE for Workforce Development Sarita Verma and Maria Tassone are co-leads of the Canadian Interprofessional Health Leadership Collaborative, which is described in Appendix C They explained the origins of IPE in Canada, which was engineered specifically to meet the health care needs of Canada.
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From page 61... ...
Helling spoke with representatives from both of these universities to consider what an ideal rotation or advanced practice experience would look like. Based on these discussions, Helling determined that, ideally, the IPE experiences would increase the students' self-directed learning, their independence, and their self-confidence.
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From page 62... ...
Tassone also commented on another important piece of work involving an organization that was funded and promoted by Health Canada, the Canadian Interprofessional Health Collaborative. This is a voluntary organization with a very small secretariat that provides Canadians with an opportunity to collect and distill some of the local examples and IPE innovations across Canada while also looking at work that is happening beyond the Canadian borders.
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From page 63... ...
Once these competencies are identified, Zodpey said, his collaborative plans to develop and pilot an interprofessional training model for physicians, nurses, and public health professionals to develop the leadership skills relevant to the 21st-century health systems in India. In Uganda, workshop speaker and Innovation Collaborative lead Nelson Sewankambo worked with colleagues to introduce IPE in 2001 because there was a shortage of teachers and health workers in the country.
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From page 64... ...
Her suggestions were to "create those teams, make them work, but protect them and create these boundaries around them so they are preserved, so they can function, and do as they're supposed to do, while at the same time we figure out about this bigger picture, big industrial health care issues that I think we're all facing." Collaborative Practices for IPE Experiences The presentation by Dennis Helling led Forum and planning committee member George Thibault to ask whether some health professions other than pharmacy might take advantage of the strong collaborative environment set
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From page 65... ...
How, she asked, might IPE be part of population and community health in a way that could integrate health and wellness with community-based social support services? Barclay talked about the difference it would make to students' educational experiences if they were exposed to interprofessional care coordination in community settings that intersect with primary care.
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From page 66... ...
, also known as advanced primary care practices. Jones described the National Committee for Quality Assurance's established standards and criteria for practices seeking to become patient-centered medical homes and the Blueprint for Health's role in developing a formal method of helping practices in Vermont prepare to be scored Having funded some of this work when she was at the W.K.
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From page 67... ...
For example, when Jack Geiger was working in rural Mississippi in the 1960s, he saw the built environment as a contributor to poor patient outcomes, so he created an IPP that involved those sectors in the built environment that could help improve nutrition. Aetna Foundation is funding some of the evaluation measures within this unique IPP to see how the farmers and farmers markets, physicians, managers, and chief executive officers of these community health centers develop an inter
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From page 68... ...
health care spending curve (see Figure 5-2) , small-group leader Thomas Feeley of the MD Anderson Cancer Center pointed out that U.S.
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From page 69... ...
De Maeseneer and Feeley suggested reframing the discussion in terms of improving the "value" of health care. In this way, there is a balance between costs and outcomes, so an ideal health care system improves value when it improves outcomes without increasing cost.
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From page 70... ...
. At the close of his presentation, Grundy strongly encouraged educators to expose health professions students to cost-effective, collaborative care models like the PCMHs so that job applicants will be ready to begin work as a team and will not require 3 to 4 years of retraining to get them to become effective collaborators and team members.
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From page 71... ...
Financial support and time are very real issues when delivering large numbers of advanced practice experiences said Helling. In his report back to the participants about the breakout group discussions he had led on lower cost, Thomas Feeley talked about the "value proposition" in health care.
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From page 72... ...
Quality is a responsibility that needs to be "shared" among all health workers, regardless of the remuneration provided for accomplishing the task. Adding to the human resources comments, Feeley asked how people other than health professionals, such as patients, caregivers, volunteers, aides, and clerks, can be included in the conversations about what is needed to provide high-quality, lower-cost health and health care.
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From page 73... ...
• IPE could be part of a population and community health sys tem that could integrate health and wellness with community based social support services. (Barclay and Feeley)
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