A Cord of Three Is Not Easily Broken. Goals and Objectives. Collaboration Best Practices in Medical Education Day

Transcription

1 A Cord of Three Is Not Easily Broken How Collaboration between Internal Medicine, Pediatrics, and Family Medicine--and Medicine, Nursing, Pharmacy--is Transforming Primary Care Teaching at the University of Minnesota Goals and Objectives Describe the interdisciplinary and interprofessional work being done in primary care education. Describe the necessary infrastructure supports to facilitate interprofessional and interdisciplinary educational endeavors Identify the elements of educational activities that are best suited to interprofessional and interdisciplinary collaboration. Appreciate the opportunities and challenges of interprofessional collaboration Opening Exercise Primary Care spans across many disciplines, professions, and training programs Physicians in Family Medicine, Pediatrics, Internal Medicine, and Med-Peds Nurse Practitioners in Family Medicine, Pediatrics, Adult/Gerontology, and Women s Health Pharmacists Social Workers Physician Assistants Nurses Medical Assistants In your clinical work, what other medical disciplines are involved? What other professions? Collaboration In 2009 the ABIM, ABP, ABFM came together with the purpose to improve training in primary care Gaps identified include: Teamwork, team approach to care delivery Patient centeredness, PCMH Measuring and improving outcomes Systems thinking Primary Care Faculty Development Initiative (PCFDI) PCFDI provides faculty an opportunity to engage in a collaborative learning experience focusing on how to train primary care residents to practice safely and effectively in a rapidly evolving health care system Faculty are then charged with going back to their respective residency programs and becoming change agents Mustafa, Borman-Shoap, Hager, Thompson Buum, Dierich 1

2 Process Grant Application Deadline December 2012 Authored by FM, IM, Peds, with support from Chairs/DIO Competitive: over 50 programs applied nationally, 4 Midwest programs chosen Grant would support travel expenses Three faculty from each discipline Two national meetings, 18 month grant cycle Why did we apply? Our University based residency programs have traditionally been focused on inpatient and subspecialty training Pediatrics Family Medicine Internal Medicine Med-Peds Why did we apply? Poised to make changes National Center for Interprofessional Practice and Education TeamSTEPPS training Support from Chair, Vice Chair, PDs After: Minnesota Primary Care Transformation Collaborative Expanded to include Pharmacy (Keri Hager, Ambulatory Care Residency, Duluth MN ) Nursing (Mary Dierich, Adult/Geriatric DNP Program) Interprofessional Opportunities Learn about each others professional curricula Improve Collaborate Learn about each others professional practice Training Scope Perspectives Interprofessional Challenges Speaking the same language Varied level of learners Logistical challenges; varied practice sites, schools, departments Academically Clinically Uniform implementation and data collection (e.g. PCOF) Mustafa, Borman-Shoap, Hager, Thompson Buum, Dierich 2

3 Identifying Commonalities How do we further the Triple Aim: Many shared competencies Many shared tasks Many shared challenges in teaching and evaluating Our Two Main Projects Introduction of an Ambulatory Curriculum: Essentials of Ambulatory Care Teaching Patient Centeredness through Direct Observation of Resident Encounters: PCOF Teaching Patient Centered Care Teaching Patient Centered Care Patient Centered Observation Form (PCOF) Why? Curriculum all could share Milestones required more observations Family Medicine had experience using Goal: Providing learners better training in effective outpatient interactions PCOF what is it? One page observation tool Patient visit broken down into discrete components Each component is defined by discrete behaviors Observer notes number of behaviors witnessed More behaviors = more patient centered PCOF implementation Faculty Development Workshops Workshop introducing form to learners Implementation of form in varied clinical settings Mustafa, Borman-Shoap, Hager, Thompson Buum, Dierich 3

4 Curriculum: Essentials of Ambulatory Care Primary Care Seminars Full day, inter-professional seminars focused on outpatient primary care Attendees included internal medicine, pediatrics, family medicine, pharmacy and nurse practitioner trainees Faculty from the same specialties Timing of the Sessions Sessions were offered twice this year Trainees were excused from other clinical work to attend All sessions included a mix of trainees Goals for the Seminars After these seminars, attendees will be able to: Communicate more effectively in the interprofessional team Understand the roles and skills of team members Describe key concepts of the Patient-Centered Medical Home Utilize Patient-Centered Observation Form in their outpatient clinic setting Articulate core components of effective transitions in care What informed our goals? Core Competencies for Interprofessional Collaborative Practice Simplifying Goals Patients First: (VE1) Place the interest of patients and populations at the center of inter-professional healthcare delivery. Who is on our team? Reflect on own values, personal and professional, and respect those of other IP team members/clients/families. Right Person, Right Job: (RR9). Use unique and complementary abilities of all members of the team to optimize patient care. Can we talk? (Relationships/Communication): (RR6). Communicate with team members to clarify each member s responsibility in executing components of a treatment plan or public health intervention. Let s Get Together: (VE5). Work in cooperation with those who receive care, those who provide care, and others who contribute to or support the delivery of prevention and health services. Triple Aim: patient outcome, patient experience, total cost of care Mustafa, Borman-Shoap, Hager, Thompson Buum, Dierich 4

5 Agenda Teamwork Focus on communication, roles Patient-Centered Medical Home Overview Patient-Centered Observation Form introduction and Overview Brief overview of transitions in care Teamwork Portion Inter-professional Teamwork Describe the training and scope of practice for the following team members in the PCMH: Physician (primary care vs. specialist care) Nurse Advanced Practice Professional Pharmacist Medical Assistant Social Worker Care coordinator Reflect on the importance of respectful and clear team communication in effective patient-centered care. Develop comfort in using a standardized communication framework (SBAR, CUS). Be familiar with evidence for effective interprofessional teambased care. Teamwork Warm-Up Team is given a scenario to work through Each member plays a role Stickers worn on forehead instruct other members how to regard input Summary Supports to Interprofessional Collaboration Coordination/administration Space (real or virtual) Time Comittment Strength of Interprofessional Collaboration Varied perspectives increase innovation Sharing tools and practices decreases need to reinvent Collaboration = community Mustafa, Borman-Shoap, Hager, Thompson Buum, Dierich 5

6 Questions and Discussion Mustafa, Borman-Shoap, Hager, Thompson Buum, Dierich 6