Transcript Interprofessional Education and Collaborative Practice

Interprofessional Education and
Collaborative Practice
Cynthia N. Nguyen, PharmD
Asst. Professor and IPECP Coordinator
FSOP Preceptor CE: October 7, 2015
Disclaimer
The speakers do not have a vested interest in or affiliation
with any corporate organization offering financial support
or grant monies for this continuing education program, or
any affiliation with an organization whose philosophy could
potentially bias the presentation
Objectives
1. Define Interprofessional Education (IPE) and key terms
2. Explain the importance of IPE and Interprofessional Education and
Collaborative Practice (IPECP)
3. Describe current programs that incorporate IPE in the UIW curriculum
• Dr. Copeland (Medical Missions)
• Dr. Nguyen (CLARION, Indigent Care Clinics, IPE training, Poverty Simulation,
Asthma Team for Kids)
4. Plan activities that incorporate IPE and IPECP during IPPE and APPE
rotations (Dr. Farrell + Ms. Tabor)
5. Practice facilitation of an interprofessional patient case
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Multidisciplinary
"Different aspects of a patient's care
are handled independently by
appropriate experts from different
professions. The patient's problems
are subdivided and treated
separately, with each provider
responsible for his/her own area."
(ACCP, 2009)
Multiple Silos…
Why Now?
 Institute of Medicine (IOM) reported concerns with the quality of
healthcare in the U.S.
 To Err Is Human
 Crossing the Quality Chasm
 Health Professions Education
 In 2004, the Joint Commission reported that more than 60% of errors are
related to failures in communication.
Founding Organizations
Supporting Organizations
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IPEC Core Competencies
0 Four domains:
0 Values/ethics for interprofessional
practice
0 Roles/responsibilities for
collaborative practice
0 Interprofessional communication
0 Interprofessional teamwork and
team-based care
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Framework for IPECP
Apply relationship-building
values and the principles of team
dynamics to perform effectively
in different team roles to plan
and deliver patient-/populationcentered care that is safe, timely,
efficient, effective, and equitable.
Work with individuals of other
professions to maintain a climate
of mutual respect and shared
values.
Values & Ethics
Communicate with patients,
families, communities, and
other health professionals in
a responsive and
responsible manner that
supports a team approach to
the maintenance of
health and the treatment of
disease.
Communication
Teamwork
Roles &
Responsibilities
Use the knowledge of one’s
own role and those of other
professions to appropriately
assess and address the
healthcare needs of the
patients and populations
served.
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What is IPE?
“When students from two or more professions learn about,
from, and with each other to enable effective collaboration and
improve health outcomes.”
Interprofessional Education
(WHO, 2010)
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What is IPCP?
 Different from “multidisciplinary” practice
“When multiple health workers from different professional backgrounds
work together with patients, families, carers [sic], and communities to
deliver the highest quality of care.”
Interprofessional collaborative practice
(WHO, 2010)
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IPE + IPCP =
Interprofessional
"The provision of health care by
providers from different
professions in a coordinated
manner that addresses the needs of
patients. Providers share mutual
goods, resources, and responsibility
for patient care." (ACCP, 2009)
Shared silos.
Why IPECP?
0 Education standards for professional schools starting to mandate IPE
requirements for accreditation.
0 National health care organizations and employers are emphasizing the
importance of a team-based approach to health care.
0 Improves quality of care
0 Cuts healthcare costs
Triple Aim
0 Results in better health outcomes
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The best care for the whole
population at the lowest cost
www.ihi.org
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There’s a difference…
Multidisciplinary
≠
Interprofessional

Multiprofessional:
ongoing learning for
professions together

Interprofessional: ongoing
learning with, from, and about other
professions to improve collaboration
and the quality of care
Barr, 2009
IPECP Initiatives at UIW
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Components of IPECP Design
0 Didactic and clinical opportunities
0 Interactive, patient related learning activities in teams
0 Experiences relating back to IPEC core competencies
0 Experiences relevant to real-life practices
0 Active reflections
0 Population health management
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Variety of Experiences
0 Various affiliations and community partnerships
0 Location and populations
0 Interprofessional team make-up
0 Team composition varies from institution to institution
0 Dependent on professional schools in the area
0 Fluxes based on the focus of project
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ACPE Key Elements
0 Interprofessional team dynamics
0 IPE Faculty development workshops
0 IPE Student workshops
0 Interprofessional team education
0 CLARION case competition
0 HRSA IPECP grant project
0 Study abroad trips
0 Poverty Simulation
0 Interprofessional team practice
0 Mission trips
0 HRSA IPECP grant project
0 Walmart health fairs
0 Team for Kids
Interprofessional Team Dynamics
Interprofessional Team Education
Interprofessional Team Practice
Medical Missions
Jeffrey Copeland, Th.M., PharmD
Pharmacy Services on a Domestic Medical Mission Trip
Interprofessional Education IPPE
Jeffrey T. Copeland, BS, Th.M., Pharm.D.; Nicole C. Farrell, Pharm.D.; Kimberly Cauthon, Pharm.D.
Department of Pharmacy Practice, Feik School of Pharmacy, University of the Incarnate Word, San Antonio, Texas
Objectives
Provide third year pharmacy students Interprofessional Education (IPE) Introductory Pharmacy Practice Experience (IPPE) opportunities on a domestic medical mission trip.
Methods
P3 students may participate in a domestic medical mission trip for IPE IPPE credit. The School of Pharmacy partners with the local Christian Medical and Dental Associations (CMDA),
Dental School, and Medical School to conduct medical mission trips to underserved populations along the American – Mexican border. The Saturday clinics are held in colonias
(impoverished communities frequently without water and electricity) and los barrios (organized and advanced colonia) within Texas. Each trip provides two free clinic sites with each
site providing medical care (diagnosis, treatment), dental care (cleanings, fillings, extractions), and consultative pharmacy services for approximately 200 patients per trip.
Prescriptions are filled free of charge by a grocery retail pharmacy in the nearest city using a pre-arranged voucher system from the company’s $5 formulary. Post-trip analyses
(reflection, recommendations) are conducted. Rubrics evaluate student performance.
Results
Thirty P3 students participated in a total of three mission trips. Pharmacy, medical, dental, and pre-professional students provided care alongside pharmacists, physicians, and
dentists. Pharmacy students provided drug information services (domestic and foreign medications) for patients, students, and providers, formulary recommendations, medication
counseling, and provided screenings (blood pressure, pulse, temperature, glucose, cholesterol, hemoglobin). Medical personnel provided positive evaluations. Students received IPPE
health fair credit. Students indicated a desire to participate in medical missions as a pharmacist following the trips.
Implications
These IPE IPPE opportunities will continue. Evaluation for expansion will occur.
Disclosure
Authors of this presentation have nothing to disclose concerning possible financial or personal relationships with commercial entities that may have a direct or indirect interest in the subject matter of this presentation.
“Pharmacy Services on a Domestic Medical Mission Trip Interprofessional Education Introductory Pharmacy Practice Experience” by Copeland, Farrell, Cauthon in American Journal
of Pharmaceutical Education 2013; 77(5) Article 109. pg 30.
Lessons Learned from IPECP
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Lessons Learned for Students
0 Exposure to various healthcare professions
0 Better understanding of roles & responsibilities (self and others’)
0 Improved willingness to communicate with other professions
0 Appreciation for how socioeconomic background impact patient health
outcomes
0 Understanding of need for healthcare teams
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Lessons Learned for Preceptors
0 Exposure to various healthcare professions
0 Conflict resolution skills
0 Interprofessional student group facilitation
0 Time commitment
0 Practice makes perfect
0 Flexibility required
0 Changing a culture
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Role as Preceptors
0 Role model for students
0 Promote teamwork
0 Demonstrate professionalism
0 Assert IPECP core competencies
0 Engage student discussions
0 Provide resources
0 Serve as the “guide on the side”
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Interprofessional Application for
Rotations
Regina Tabor, R.Ph.
Nicole Farrell, Pharm.D.
Preceptor CE: October 7th, 2015
Interprofessional Care
Joint assessment and management of patients
by health professionals from more than one
discipline, closely linked in time and space.
Interprofessional Teams
0 To work in Collaboration with other health care
professionals requires:
0 Knowledge of others’ roles
0 Ability to communicate with other professionals
0 Ability to interact with other professionals
Interprofessional education (IPE)
0 Occurs when 2 or more professionals learn
form, with and about each other to:
0 Improve collaboration
0 Quality of care
0 There must be interactive learning not just
to be alongside one another in parallel.
Community Rotation IPCP
0 Pharmacy student calling physician’s office
0 Obtaining new/refill prescriptions
0 Clarifying prescriptions and obtaining answers to
questions
0 After medication therapy management session (MTM)
0 Physician detailing (meeting and discussing services with
local physicians)
Community Rotation IPE
0 Pharmacy student meeting with the Nurse
practitioner at the pharmacy
0 Providing drug information
0 Assisting in community education
0 Assessing with nurse the patients’ vital signs
0 Blood glucose, cholesterol levels on intake.
Interprofessional (IPE) Experiences
0 Exposing students to multiple examples in experiential
settings has a great impact on:
0 Knowledge
0 Skills
0 Attitudes
Institutional Rotation IPCP
0
0
0
0
0
0
0
0
0
0
0
Interprofessional team rounding
Discharge planning
Treatment team meetings
Pharmacy and Therapeutic Committee meetings
Infection Control Meetings
Quality Control Meetings
Follow & assist nurses on the unit for a day
Laboratory and Microbiology
Respiratory Therapy team
Medication Reconciliation
Projects with other health care professional students
Recap
0 Multiprofessional:
ongoing learning for
professions together
0 Interprofessional:
ongoing learning with,
from, and about other
professions to improve
collaboration and the
quality of care
Barr, 2009
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Resources for Pharmacists
0 No need to reinvent the wheel
0 Recommended resources:
0 IPE Collaborative: www.ipecollaborative.org
0 MedEdPortal: www.mededportal.org
0 IHI: www.ihi.org
0 National Center for Interprofessional Practice and Education: www.nexusipe.org
0 TeamSTEPPS: http://teamstepps.ahrq.gov/
0 Conferences:
0 IPEC Institute
0 Collaborating Across Borders V
0 All Together Better Health 8
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Future Directions
0 Accreditation requirements promote need for IPECP.
0 IPECP can be done in various ways.
0 Do not reinvent the wheel—many resources available.
0 Sustainability is important.
0 More research is needed.
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Selected References
0 World Health Organization (WHO). (2010). Framework for action on interprofessional
education & collaborative practice. Geneva: World Health Organization.
0 American College of Clinical Pharmacy, Page, R. L., Hume, A. L., Trujillo, J. M., Leader, W. G.,
Vardeny, O., Neuhauser, M. M., Dang, D., Nesbit, S. and Cohen, L. J. (2009), Interprofessional
Education: Principles and Application A Framework for Clinical Pharmacy.
Pharmacotherapy, 29: 879. doi: 10.1592/phco.29.7.879
0 Interprofessional Education Collaborative Expert Panel. Core Competencies for
Interprofessional Collaborative Practice: Report of an Expert Panel. Washington, DC:
Interprofessional Education Collaborative; May 2011.
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Selected References:
0 PW Jungnickel, KW Kelley, DP Hammer, et al.,Addressing
Competencies for the Future in the Professional Curriculum,
Am J of Pharm Ed. 2009, 73 (8) Article 156,1-6.
0 S Shrader, C Griggs, Multiple Interprofessional Education
Activities Delivered Longitudinally Within a Required
Clinical Assessment Cours, Am J of Pharm Ed. 2014, 78 (1)
Article 14. 4.
Selected References:
0 Krinsky D, Schneider S. Community Pharmacy. In:
Soric MM, ed. Maximize Your Rotations. Bethesda,
MD: ASHP; 2013.
Questions
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Interactive Activity
Post-Test Questions
1. What does IPECP stand for? (Objective #1)
a)
b)
c)
d)
Interprofessional Education and Collaborative Practice
Intraprofessional Education and Collective Practice
Interprofessional Effective and Compliant Pharmacy
Interprofessional Education for Collaborative Pharmacy
Post-Test Questions
2. Why is IPECP important? (Objective #2)
a)
b)
c)
d)
Need to train pharmacy students to be effective on healthcare teams upon graduation
Need to meet ACPE accreditation requirements
Need to help meet the IHI’s Triple Aim
All of the above
Post-Test Questions
3. FSOP has activities/programs that allow for interprofessional
education and/or collaborative practice. (Objective #3)
a)
b)
True
False
Post-Test Questions
4. Appropriate examples of Interprofessional Education/Collaboration
on an Institutional rotation include which of the following?
(Objective # 4)
a)
b)
c)
d)
e)
Active participation in multidisciplinary team rounding
Active participation in discharge planning
Active participation in treatment team meetings
Active participation in pharmacy and Therapeutic Committee meetings
All of the above