1. ICME Interdisciplinary Case Management Experience

2. Team Introductions In your teams introduce yourself by NAME & DISCIPLINE and answer the following questions: What do you want everyone to know about your discipline? What stereotype do you hate the most about your discipline?

3. Interdisciplinary Case Management Experience ICME The focus of this experience is actual “practice” working with an interdisciplinary team to plan a family meeting and to critique a videotaped meeting based on this patient’s care.

4. Activities for Today You will: – Participate in team discussions and activities representing your discipline as a team member involved in the care of the patient, Mr. Jerry Freeman – Observe videotaped interactions between members of the palliative care team caring for Mr. Freeman – Plan a family meeting based on your knowledge of the patient and his family – Compare your plans to an actual family meeting – Critique the meeting you will observe – Develop an interdisciplinary plan of care for this patient

5. “Ground Rules” Turn electronic devices OFF—this is a time for personal interaction Participate in all discussions Respect one another—allow others to speak, do not interrupt Keep confidentiality related to team discussions Ask for clarification if you do not understand Have FUN!!

6. Let’s think about what you’ve learned

7. Multidisciplinary Team Strong, focused leadership Individual accountability Individualized work products Efficient meetings Success = influence on others Adapted from: the Discipline of Teams by Katzenbach and Smith, 1993.

8. Interdisciplinary Team Shared leadership Individual and mutual accountability Open-ended discussions, active problem-solving Success = collective work-products

9. What does this quote mean to you? “If they don’t have scars, they haven’t worked on a team.” Balfour Mount

10. Two Important Functions of a Palliative Care Team Conducting Family Meetings Developing an Interdisciplinary Plan of Care Today You Will Practice Both

11. Introducing: Jerry Freeman

12. Team Assignment Based upon the written summary, each team will explore different issues of Jerry Freeman’s case. 1)identify Mr. Freeman’s main issues in the area listed on your team’s chart paper 2)identify other information related to those issues needed to develop a care plan List these on chart paper. Select a reporter to share your ideas with the full group.

13. Video Vignette During the video vignette a clinician from each discipline has an interaction with Jerry Freeman’s family. A Communication Checklist is provided for you to use in evaluating these interactions. After the video, in your small groups you will analyze what you observed.

14. BREAK 10 minutes

15. What Do You Think? Would a family meeting be helpful? Why or why not? What should be included in a family meeting?

16. What are the reasons for having a family meeting? Share information about patient, treatment options, services available with all involved Assure that all involved receive the same information Develop and/or clarify goals of care Hear from all involved parties Address caregiving needs and carer needs Support family members Assess family functioning based on interactions, expressed and unexpressed feelings Identify and begin to address any conflict and/or obstacles to achieving defined goals Develop a shared plan for moving forward Assure that patient is receiving holistic care based on knowledge of the patient’s medical condition, psychosocial & spiritual needs of both the patient and family

17. Team Assignment Knowing what you now know about Jerry and his family, you are to plan a family meeting using the steps outlined in the next slide and answering the questions in the handout your facilitator has for you. Your facilitator will listen while you do this on your own. When you are done, your facilitator will comment on your interactions and application of what you know about Jerry in planning his family meeting.

18. Preparing for the Family Meeting Review what is known medically about the patient (review medical record, share observations & assessments) Review advance care planning documents and/or verbal preferences Review family psychosocial issues; keep open mind re: reported conflicts Coordinate medical opinions among consultant physicians Decide who should be present from the team Determine who should be present as family; ask the patient if possible; if not, ask patient’s surrogate Check your own emotions

19. Conducting the Family Meeting Establish the proper setting Introductions and goals for the meeting Determine family understanding of pt’s condition Review patient’s medical condition Allow for and respond to emotions If appropriate, provide prognostic information Review options, make decisions Set goals Make plan for moving forward

20. JERRY’S FAMILY MEETING Now let’s view

21. Follow-Up to the Family Meeting Debrief as a team Document Team members complete individual assignments Revisit the content and goals of the meeting with family members If patient is to leave facility, plan for continuity of care

22. Team Assignment Based on what you now know about Jerry Freeman and his family, working as a team you are to develop an interdisciplinary plan of care for the patient using the form your facilitator will provide. Each team will select a scribe to complete the form and develop one plan of care. Again, your facilitator will observe your work and provide feedback when you have completed the assignment.

23. Evaluate the Process As a team, you will evaluate your process of developing an interdisciplinary plan of care. Team facilitators have questions to guide the discussion. Each team facilitator will share observations about the process.

24. Thank you TEAM FACILITATORS: Collect one copy of the IDT (students may keep other forms) Complete the student evaluation form Thank the students for their participation.