ADVANCED LEARNING ADVANCED PRACTICE ADVANCED CARE

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1 Stakeholder Meeting Chronic Disease Management September 30, 2015

2 TABLE OF CONTENTS AGENDA... 3 OPPORTUNITIES FOR PARTNERSHIPS, GROWTH, AND IMPACT... 4 About ACPAC... 4 Impact, Scope, and Value of ACPAC and Beyond... 5 Partnership with CPD... 5 New Activities... 6 Opportunities for Partners and Champions... 6 PROGRAM IMPACT AND ACADEMIC SUCCESS... 7 NATIONAL SCOPE... 9 THE PROGRAM...10 Learning Objectives A NEW MODEL OF CARE: CHRONIC DISEASES MANAGEMENT...11 Chronic Diseases Management: An Integrated Solution UPCOMING EVENTS...13 PARTNERS AND FUNDERS...14 SELECTED PUBLICATIONS...15 SELECTED PRESENTATIONS...15 SELECTED AWARDS...16 RESEARCH PAPER OVERVIEW...17 The patient perspective: Arthritis care provided by Advanced Clinician Practitioner in Arthritis Care program-trained clinicians Don t let up: implementing and sustaining change in a new post-licensure education model for developing extended role practitioners involved in arthritis care NOTES

3 07:30am 08:00am 08:00am 08:05am 08:05am 08:30am 08:30am 08:45am 08:45am 08:50am 08:55am On AGENDA Wednesday September 30, :30am 10:00am Registration, Open Networking, and Refreshments Welcome, Introductions, and Goals for the Meeting Suzan Schneeweiss MD, MEd, FRCPC Academic Director, Continuing Professional Development Director of Education and Staff Emergency Paediatrician Division of Paediatric Emergency Medicine The Hospital for Sick Children Associate Professor, Department of Paediatrics Faculty of Medicine, University of Toronto The ACPAC Education Model for Chronic Diseases Management Katie Lundon BSc (P.T), MSc, PhD ACPAC Program Director Faculty of Medicine, University of Toronto ACPAC Therapist Presentation: Innovation in Patient-Centric Care Sue MacQueen BSc (P.T) Advanced Clinician Practitioner in Arthritis Care, The Arthritis Society Building Capacity in Arthritis Care and Chronic Disease Management Rachel Shupak MD, FRCPC ACPAC Program Medical Director Clinician-Educator, Associate Professor Division of Rheumatology, Department of Medicine St. Michael s Hospital Faculty of Medicine, University of Toronto Community Champions All hands in the middle: The necessity of an inter-disciplinary approach to service provision for Children's Mental Health Kimberly Moran President & CEO, Children's Mental Health Ontario Become a Champion: Invitation to Support ACPAC and CDM Peter Azmi MSc, PhD Business Development, Innovations + Education Office Faculty of Medicine, University of Toronto Closing Remarks; Open Q&A; Networking Trevor Cuddy BCom, BA, MEd Director, Continuing Professional Development Faculty of Medicine, University of Toronto 3

4 OPPORTUNITIES FOR PARTNERSHIPS, GROWTH, AND IMPACT About ACPAC The Advanced Clinician Practitioner in Arthritis Care (ACPAC) program is a unique post-licensure academic and clinical educational program that prepares experienced physical therapists, occupational therapists and nurses for extended practice roles using advanced knowledge and skills training in the diagnosis and management of patients with arthritis. More about ACPAC: ACPAC serves the interests of many stakeholders within the arthritis care and chronic disease care communities and beyond: 4

5 Impact, Scope, and Value of ACPAC 1. The ACPAC Program facilitates the development of new models of care by expanding the role of existing human health-resources in chronic disease management care. 2. In keeping with Ontario s Action Plan for Health Care 2012 and the Government of Canada Advisory Panel on Healthcare Innovation Report 2015, ACPAC graduates (n=54) have successfully provided: Improved access to and quality of arthritis care Strengthened healthcare capacity Responsiveness to demographic challenges 2015 and Beyond Over the last 10 years, ACPAC has proven to be an extremely successful post-licensure training model 1. Since 2013, ACPAC has established an administrative model that will ensure ongoing support for the Program, and will better allow for investment and new growth opportunities. The success of ACPAC has led to an increase in demand for ACPAC-trained professionals, while simultaneously developing complementary training programs based on the ACPAC model. To sustainably address these needs, the Program has partnered with the University of Toronto s Department of Continuing Professional Development (CPD), where ACPAC can leverage existing infrastructure, staff and business resources required to grow and support the Program into the future. Partnership with CPD The Office of Continuing Professional Development (CPD), University of Toronto offers ACPAC several key operational advantages, which include: The ability to offer ACPAC as an advanced certificate program accredited by CPD, University of Toronto Access to a dedicated academic business development and knowledge translation team (see innovatingedu.ca) Communications and information technology resources, including development of the new website, Project management and event coordination services (see cpd.utoronto.ca) Legal and copyright services 1. Lundon, K., Shupak, R., Schneider, R., and McIlroy, J Development and Early Evaluation of an Interprofessional Post-Licensure Education Program for Extended Practice Roles in Arthritis Care. Physiotherapy Canada 63(1):

6 New Activities ACPAC trainees have been shown to significantly improve patient health outcomes, while improving the rate at which patients are managed in the healthcare system 2. Over the next several years, ACPAC s objectives are to: Increase the number of learners we train in the ACPAC Program per year Improve access to the ACPAC Program across Canada Expand strategic partnerships with key stakeholders and address emerging needs Enhance the impact of ACPAC workshop events and community outreach initiatives Improve network connectivity among current and past ACPAC graduates Opportunities for Partners and Champions ACPAC is actively seeking partners to support the Program s action plan. 2. Passalent, L., Kennedy, C., Lundon, K., Rozmovits, L., Sinclair, L., Soever, L., Schneider, R., Brooks, S., Warmington, K., Shupak, R System integration and clinical utilization of the Advanced Clinician Practitioner in Arthritis Care (ACPAC) program-trained extended role practitioners in Ontario: a 2-year system-level evaluation. Healthcare Policy 8(4):

7 PROGRAM IMPACT AND ACADEMIC SUCCESS 7

8 8

9 NATIONAL SCOPE 9

10 THE PROGRAM The ACPAC (Advanced Clinician Practitioner in Arthritis Care) Program is an innovative, interprofessional academic and clinical-education training program in advanced musculoskeletal/arthritis care currently offered to experienced physical therapists, occupational therapists, and nurses. The program is hosted by St. Michael s Hospital, in collaboration with The Hospital for Sick Children. It is a certificate-based program offered at the post-licensure level in association with CPD, University of Toronto. The ACPAC Program was developed in response to the well-recognized need for an interprofessional, patient-centred collaborative approach to better manage patients presenting with osteoarthritis (OA) as well as in the early detection of rheumatoid arthritis (RA) by improving access to (shortened wait times) and efficiency of care. The ACPAC Program provides the mechanism for training extended role practitioners to assume vital roles of triage, education and in select cases, management of patients with osteoarthritis and inflammatory arthritis. Learning Objectives 1. Participants will learn the basic and clinical science underlying arthritis/musculoskeletal disorders. 2. Participants will learn to identify, assess and provide differential diagnosis between inflammatory and degenerative arthritic disorders. 3. Participants will learn an approach to interpretation of plain musculoskeletal radiographs. 4. In relation to the above, the participants will learn skills of triage for arthritic disorders. 10

11 A NEW MODEL OF CARE: CHRONIC DISEASES MANAGEMENT In the current health care paradigm, patients needing to seek appropriate care are faced with several challenges, all of which limit appropriate access to care for the patient. These challenges arise from several distinct issues: 1. Difficulties in managing complex, chronic diseases, including: 1. Inadequate triage at the point of primary care 2. Inadequate management post specialist intervention leading to suboptimal treatment outcomes 2. Access to specialists is diminished through: 1. A dearth of specialists in comparison to the demand for services 2. Specialists consulting on a large number of inappropriate referrals 11

12 Chronic Diseases Management: An Integrated Solution Chronic Diseases Management (CDM) focuses on developing the skills of the allied health professional, which in-turn can help develop innovative models of care. For more information: 12

13 ACPAC UPCOMING EVENTS Contact Us for Partnership Opportunities Visit acpacprogram.ca or 13

14 ACPAC PARTNERS AND FUNDERS In , the ACPAC Program has been generously supported by tuition fees, The Ontario Ministry of Health, St. Michael s Hospital Foundation, The Arthritis Society (Ontario), and Industry. The ACPAC Program is endorsed by the Arthritis Alliance, the Canadian Rheumatology Association, and the Arthritis Health Professionals Association. Thank you! ACPAC Program trainees and graduates; academic and clinical faculty. The Ministry of Health and Long-Term Care (Health Force Ontario), Ontario, Canada. St. Michael s Hospital Foundation, Toronto, Canada. The Arthritis Society. Arthritis Health Professions Association (AHPA), Canada. Canadian Rheumatology Association (CRA) and Ontario Rheumatology Association (ORA). Canadian Initiative for Outcomes in Rheumatology Care (CIORA). Industry Supporters: AbbVie, Amgen, Janssen, Pfizer, Roche, UCB, Wyeth. 14

15 ACPAC SELECTED PUBLICATIONS Lundon, K., Shupak, R., Canzian, S., Ziesmann, E. Schneider, R. (2015). Don t Let Up: Implementing and Sustaining Change in a New Post-Licensure Education Model for Developing Extended Role Practitioners involved in Arthritis Care. Journal of Multidisciplinary Healthcare. Journal of Multidisciplinary Healthcare 2015(8): Warmington, K., Kennedy, C., Lundon, K., Soever, L., Brooks, S., Passalent, L., Shupak, R., Schneider, R.. (2015). The Patient Perspective: Arthritis care provided by Advanced Clinician Practitioner in Arthritis Care (ACPAC) Program trained clinicians. Open Access Rheumatology: Research and Reviews 2015(7):45 53 Passalent, L., Kennedy, C., Lundon, K., Rozmovits, L., Sinclair, L., Soever, L., Schneider, R., Brooks, S., Warmington, K., Shupak, R. (2013). System integration and clinical utilization of the Advanced Clinician Practitioner in Arthritis Care (ACPAC) program-trained extended role practitioners in Ontario: a 2-year system-level evaluation. Healthcare Policy 8(4): Lundon, K., Kennedy, C., Rozmovits, L., Sinclair, L., Soever, L., Schneider, R., Brooks, S., Passalent, L., Warmington, K., Shupak, R. (2013). Evaluation of Perceived Collaborative Behaviour Amongst Stakeholders and Clinicians of a Continuing Education Programme in Arthritis Care. Journal of Interprofessional Care 27(5): Lineker, S., Lundon, K., Shupak, R., Schneider, R., MacKay, C, and Varatharasan, N. (2011). Arthritis Extended-Role Practitioners: Impact on Community Practice (An Exploratory Study). Physiotherapy Canada 63(4): ACPAC SELECTED PRESENTATIONS Lundon, K., and Soever, L. Leadership and Innovation in Post-Licensure Education: The ACPAC Program Model. Podium. Canadian Physiotherapy Association, National Congress, Halifax. June 18-20, Lundon, K. The ACPAC Program: Ahead of its Time or Just in Time? Podium, Guest Speaker, Canadian Rheumatology Association Annual Scientific Meeting- Whistler, BC. February 26-29, Lundon, K. The Advanced Clinician Practitioner in Arthritis Care (ACPAC) Programtrained Extended Role Practitioner: Can They Fill the Gap in Post- Licensure Education and Practice in Arthritis Care? Irish Society of Chartered Physiotherapists Annual Conference Innovation: Ideas into Action -Dublin, Ireland. KEYNOTE SPEAKER, November 16-17,

16 Warmington K, Passalent L, Kennedy C, Soever L., Brooks S, Lundon K, Shupak R, Schneider R. The Impact of Advanced Clinician Practitioner in Arthritis Care (ACPAC) program-trained extended role practitioners on healthcare delivery: A two year prospective study. Poster presentation: Annual European Congress of Rheumatology - EULAR, Berlin, Germany. June 6-9, Lundon K, Kennedy CA, Soever L. The ACPAC (Advanced Clinician Practitioner in Arthritis Care) Program Trained Extended Role Practitioner (ERP): Can They Fill the Gap in Post licensure Education and Practice in Arthritis Care? Podium presentation: Canadian Physiotherapy Association Congress, Saskatoon, SK. May 24-27, ACPAC SELECTED AWARDS 2015 Canadian Physiotherapy Association (CPA) Honorary Membership Award (Katie Lundon) 2015 Arthritis Health Professions Association (AHPA) Clinical Innovation Award 2012 Queen Elizabeth II Diamond Jubilee Medal (Rachel Shupak) 2009 Ministry of Health Ontario Innovation in Human Health Resources Award 2008 Ted Freedman Ontario Hospital Association Award: Certificate of Excellence at HealthAchieve2008 for innovation, effective use of technology and ability to positively impact change using education 2007 Colin Woolf Award: Excellence in Course Design and Coordination from Continuing Professional Development, Faculty of Medicine, University of Toronto (Rachel Shupak) 16

17 ACPAC RESEARCH PAPER OVERVIEW The patient perspective: Arthritis care provided by Advanced Clinician Practitioner in Arthritis Care program-trained clinicians Warmington K., Kennedy C.A., Lundon K., Soever L.J., Brooks S.C., Passalent L.A., Shupak R., Schneider R. (2015). Open Access Rheumatology: Research and Reviews 2015(7):45 53 Abstract Objective: To assess patient satisfaction with the arthritis care services provided by graduates of the Advanced Clinician Practitioner in Arthritis Care (ACPAC) program. Materials and methods: This was a cross-sectional evaluation using a self-report questionnaire for data collection. Participants completed the Patient Doctor Interaction Scale, modified to capture patient practitioner interactions. Participants completed selected items from the Group Health Association of America s Consumer Satisfaction Survey, and items capturing quality of care, appropriateness of wait times, and a comparison of extended-role practitioner (ERP) services with previously received arthritis care. Results: A total of 325 patients seen by 27 ERPs from 15 institutions completed the questionnaire. Respondents were primarily adults (85%), female (72%), and living in urban areas (79%). The mean age of participants was 54 years (range 3 92 years), and 51% were not working. Patients with inflammatory (51%) and noninflammatory conditions (31%) were represented. Mean (standard deviation) Patient Practitioner Interaction Scale subscale scores ranged from 4.50 (0.60) to 4.63 (0.48) (1 to 5 [greater satisfaction]). Overall satisfaction with the quality of care was high (4.39 [0.77]), as was satisfaction with wait times (referral to appointment, 4.27 [0.86]; in clinic, 4.24 [0.91]). Ninety-eight percent of respondents felt the arthritis care they received was comparable to or better than that previously received from other health care professionals. Conclusion: Patients were very satisfied with and amenable to arthritis care provided by graduates of the ACPAC Program. Our findings provide early support for the deployment and integration of ACPAC ERPs into the Ontario health care system and should inform future evaluation at the patient level. To read the paper visit: 17

18 ACPAC RESEARCH PAPER OVERVIEW Don t let up: implementing and sustaining change in a new post-licensure education model for developing extended role practitioners involved in arthritis care Lundon K., Shupak R., Canzian S., Ziesmann E., Schneider R. (2015). Journal of Multidisciplinary Healthcare 2015(8): Abstract Key message: Across a 9-year period, the Advanced Clinician Practitioner in Arthritis Care program has achieved a set of short-term wins giving direction and momentum to the development of new roles for health care practitioners providing arthritis care. Implications: This is a viable model for post-licensure training offered to multiple allied health professionals to support the development of competent extended role practitioners (extended scope practice). Challenges at this critical juncture include: retain focus, drive, and commitment; develop academic and financial partnerships transferring short-term success to long-term sustainability; advanced, context-driven, system-level evaluation including fiscal outcome; health care policy adaptation to new human health resource development. Supporting evidence: Success includes: completed 2-year health services research evaluating 37 graduates; leadership, innovation, educational excellence, and human health resource benefit awards; influential publications/presentations addressing post-licensure education/ outcome, interprofessional collaboration, and improved patient care. To read the paper visit: Publication-.pdf 18

19 NOTES 19

20 2015 University of Toronto ACPAC Program For more information