Preparing Health Professions Students as CollaborationReady Interprofessional Team Members in a Community Setting April 10, 2015 Interprofessional Health Care Summit Armstrong State University, Savannah, GA David Pole, PhD (c), MPH Director SLU Center for Interprofessional Education and Research poledc@slu.edu Disclosure Statement I have no financial or other conflicts of interest to disclose related to this presentation From Education to Practice… Collaboration Ready for Community Health 1.Discuss the IPE Programs at SLU 2.Introduce the IPE Community Practicum 3.Discuss two sample community partner agencies and student team projects 4.Share the evaluations and impact for both students and community agency partners SLU-IPE Program Overview • In 2000, completed 3 year effort of Task Force on IPE • Literature Review (99) • Assumptions • Premises • Curriculum integration recommendations • Ruebling, I., Lavin, M., Banks, R., Block, L., Counte, M., Furman, G., . . . Viehmann, V. (2000). Facilitating factors for, barriers to, and outcomes of interdisciplinary education projects in the health sciences. Journal of Allied Health, 29 (3), 165-170. SLU-IPE Program Overview • 2006, President’s Challenge • Integrated curriculum across nursing and health sciences • Established Five Domains of SLU IPE • 2009, Integrated IPE to Post-Baccalaureate Programs • Seven professions, series of six 90 min seminars Ruebling, I., & Royeen, C. (2010). Saint Louis University Interprofessional Education Program. Journal of Allied Health (Online 19445-404X), 39(3 Pt 2 (Special Issue)), e-123-e1124. Breitbach, A., Sargeant, D., Gettemeier, P., Ruebling, I., Carlson, J., Eliot, K., Kienstra, K., Zeibig-Blassing, E. (2013). From Buy-in to Integration: Melding an Interprofessional Initiative into Academic Programs in the Health Professions. Journal of Allied Health, Vol.42(3). SLU-IPE Competency Domains • Interprofessional Practice • Patient-Centered Care • Wellness • Patient Safety and Quality Care • Social Justice SLU-IPE Competency Domains - Unique to the Mission of SLU - Guide SLU IPE Programs at all levels - Subsequent link to IPEC competencies • Interprofessional Practice • A collaborative, interdependent use of shared expertise directed toward a unified delivery of optimal patient care understanding professional roles, scope of practice, and skills for ethical and collaborative decision making and team-based communication. • Patient-Centered Care • The development of attitudes and communication skills that support patient empowerment and inclusion in care planning, while demonstrating sensitivity to autonomy, culture, language, literacy, socioeconomic conditions, patient comfort and ethical concerns. SLU-IPE Competency Domains • Wellness • The integration of evidence-based prevention guidelines and development of patient education skills enabling a system change from “sick-care” to wellness and prevention. • Patient Safety and Quality Care • The ability to demonstrate personal and systems quality improvement processes and communication skills across professions that lead to a reduced risk and improved quality care • Social Justice • Recognize one’s responsibility to act for the good of others and apply knowledge and skills in helping the most vulnerable and addressing health equity Conceptual Framework of SLU Minor in Interprofessional Practice *IPE 110: Introduction to IP Practice - Roles and Responsibilities; Collaboration Skills; Teams and Teamwork; SLU IPE Domains The IPE and IPCP principles and concepts introduced in IPE 110 are then applied in the context of how and where health professions work together… *IPE 350: IPCP in the context of the health care system *IPE 420: IPCP in the context of individual patient care (caring response) HCE 201: Foundations of Clinical Health Care Ethics *IPE 490: IPCP in the context of community/population health, HP/DP IPE 493: IPCP in the context of the clinical care team ORES 232: IPCP in the context research, IP care team and impact on patient care/outcomes Integrating IPE into PostBaccalaureate Health Professions: IP Team Seminars (IPTS) • • • • Medicine Physician Assistant Physical Therapy Pharmacy (STLCOP) Nursing (ABSN, AGMSN), Social Work (MSW), Occupational Therapy • Series of Six, 90-min Seminars • Revised curriculum framework in 2012, embed IPEC behaviors and critical reflection on clinical application Pole, D. (2015) Doctoral dissertation on medical student outcomes L'Ecuyer, K., Pole, D., & Leander, S. (2015, April Special Issue). The use of PBL in an interprofessional education course for health-care professional students. The Interdisciplinary Journal for Problem-Based Learning, Vol.9, Issue 1. (Platform VII-G Shelia Leander) IPE 490: Community Practicum • Course Advisory Committee • Faculty Facilitators • Community Sites and Site Coordinators • Identify agencies and sites serving medically underserved populations • Address the Triple Aim: Population Health • Learn about community needs • Learn about agency efforts to address needs • Develop and implement a project in support of the agency & community need IPE 490: Learning Objectives 1. Work effectively as a team to accomplish a common goal based on evidence-based practice. 2. Demonstrate sensitivity to the cultural diversity of the selected population, e.g. health literacy needs, an understanding of their health beliefs and practices, etc. 3. Exhibit an understanding of the scope of practice and values of the other health professionals on the team. 4. Identify factors contributing to health disparities and potential strategies for advocacy for social system change. 5. Collect appropriate data and critically analyze outcomes of the interprofessional team project and improved quality outcomes 6. Demonstrate the ability to identify actual and/or potential ethical issues associated with the chosen project. IPE 490: Community Partners • • • • • • • • • • • • Family Care Health Centers (FQHC) Peter and Paul Community Services Our Lady’s Inn American Diabetes Association St Louis County Corrections Medicine Asthma and Allergy Foundation of MO Neighborhood Houses Hope Lodge (Amerian Cancer Society) Midtown Catholic Charities St Louis Area Agency on Aging The Brain Injury Association ETC…. (28 agencies, 32-35 teams per semester) Final Poster Presentation Describe the community agency and your project (Agency Assessment) Outline the components of Key reflection points from your project – what you your team members did (Work Plan) (reflection assignment) Rationale, literature or program model that informed your project design or plan Project outcomes – info, participant comments, or pictures (documentation of outcomes and analysis) Recommended next steps or needs to move the project forward • Professional Poster Presentation • Brief Write Up of Project Abstract • 2 minute “Poster Talk” Neighborhood Houses After School(Sp.2014) Student Outcomes • First experience in the community for many students • Posters and presentations improved each year • Critical Reflections • • • • • Different needs assets in community than were aware of before Challenges of working as a team Learned significantly about teamwork in a real setting and project New awareness of challenges of working in/with community “490 taught me to be respectful of other professions opinions and how to work as an interprofessional team to achieve a common goal” • “sometimes the needs of the community required my contribution to a team that was beyond just my professional skills” Leander, S. A., Maloney, S. Maggie, Ruebling, Irma, Banks, Rebecca, Pole, David, & Kettenbach, Ginge. (2014). “The Power of Many Minds Working Together”: Qualitative Study of an Interprofessional Service-Learning Capstone Course Journal of Research in Interprofessional Practice and Education, V4.No 2, 1-17. IPE 490 Practicum: St. Louis County Corrections Medicine • Learn about the Community Site • Comprehensive team-based care, screening, aftercare coordination • Striving for National Accreditation by CHC • Requires HIV Screening and QI Plan Quality Improvement The model has two parts: Three fundamental questions, which can be addressed in any order. The Plan-Do-Study-Act (PDSA) cycle to test changes in real work settings. The PDSA cycle guides the test of a change to determine if the change is an improvement. Steps in the QI Plan: HIV Screening • Identify Current State • Determine Future State (Goal) • Develop Plan and PDSA • Implement, assess, propose future projects Building a Model for Community Collaboration & IPE • Grant from J. Macy Foundation • Added Community Coordinator • Faculty Resources • Summary of past projects • Google Sites: https://sites.google.com/a/slu.edu/slu-ipe-490--corrections-medicine/home • Site Visits and Site Satisfaction Survey • • • • Agency felt informed about purpose of IPE Program…. 4.36 (5pt) Engagement with agency in planning, implement, evaluation…4.22 Student teams helped address agency goals…. 4.10 “more communication” “more interaction” “good exp but isolated” • Public /CBPR Approach – Agency Goals for addressing community health needs, have these drive projects Evaluation of Community Impact • No student team is going to change community health • Assess the community agency readiness/ability to engage in collaboration and use of student teams • Agency clarification of project goals, mission, community need • How have projects increased agency capacity and/or ability to meet community health needs? • Modify IP-Compass Tool • Develop longitudinal projects Conclusion: Collaboration Ready for Community/Population Health 1. Students develop skills to identify community health needs and understand community agencies 2. Help the agencies identify goal or project areas 3. Develop faculty capacity to facilitate meaning 4. Students develop projects to meet those goals/needs 5. Students discuss projects in the context of IPE 490 learning objectives to cultivate personal meaning 6. Present professional poster and oral report on project, meaning to community, & personal meaning QUESTIONS or COMMENTS