Transcript PPT - The New York Academy of Medicine

Highlighting Geriatric Interprofessional Social Work Programs
Paul Gould, LCSW, PhD
Frances Wilby, LCSW, PhD
Visiting Assistant Professor,
Department of Social Work
Assistant Director, Southern Tier
Center on Aging
Binghamton University
Executive Director W.D.
Goodwill Initiatives on Aging
Belle S. Spafford Endowed
Chair in Social Work
College of Social Work, University
of Utah
Multidisciplinary Team Approach
– Professional Silos are common
• “A multidisciplinary approach to service delivery means that
persons from several disciplines are involved in the delivery
of services.
– The approach, however, is discipline-oriented with each team member
responsible only for the activities related to his or her own discipline
(Melvin, 1989; Rothberg, 1981).
– One team member is affected very little by the efforts of the other
team members..”
Melvin, J. L. (1989, April). Status report on interdisciplinary medical education. Archives of Physical Medicine
and Rehabilitation, 70, 273–276.
Rothberg, J. (1981, August). The rehabilitation team: Future direction. Archives of Physical Medicine and
Rehabilitation, 62, 407–410.
as cited in Catlett, C. & Halper, A. (1992, Summer). Team Approaches: Working Together to Improve Quality ASHA
Quality Improvement Digest. http://www.asha.org/uploadedFiles/aud/TeamApproaches.pdf
Interdisciplinary Team
• An interdisciplinary approach to service delivery requires
– Interaction among the disciplines.
– Not only are individuals from several disciplines working
toward a common goal, but the team members have the
additional responsibility of the group effort (Rothberg,
1981).
– Effective communication is required among those involved
(Melvin, 1989).
– The team includes the patient/client and his/her family
Melvin, J. L. (1989, April). Status report on interdisciplinary medical education. Archives of Physical
Medicine and Rehabilitation, 70, 273–276.
Rothberg, J. (1981, August). The rehabilitation team: Future direction. Archives of Physical Medicine
and Rehabilitation, 62, 407–410.
as cited in Catlett, C. & Halper, A. (1992, Summer). Team Approaches: Working Together to Improve
Quality ASHA Quality Improvement Digest. http://www.asha.org/uploadedFiles/aud/TeamApproaches.pdf
Transdisciplinary Team Model
“A transdisciplinary model includes the following components:
• one person can perform professionals’ roles by providing services to the
patient/client under the supervision of the individuals from the other
disciplines involved.
• Disciplines work together in the initial evaluation and care plan, but only
one or two members actually provide the services.
• Professionals are still accountable for areas related to their
specific discipline and for training the team member delivering
the service” (e.g., ACT).
Bailey, D. B., & Wolery, M. (1989). Assessing Infants and Preschooler With Handicaps. Columbus,
OH: Merrill Publishing Co.
Connor, F. P., Williamson, G. G., & Stepp, J. M. (1978). Program Guide for Infants and Toddlers With
Neuromotor and Other Developmental Disabilities. New York: Teachers College Press.
as cited in Catlett, C. & Halper, A. (1992, Summer). Team Approaches: Working Together to Improve Quality
ASHA Quality Improvement Digest. http://www.asha.org/uploadedFiles/aud/TeamApproaches.pdf
Definition of Interprofessional Team
Collaboration
“ Interprofessional collaboration is
a ‘partnership’ between a team of
health providers and a client in a
participatory collaborative and
coordinated approach to shared
decision making around health and
social issues.”
Canadian Interprofessional Health Collaborative. A national interprofessional competency framework. February 2010.
Available from: http://www.cihc.ca/files/CIHC_IPCompetencies_Feb1210.pdf
Interprofessional Collaborative Practice
Principles
• A process by which professionals:
– Reflect on and develop ways of practicing that provides an integrated and cohesive
answer to the needs of the client/family/population.
– Involves continuous interaction and knowledge sharing between professionals.
– Organized to solve or explore care and social issues while seeking to optimize the
patient’s participation.
Morrison S. Working together: why bother with collaboration? Work Bas Learn Prim Care. 2007;5:65–70.
Sources: Core Competencies for Interprofessional Collaborative Practice . Report of an Expert Panel, May 2011,
Sponsored by the Interprofessional Education Consortium, p 8 . http://www.aacn.nche.edu/educationresources/ipecreport.pdf
Community Based Interprofessional
Education
• Neighbors Helping
Neighbors—HPPAE in the
College of Social Work,
University of Utah
• Service program
providing services to
older adults to remain
independent in their
homes and communities
• MSW students provide
care management
services to older adults
• Complete mini-rotations
providing therapeutic
groups in senior centers
and bereavement groups.
• Complete one semester
rotation in outside agency
serving older adults
Community Based Interprofessional
Education
Disciplines represented:
When “students” from two or more
professions learn about, from,
and with each other to enable
effective collaboration and to
improve health outcomes*
*Framework for Action on Interprofessional Education & Collaborative
Practice, World Health Organization, 2010
• Social Work
• Nursing
• Gerontology Interdisciplinary
Program
• Health Educators
• Physicians
• Nursing
• Pharmacists
• Licensed Professional Counselors
Community Based Interprofessional
Education
• Activities
– Care management of NHN
participants
– Interdisciplinary Seminar
Series in Aging
– Group work in senior
centers
– Group work in
bereavement program
– Hospice
– Veterans Administration
– Utah State Division of
Aging and Adult Services
How do professions work and learn together?
• Nursing students and social work students
work together with NHN participants to
improve quality of life.
• Presenters from different disciplines
provide educational opportunities through
the Interdisciplinary Seminar Series on
Aging.
•
Students from various disciplines attend
the Interdisciplinary Seminar Series on
Aging.
•
Students in health concentration
complete an interprofessional training
module with nursing, medicine, P.T. , O.T.,
and pharmacy which includes a simulation
lab.
HPPAE students work in interprofessional
teams in rotation placements.
HPPAE-VA GRECC Program
•
•
Binghamton University HPPAE
Geriatric Consultation Clinic
• Interprofessional
Learning Experience
• Part of the rotational
model for HPPAE
• MSW students
collaborate with
Medical Students from
Upstate Medical
University
• Conduct a 2-part
Comprehensive
Geriatric Assessment
1. Home Visit
2. Clinic Visit
• Team Structure:
• Clinical Social Worker
• Geriatrician
• Students from both
disciplines
• Family
Student Learning
 Chief Complaint(s)
 Medical History
 Social History
 Family History
 Functional Assessment
 Review of Systems
 Routine Health
Maintenance
 Advance Directives
 Review of Medications
Tools used:
• Mini-Mental State Exam
(MMSE)
• Geriatric Depression
Scale
• Clock Test
• Get Up & Go Test
• Home Safety Checklist
• Elder Abuse Screening
• 5 Wishes
Identified Competencies
EPAS 2008
EP 2.1.3 – Apply critical thinking
to inform and communicate
professional judgments
GSCW-II
II-2 – Adapt interviewing methods
to potential sensory, language,
and cognitive limitations of the
older adult
EP 2.1.4 – Advance diversity and
difference in practice
II-3 – Conduct a comprehensive
geriatric assessment
EP 2.1.7 – Apply knowledge of
human behavior and the social
environment
III-4 – Mediate situations with
angry or hostile older adults
and/or family members.
EP 2.1.10 – Engage, assess,
intervene, and evaluate with
individuals, families, groups,
organizations and
communities
III-10 – Adhere to laws and public
policies related to older adults
Binghamton University HPPAE
Mental & Behavioral Health Outreach
 Multidisciplinary Learning
Experience
 HPPAE Fellows are placed in
agencies which do not
employ MSWs. Fellowship
provides opportunities for
community enhancement.
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Agency Partners
Broome County Office for
Aging
Tioga Opportunities, Inc. –
Dept. on Aging
Broome County Council of
Churches
Association for Vision
Rehabilitation &
Employment
Rural Health Network of
South Central New York
Delaware County ARC
Retired Senior Volunteer
Program (RSVP)
Alzheimer’s Association
Identified Competencies
EPAS 2008
EP 2.1.10 – Engage, assess,
intervene, and evaluate with
individuals, families, groups,
organizations and
communities
EP 2.1.8 – Engage in policy
practice to advance social and
economic well being and to
deliver effective social work
services
EP 2.1.6 – Engage in researchinformed practice and
practice-informed research
GSCW-II
III-2 – Adapt interviewing
methods to potential sensory,
language, and cognitive
limitations of the older adult
III-3 – Utilize group interventions
with older adults and their
families.
III-5 – Assist caregivers to reduce
their stress levels and maintain
their own mental and physical
health.
III-9 – Advocate on behalf of
clients with agencies and
other professionals to help
elders obtain quality services
University of Louisville
Geriatric Evaluation & Self-Management
(GEMS) Project
 Interdisciplinary Learning
Experience
 Interdisciplinary homebased geriatric
assessment services
 SW & PT faculty, students
& community providers
collaborating with PCP
 Self-management care
plan including:
 Individualized exercises
 Community resources
 8 phone calls over 12-week
period
• Experimental longitudinal,
pre-post design to test
two service delivery
models:
–
–
Assessment and Brief
Intervention
Assessment and
Telehealth Intervention
GEMS Assessment
 Mini-Cog (dementia screening tool)
 General Assessment and Self-Management
Questionnaires
 Ecomap and Genogram
 Instrumental Activities of Daily Living (IADL)
 Physical Therapist Systems Review
(integumentary, cardiovascular, musculoskeletal,
neuromuscular)
 Functional Reach Test (balance)
 Timed Get Up and Go test (functional mobility)
 Timed Chair Stand Test (lower extremity muscle
strength)
 Geriatric Depression Scale 5/15
 Lubben Social Network Scale
West Virginia University
Gero Certificate Program
 A credit-bearing gero
certificate program that
includes students from
SW, public health,
pharmacy, speech
pathology, and nursing.
 Developing an
interprofessional CEU
certificate scheduled to
launch in January 2013
 Rural Focus
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Teaching Methods
Labs
Simulation
Medical
Paraprofessional
Rural
Community dwelling and
institutional older adults
Next Webinar
Evaluation and Measurement of Interprofessional Geriatric Programs
Date: December 18th, 2012, 1:30 EST
Facilitator: Paul Gould, Binghamton University &
Kris Hash University of West Virginia
Other Opportunities for Inter-professional
Geriatric Education and Practice
Date: January 15th, 2012, 2:00 EST
Facilitator: Robyn Golden, Rush University