1. Preparing the Future Primary Care Workforce Together
Professionals Accelerating Clinical and Educational Redesign (PACER)
Where Do We Go From Here?

2. “The only time you should ever look back, is to see how far you’ve come.”*
*Google image search: author unknown

3. What Have We Really Provided in PACER?
We brought faculty teams together
We coached you and empowered you
We showed you models of how this could work
We instilled hope that you could come together around your similarities and be strengthened by your differences

4. What Have You Done? You have forged new relationships
Teams have unified around a shared vision
You have fostered peer and stakeholder support for your efforts
You have strengthened primary care at your institutions
You have moved IPE from the classroom to clinical settings

5. You Have Created New Paths
Solving problems together
Learning from others farther down the path
Learning from others with different perspectives and different strengths

6. Some Early PACER Quotes….
“As an intern, I had to utilize other team members to get the work done - ‘How can the team help me get my work done,’ but by third year, my goal is to maximize how well the team is working.” – ‘How can I help the team.’ -FM 3rd year resident
“PACER has given us hope that we can change.” - IM faculty
“PACER now comes into my thinking regularly – makes we ask the question, ‘how is this interprofessional?’” - PA faculty
“We are now asking patients questions we would have never asked before because we can now do something about the answers.” – FM faculty on the benefit of IP practice
“We’ve gone to each other’s houses, but now we need to see what’s in each other’s drawers.” – Psychology faculty

7. And it’s Damn Hard Work….
Primary care faculty are under siege and under- resourced
You struggle to add this work on top of everything else you are doing
Some of you need a project manager and don’t have one
You have stakeholders who are passively supportive but unwilling to provide real resources
You get push-back and resistance from other faculty and staff
Having multiple professions at the table is complex and challenging

8. Challenges in PACER
Negotiating memoranda of understanding between different schools/institutions
Scheduling learners in meaningful ways that provide continuity to both learners and patients
Getting all staff to work at the highest level of their licenses
Negotiating with institutional and residency leaders to change within the confines of accreditation requirements
Preparing clinical settings and patients for interprofessional learners working with them as part of their healthcare visits

9. PACER Regional Centers
Vision: “PACER Regional Centers will function post-PACER to provide professional development for faculty in primary care residencies and health professions schools to catalyze transformation in primary care and interprofessional education (IPE) and foster collaboration among primary care health professionals.”

10. 9 PACER Teams 3 Regional Centers Planned
UC Davis Wright State University
UCSF Fresno Univ of So. Carolina/Palmetto Health
University of Colorado Eastern Virginia Medical School
Mayo Clinic Northwell Health
Western Michigan University

11. Areas of commonality emerging from PACER teams
Continuity of care
Care coordination
Managing transitions of care
Patient engagement
Team huddles
Shared measures for evaluating change
Learning more about professional training and roles for PAs, NPs, pharmacy, behavioral health

12. PACER Regional Center - Features
Focus on efforts that empower faculty to be more successful in their work
Build connections & collegial support
Share ideas & struggles
Use imbedded experience and work activities as the stimulus for growth and learning
Have varied combinations of training programs that could function as a group of connected “assets”

13. PACER Regional Center – Potential Services
Convene Programs (annual or semi-annual meetings)
Share innovations
Build skills
Foster connectivity
Resource Conduit & Connector
Share tools, resources and innovations developed by PACER teams
Develop a group of identified experts from the PACER teams that can share experience/wisdom
Individual Program Assistance
Residency assessment
Transformation Coaching
Multi-site Projects

15. PACER Regional Center 1 Advocate Lutheran General Hospital
Builds on the work and leadership established in our pilot - Advocate Primary Care Transformation Collaborative (APCTC) - the team of primary care residency faculty created during PCFDI
Lead Primary Care Practice Transformation
Conduct Faculty Development Activities:
Teach with Quality Data
Sponsor Regional Center Primary Care Conference - “The Future of Primary Care-Hot Topics and Challenges,” Sep 28, of you attending!!

16. PACER Regional Center 2 Under Discussion - I3 Collaborative
I3 operating for 11 years; built infrastructure to support funded multi-site projects; network of 25 PC residencies (VA, SC, NC, GA, FL, TN)
I3 Collaborative as the vehicle to disseminate the innovations and learnings from PACER –expand beyond residencies to other professions
EVMS and PH/USC PACER Teams provide leadership for this effort
Future goal to expand to add more residencies to I3

17. PACER Regional Center 3 Under Discussion – University of Colorado DFM
Built network of primary care residency programs which collaborate on practice and educational re- design.
DFM currently providing services that catalyze the transformation work of residencies, e.g. PCMH e- learning modules
Build on strengths and expertise in integrated behavioral health
Synergistic with University of CO student IPE programs

18. What’s Needed for Sustainability?
Infrastructure
Project manager
Dedicated faculty time
Conference support –logistics, CME, speaker fees
Dedicated IT support for QI
Training Program Learning Collaborative
Build on PACER foundational work
Invite new partners
Stay connected to PACER Regional Centers
Share materials and resources on pcpacer.org

19. Strategies for Sustainability
Create a Steering Committee made up of institutional stakeholders
Seek alignment and synergies with broader system priorities
Establish multi-source funding for infrastructure
Departments, Dean’s office, Faculty Practice Plan, Health system
CME funds
Grants
Use your local PACER projects as a pilot for a larger grant
Leverage PACER teams as a dissemination “collaboratory”

20. How Will You Keep PACER Alive?