Interprofessional Collaboration and Stroke Best Practice Janine Theben, janine.theben@trilliumhealthpartners.ca Problem: keeping stakeholders up to date on what programs and resources were available to stroke patients throughout the region with changing program AND changing staff as well as community partners developing more and more therapuetic recreation programs appropriate for stroke clients.

“Interactions amongst team members are pivotal to team success and positive patient outcomes in stroke survivor care and rehabilitation” (Johnson et al., 2015) Why? Stroke expertise Shared care plan Patient goals set across several disciplines (shared goals, eveyone is on the ‘same page’) Quicker identification of barrier or issues related to medical or discharge planning

From the Interprofessional Competency Framework Collaboration (2010 ) From Canadian Stroke Best Practice - Role Clarification Interproffesional communication Team functioning Patient/family/community-centered care Collaborative leadership Interproffesional conflict resolution Dedicated interproffesional stroke team with broad expertise Daily/weekly patient care rounds with interproffesional stroke team to conduct case reviews, discuss pt. management issues, family concerns or needs, discharge planning or transitions Staff members have interest in stroke care; participation in continuing education and training; early engagement in rehabilitative process Screening completed by Interprofessional team members (for dysphagia, cognition, depression etc.) Interdisciplinary rehabilitation assessment, treatment or review from staff with stroke experience Family members and informal caregivers should have early and active involvement The Interprofessional team follows evidence based practices Case coordination approach with regular team communication

Comment elements across the care continuum Services should be provided by a specialized Interprofessional team with stroke expertise (acute, rehab, OP/Community) Regular team communication Include stroke survivor, family and caregiver in management, goal setting and transition planning Recommendations for Acute Care Core interproffesional team should consist of: physicians, nurses, OT, PT, SLP, Social work, clinical Nutrionist (dietary) Access to pharmacist, discharge planner or case manager, neuro psychologist, palliative care specialist, recreational and vocational therapies, spiritual care providers Recommendations for Rehab The core rehabilitation team should include physiatrists, other physicians with expertise/core training in stroke rehabilitation, OT, PT, SLP, Nurses, Social Work, Dietician. The patient and family are also considered part of the core team. Additional team members include rec therapy, psychologists, voc. therapy, education therapists kinesiology's, rehabilitation therapy assistants, pharmacy, neuropsychology, palliative care specialists, therapy assistants, spiritual care providers, peer supporters and stroke recovery group liaisons. Same for OP/Community Rehab

Learning Objectives for Stroke Care What is it? The Core Competency Framework aims to provide health care professionals working in stroke care with a clear, comprehensive way to achieve the core competencies needed for evidenced based stroke care Why? A key components of Stroke Unit Care is that the core interprofessional team should consist of healthcare professionals with stroke expertise What does this have to do with interprofessional collaboration? A common learning objectives for each discipline is: Be able to discuss and compare the roles of other disciplines involved in the care of stroke survivors within the context of an interprofessional model of care Link to Core Competency Framework and Toolkit

Take home message “ An effective Interprofessional team has members who cooperate rather than compete with one another, and put the interests of the patient first” (Johnson, 2015).