Care Management for Persons with Comorbid Severe Mental Illness, Substance Use, and Chronic Disease: An Interprofessional Clinical Elective Mandy Peacock, RN, DNP, AGPCNP-C | [footer text here]

Objectives Discuss the interprofessional clinical elective project and receive feedback Logistics of scheduling multiple professions Precepting and oversight of different professions Evaluation tools | [footer text here]

Innovations Proposal | [footer text here]

Background Progress Foundation Interprofessional Primary Care Outreach for Persons with Mental Illness (IPCOM) UCSF Interprofessional Education | [footer text here]

Specific Aims To design, implement, and sustain an IP clinical elective where AGPCNP, PMHNP, Pharmacy, and Physical Therapy (PT) learners Apply IP knowledge and skills gained throughout the UCSF IP curriculum in order to accomplish Interprofessional Education Collaborative (IPEC) competencies (Interprofessional Education Collaborative, 2016) Examine the impact of social determinants of health and enhance students' processing of their feelings toward, and understanding of, mental health and substance use | [footer text here]

Methods: Who? 1st year PMHNP & AGPCNP students 2nd/3rd year physical therapy students 4th year pharmacy students Faculty (SON, Pharmacy, PT) Counselors and providers at Progress Foundation | [footer text here]

Methods: What? Weekly 4-hour immersive clinical experiences Huddles Client visits Debriefs Group education for clients Students learn with, about, and from each other. | [footer text here]

Methods: When? 6-8 week elective 1 cohort per quarter 2018-2019 | [footer text here]

Methods: Where? Rypins (Seniors) - a 6-bed Progress Foundation house serving adults > 60 years | [footer text here]

Evaluation: Interprofessional Collaboration and teamwork Collaborative Practice Assessment Tool (CPAT) | [footer text here]

Evaluation: IP competencies Interprofessional Education Reflection Worksheet What was your reaction to this experience? What did you enjoy? What might you have changed if you could repeat the experience? Provide examples of knowledge, skills, or attitudes that you or a team member applied or gained from the IPE experience. Which will you reapply? How has (or will) this training improve delivery of patient care? | [footer text here]

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Plan for Sustainability Process evaluation will be ongoing - refine Create a unique course number that will increase visibility and be applied toward the UCSF IPE passport Apply for funding from Macy Foundation, RWJF, HRSA, etc. Continue cycling cohorts and improving Additional cohorts, placements? Evaluation of client outcomes | [footer text here]

Current status | [footer text here]

Since Innovations Funding Approval IRB approved as ‘exempt’ Team meetings scheduled (6/19, 7/17…) Recruitment plan: Word of mouth, narrative by student Met with team members of previous clinical elective Scheduling discussion ongoing Supervision discussion ongoing Course creation Next team meeting… What we found meeting with team members of previous elective – barriers, facilitators, what worked well, what didn’t. Scheduling – evenings? Dyads, triads vs. four students at a time Supervision – NPs can be supervised by any NP, MD and NPs will be primary preceptors. What can PT/pharm students do without direct supervision by faculty? Teleprecepting? Course creation – same process for PT and pharmacy as previous clinical elective. Folded into clinical practicum (PMHNP and AGPCNP) for this pilot and then looking to create separate course number as part of sustainability plan.

Barriers and Facilitators Identified Competing schedules Oversight Some students will be early in IPE curriculum Time Facilitators Faculty with expertise in IP education/practice Longstanding relationship with community partner Technology Need for clinical placements | [footer text here]

Remaining Questions Who can provide oversight – to whom? In what capacity? What role can ‘teleprecepting’ play? What day/time works best for faculty and learners? Evaluation What is the optimal timing/load of evaluation? Are these the best instruments to measure our outcomes? | [footer text here]

Next Steps Follow-up with pharmacy contact regarding supervision, scheduling Meet with Progress Foundation stakeholders to update and get feedback on plan Reach out to director, counselor, NPs at selected program Course schedule and syllabus Recruit students | [footer text here]

Questions and Feedback Thank you! | [footer text here]