Sandra Banas Ruth Ballweg Program Directors 101 Where Does Interprofessional Education (IPE) Fit Into Your Program Curriculum? Sandra Banas Ruth Ballweg

Objectives Define interprofessional education Describe the concept interprofessional team based care Describe the interprofessional practice competency domains Design strategies to implement interprofessional curriculum

What Is Interprofessional Education (IPE) ? When students from 2 or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes. WHO, Framework for IPE, 2011

Why IPE? Medical errors result from poor communication and gaps in delivery of care Institute of Medicine, To Err is Human (1999) Our motivations for involvement stem from our own experiences as clinicians, faculty and as patients or friends/family of patients….we’ve all had good and not so good healthcare experiences… The impetus for IPE was spurred by formal recognition in the literature of the medical errors and gaps in care that result from poor communication and from limited collaboration of team members.

Why IPE? The Triple Aim Safety Efficiency Patient Satisfaction Beyond safety…. Interprofessional patient/client-centered care Optimal individual patient health outcomes Improvements in community level (population) health Effective and efficient delivery of health care services Advocacy for improvement of health and health services …… Add Citation….the Bridge to Quality-Bambi and tie to alignment with President’s strategic plan. Institute of Medicine, Crossing the Quality Chasm: A New Health System for the 21st Century (2001)

Paradigm Shift Physician centered practice to Patient centered practice Practitioner autonomy to Team collaboration Focus on illness & cure to Focus on health promotion Passive patient role to Involved patient & families Acute, episodic care to Care for chronic conditions The Triple Aim signals a paradigm shift in the delivery of healthcare….. How many of you have witnessed these changes taking place during your lifetime? This is a dynamic process and one that we’re experiencing and helping to prepare students for here at Upstate. Aschenbrener CA, Clearing a Path Ahead for IPE Presentation: Collaborating Across Borders II, Halifax, 2007 Institute of Medicine, Crossing the Quality Chasm

Goal of Interprofessional Education​ Prepare all health professions students for deliberatively working together with the common goal of building a safer and better patient-centered and community-population oriented U.S. health care system.

Interprofessional Team-Based Care​ Care delivered by intentionally created, usually relatively small work groups in health care, who are recognized by others as well as by themselves as having a collective identity and shared responsibility for a patient or group of patients.​ Rapid response teams​ Palliative care teams​ Primary care teams​ Operating room team​ Interprofessional Education Collaborative Expert Panel. Core competencies for Interprofessional collaborative practice: Report of an expert panel. May 2011. Washington, DC. Interporfessional Education Collaborative.

Teamwork No elite sports team or marching band is successful without teamwork.​

Collaborative Education Practice Collaborative Practice Collaborative Education PATIENT

How will IPE benefit students as future clinicians? Understanding of others Fosters communication Personal growth/humility Decreased med errors Increased career satisfaction Understanding place in health care system Improved patient care

U.S. Health Professions Accreditation Organizations

Standards for the Curriculum​ B1.08 The curriculum must include instruction to prepare students to work collaboratively in interprofessional patient centered teams. ​ ANNOTATION: Such instruction includes content on the roles and responsibilities of various health care professionals, emphasizing the team approach to patient centered care beyond the traditional physician-PA team approach. It assists students in learning the principles of interprofessional practice and includes opportunities for students to apply these principles in interprofessional teams within the curriculum. ​    ​

Interprofessional Education Collaborative – Expert Panel IPEC Report, May 2011 IPEC Competencies Report provides core competencies for interprofessional education​ Includes:​ American Association of Colleges of Pharmacy (AACP)​ American Association of Colleges of Nursing (AACN)​ Association of American Medical Colleges (AAMC)​ American Dental Education Association (ADEA)​ American Association of Colleges of Osteopathic Medicine (AACOM)​ Association of Schools of Public Health (ASPH)​ Interprofessional Education Collaborative Expert Panel. Core competencies for interprofessional collaborative practice: Report of an expert panel. May 2011. Washington, D.C. Interprofessional Education Collaborative.

Interprofessional Collaborative Practice Competency Domains Values/Ethics for Interprofessional Practice Work with individuals of other professions to maintain a climate of mutual respect and shared values Competency Domain 1 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 to promote and advance the health of populations Competency Domain 2 Interprofessional Communication Communicate with patients, families, communities, and professionals in health and other fields in a responsive and responsible manner that supports a team approach to the promotion and maintenance of health and the prevention and treatment of disease. Competency Domain 3 Teams and Teamwork Apply relationship building values and the principles of team dynamics to perform effectively in different team roles to plan, deliver and evaluate patient-/population centered care and population health programs and policies that are safe, timely, efficient, effective, and equitable Competency Domain 4

Interprofessional Planning: Where the Rubber Meets the Road !!

IPE Planning Committee Members Profession Representation University or College Programs Program Representation Advocate Pragmatic Realist Student Representation Very Important ! Who should be on the planning committee?

Who is On Your IPE Planning Committee?

IPE - Good News and Bad News Models best practice Patient centered care Emphasis on: Communication Teamwork Patient safety Bad News Talking the talk but not walking the walk Faculty buy in Faculty development MUST have dedicated time Planning Implementation IPE warriors can overshadow other members IPE warriors who overshadow other members – those who try to fit their profession into every activity, whether or not it is relevant.

IPE Implementation

Implementing IPE Experiences Involve planning committee, including students ! Walk the talk ! Incorporate innovative practice models into the curriculum and link these models to IPEC competencies Start small Schedule dedicated time for IPE experiences Set aside time for reflection

IPE Evaluation Involve planning committee, including students ! Develop assessment tools based on team objectives Integrated evaluation plan

IPE Best Practices Begin early Identify topics that cross all professions Ethics Social determinants of health Opioid epidemic Palliative care Quality & safety Implement experiences throughout program Didactic Clinical Reflection & feedback

How Do PA Programs Do This?

Interprofessional Education at Nova Southeastern University First Semester​ Intro to PA Profession course – Focus on healthcare team.  ​ Lecture and Activity to interview other health professions​ Second & Third Semester​ IPE Day – Scheduled day for DO, PT, OT, PA, Pharmacy and Nursing students​ Lectures, Activities, Simulation exercises​ Fourth Semester​ Students required to spend half day observing interprofessional team of PA, Social Worker and law enforcement managing care of homeless through Project H.O.P.E.​

Interprofessional Education at Shenandoah University Co-curricular activities​ Brown-Bag lunches​ Simulation Exercises​ Clarion Competition​ Primary Care Progress​ Interprofessional Service Learning Project​ Interprofessional Student Run Clinics​

Interprofessional Education at Upstate Medical University White Coat Ceremony (CHP) Case-Based Activity (PA, MD, NP, PT) Virtual Medical Error Room Service activities Community Engagement Session Case based activity - Scenario involved pt, unfamiliar to healthcare system in US, who presents to ER with acute back pain unrelieved by analgesics. Take home messages – respect one another, communication is key, understanding role of each profession.

Summary Interprofessional Collaboration improves patient outcomes​ Interprofessional Collaboration is expected and is reflected by US Healthcare Reform policies​ Interprofessional Education is necessary to prepare the healthcare workforce to work collaboratively​ Interprofessional Education takes time; time is essential for planning and implementation ​ Barriers and challenges are inevitable – be prepared and be flexible !

Questions?

Acknowledgements Many thanks to: Rachel Carlson, Melissa Coffman & Joan Ward who contributed content to this presentation

References Institute of Medicine. Educating for the Health Team. October 3, 1972. Available at:​ http://www.ipe.umn.edu/prod/groups/ahc/@pub/@ahc/@cipe/documents/asset/ahc_ asset350123.pdf. Accessed June 2, 1013.​ Barr H, Ross,F. Mainstreaming Interprofessional Education in the United Kingdom: A position paper. Journal of​ Interprofessional Care, 2006, Vol. 20, No. 2 , Pages 96-104.​ Institute of Medicine. Health Professions Education: A Bridge to Quality. April 18, 2003. Available at:​ http://www.iom.edu/Reports/2003/Health-Professions-Education-A-Bridge-to- Quality.aspx. Accessed June 2, 2013.​ Interprofessional Education Collaborative Expert Panel. Core competencies for interprofessional collaborative practice: Report​ of an expert panel. May 2011. Washington, D.C. Interprofessional Education Collaborative Available at: http://www.aacn.nche.edu/education- resources/ipecreport.pdf. Accessed June 2, 2013.​ ​