1. Beating the Collaboration Blues – the Story of Two Community Mental Health Teams Funded by: Health Canada and AB Health & Wellness March 4, 2011, Saskatoon Esther Suter Siegrid Deutschlander Jeanne Besner Health Systems and Workforce Research Unit Health Professions Strategy & Practice

2. 2 The Project Funded by Health Canada and Alberta Health and Wellness for 1 year Across four Western Provinces Creating Collaborative Learning & Practice Environments Implement changes at education, practice and organizational levels Engage students if possible Focus on developing IP competencies

3. 3 Participating Sites Two community mental health programs; serve adults with psychiatric problems with pervasive impairments across different areas of functioning (Axis 1 diagnosis). Interprofessional staff mix (SOWK, nursing, psychology therapists, independent living support workers, OT). Services: intake assessments, psychiatric consultations, individual and group therapy, medication management, outreach and transition support. Regular student placements from nursing, social work, occupational therapy, psychology and psychiatry.

4. 4 Baseline Assessment Data collected from May 15, 2010 – August 31, 2010 –Observation check list –Staff interviews –Social Network Survey Presenting data back to staff for validation Highlight opportunities for intervention: Staffing, client referral processes, approaches to care, team collaboration, organizational culture, client/family- centred care, student placements

5. 5 What We Also Heard… “We’re doing it already” – collaborate, that is… “We don’t have time…” “We need more staff…” “They don’t let us spend time on professional development…” “We don’t have the power to change anything…” “It’s the system...” “We need to focus on important things”

6. 6 How to Get Started (2) Show them the facts Informal advice

7. 7 How to Get Started (1) Show them the facts Treatment planning

8. 8 How to Get Started (3) Be clear about what IP Education /Collaborative Practice is and what it’s not Formal interprofessional education aims to promote collaboration and enhance the quality of care through intentional development of IP competencies; it is an educational or practice development opportunity that brings people from different professions together to engage in IP learning activities. Debriefs, reflections and evaluation of IP competencies (such as roles, shared decision-making) are critical to formal IP education. Informal /incidental interprofessional education happens at times when learners from different professions or occupational groups are together; however, at its inception, incidental IP education lacks the intention, and would fail to acknowledge, the IP nature and learning potential of the opportunity. Hence, IP learning outcomes (i.e. development of IP skills and competencies) are limited. (Adapted from Freeth et al. 2005).

9. 9 How to Get Started (4) Set realistic expectations (time commitment, work required, desired outcomes) Let them vent Meet them where they are at Be patient Don’t get discouraged when team motivation is low Help the team to problematize their practice

10. 10 How to Keep them Going (1) Create incentives along the way –Professional development opportunities –Bring treats Find their passion Challenge them Stretch and fold Track ongoing discussions

11. 11 How to Keep them Going (2) Let them explore dead ends Appeal to their creativity Boost energy through team building retreats

12. 12 How to Make it Stick Focus on sustainability early on Build capacity

13. 13 Activities to Date Staff sessions: 1hr every 2 weeks Student sessions: 2 hrs every 2 weeks to discuss CIHC IP competencies and debrief on IP mentoring activities Workshop for staff and students (IP competencies framework, IP mentoring) Staff retreat for communication, team building, visioning Education series – six invited speakers Practice education days

14. 14 Achievements to Date Team 1: Protocol for sharing of complex clients Protocol for case presentations at team meetings Starting to revamp discharge process Improved access to family physicians Team 2: Addictions expertise/consultation Simple rules Starting to develop “care pathways” Improved access to family physicians

15. 15 The More Subtle Changes… Things are shifting “I think we are on to something…” Tentative commitment from both teams to continue until September More structured conversations More engagement in conversations Recognition that we as facilitators challenge them in a good way More reflective about their practice

16. 16 What’s Next Complete activities around discharge and care pathways Focus on sustainability and capacity building Initiate education series Develop mini-retreats for focused work and teambuilding Conduct final evaluation Celebrate accomplishments

17. 17 Thank You! The Project is funded by Health Canada and Alberta Health and Wellness Thanks to the two teams and to my facilitator colleague Siegrid for hanging in there