Transcript The McGill Educational Initiative in Interprofessional

The McGill Educational Initiative in
Interprofessional Collaboration:
Partnerships for patient & family
centered practice
Margaret Purden, N, Ph.D.
David Fleiszer, M.D.
Hélène Ezer, N, Ph.D.
Jeffrey Wiseman, M.D., M.Ed.
Yvonne Steinert, Ph.D.
Bruce Shore, PhD
Aliki Thomas, OT, PhD (C)
Liliane Asseraf Pasin, PT, Ph.D. (C)
Kathryn Carnaghan-Sherrard, N, M.Sc.A
Linda Snell, M.D.
Nancy Posel, N, M.Ed
The McGill Educational Initiative in
Interprofessional Collaboration:
Partnerships for Patient & Family-Centred
Practice
The Who, Why, What & How
Interprofessional Collaboration:
Who at McGill?
Institutional Lead: The Faculty of Medicine
School of Medicine
School of Nursing
School of Physical and Occupational Therapy
&
School of Human Communication Disorders
Clinical Partners:
The McGill University Health Centre
The SMBD Jewish General Hospital
Interprofessional Education:
Who in Canada?
University of British Columbia
Building Capacity and Fostering System Change
Dr. Grant Charles
Calgary Health Region:
Creating an Interprofessional Learning Environment
through Communities of Practice - Dr. Esther Suter
University of Saskatchewan:
Patient Centre Interprofessional Team Experiences
Dr. E.L. Harrison
University of Manitoba:
Interprofessional Education for Geriatric Care
Dr. Ruby Grymonpre
Interprofessional Education:
Who in Canada?
Queen's University:
The QUIPPED Project
Dr. Medves
Ontario Council of Universities:
Institute of Interprofessional Health Sciences Education
Mrs. Marge Harrington
University of Toronto:
The SCRIPT Program
Dr. Catharine Whiteside
Interprofessional Education:
Who in Canada?
Universite Laval:
Le Patient au Coeur de Nos Actions: Mieux se Former Pour
Mieux Collaborer
Dr. André Bilodeau
Dalhousie:
Seamless Care: An Interprofessional Education Project for
Innovative Team-Based Transition Care
Dr. Judith McFetridge-Durdle
Memorial University of Newfoundland:
Collaborating for Education and Practice: An Interprofessional
Education Strategy for Newfoundland and Labrador
Dr. Vernon Curran
Interprofessional Education:
The Why
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Complexity of care
Rising expectations
Professional proliferation
Students want to know
Community based care
Teamwork
Interprofessional conflict
New models of practice
Legislation & redefinition of professional
roles
Effectiveness of interprofessional practice
Interprofessional Education:
The Why
Mounting evidence that Collaborative
Practice improves outcomes in a number
of patient populations studied to date.
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Geriatrics, ER care for abused women,
STD screening, Adult immunization,
fractured hips & neonatal ICU care,
depression care, and in simplifying
medications
(Zwarenstein et. al. 2004)
Systematic Review of Recent Trials of
Effective Collaboration Interventions
Study
A randomized clinical trial of
outpatient geriatric evaluation
and management
Source
Boult et al. J Am
Geriatr Soc
2001;49:351-9.
An evaluation of a systemCampbell et al.
change training model to
Acad Emerg Med
improve emergency department 2001;8:131-8
response to battered women.
Intervention
Comprehensive assessment
followed by interdisciplinary
primary care.
Team participated in 2 day
didactic training and team
planning exercise.
Can differences in management
processes explain different
outcomes between stroke unit
and stroke-team care?
Evans et al. Lancet, Stroke unit, no specific
358 (9293), 11-10- interventions to encourage
2001, 1586 – 1592 collaboration of team.
Interdisciplinary inpatient care
for elderly people with hip
fracture: A randomized
controlled trial.
Naglie et al. CMAJ
2002;167:25-32.
Interdisciplinary rounds to
discuss each patient twice
weekly.
Systematic Review of Recent Trials of
Effective Collaboration Interventions
Study
Source
Intervention
Reduced mortality in treating
acutely sick, frail older patients
in a geriatric evaluation and
management unit (GEMU). A
prospective randomized trial.
Saltvedt et al. J
Effect of a clinical practice
improvement intervention on
Chlamydia screening among
adolescent girls.
Shafer et al. JAMA
2002;288:2846-52
Audit and feedback, barrier
identification, team
building and meetings,
iterative approach.
Cluster randomized controlled
trial of an educational outreach
visit to improve influenza and
pneumococcal immunization
rates in primary care.
Siriwardena et al.
Academic detailing to team
in each practice to promote
immunization, combined
with audit and feedback.
Control group received
audit and feedback only.
Am Geriatr Soc
2002;50:792-8.
Br J Gen Pract
2002;52:735-40
GEMU, the treatment strategy
emphasized interdisciplinary
assessment of all relevant
disorders, prevention of
complications and iatrogenic
conditions, early
mobilization/rehabilitation, and
comprehensive discharge
planning.
Systematic Review of Recent Trials of
Effective Collaboration Interventions
Study
Source
Reducing medication regimen
complexity: A controlled trial.
Muir et al. J Gen
Economic implications of
neonatal intensive care unit
collaborative quality
improvement.
Rogowski et al.
A CQI intervention to change
the care of depression: A
controlled study.
Solberg et al. Eff
Intern Med
2001;16:77-82
Pediatrics
2001;107:23-9.
Clin Pract
2001;4:239-49
Intervention
For intervention patients, a
medication grid was created that
displayed all of the patients’
medicines and the times of
administrations for 1 week. This
grid was delivered to the
admitting resident soon after
admission. Information transfer
intervention.
Multidisciplinary teams doing
collaborative quality improvement,
reviewing performance data,
developing shared goals,
designing improvements to their
practices.
CQI intervention in which
participants from intervention
clinics developed an approach to
depression care.
Interprofessional PatientCentred Practice
The active participation of different
professional groups in decision making
and delivery of patient and family centred
care. It is responsive to patient and family
goals, opens mechanisms for continuous
communication and fosters mutual respect
among professionals”
Interprofessional Education
Occasions when two or more professions
learn from and about each other
to improve collaboration
and the quality of care
Source: CAIPE (UK Centre for the Advancement of Interprofessional
Education), 1997
Interprofessional Education
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A new name
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An evolving idea
The Nature of Collaboration
Interprofessional Education
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Many methods of implementation
Interprofessional Education:
The “What” at McGill ?
Beliefs /Assumptions
Responsive to needs of patients and families
 Partnerships between educators and
clinicians for IP education and practice
 Student involvement in planning and
implementation
 Collaboration as an expanded concept
 Principles of adult learning
 Institutional support is essential for
sustainability
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What are Our Unique Strengths
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Students who want to understand the
roles of other professionals
Practitioners across all professions who
are skilled in IPP
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Support of educational leaders
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Well developed Joint Appointment System
What are Our Challenges
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Silo approaches to education
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Respecting professional identities
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Logistical considerations
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Mapping across curricula
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Resistance to change
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Bridging learning and practice environments
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Maintaining support of educational leaders
Interprofessional Education:
The “How” at McGill ?
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Promoting commitment and understanding of
IPE and IPP among faculty, clinical teachers &
clinicians
Develop and utilize learning resources that
facilitate interprofessional education
Mount a comprehensive program for IPE
delivered within and across programs
Identify exemplar learning environments that
enable and enhance IPE and IPP
Project Timeline
Interprofessional Education:
The “How” at McGill ?
The Process
12. Broadening
11. Growth
10. Cooperation
9. Fine-Tuning
8. Development
7. Agreement
6. Negotiation
5. Examination
4. Proposition
3. Selection
Scheuing (1994), The Power 2. Decision
of Strategic Partnering.
1. Need