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1 Barbara F. Brandt, PhD Director Associate Vice President for Education University of Minnesota The National Center for Interprofessional Practice and.

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Presentation on theme: "1 Barbara F. Brandt, PhD Director Associate Vice President for Education University of Minnesota The National Center for Interprofessional Practice and."— Presentation transcript:

1 1 Barbara F. Brandt, PhD Director Associate Vice President for Education University of Minnesota The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP In addition, the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation (RWJF), the Gordon and Betty Moore Foundation, and the John A Hartford Foundation have collectively committed up to $8.6 million in grants over five years to support and guide the Center, which will work to accelerate team work and collaboration among doctors, nurses and other health professionals as well as patientsand break down the traditional silo-approach to health professions education.

2 2 Its scope of practice! Its health professions education system Its the payment system! Its the health delivery system! More primary care !! There is no problem our system is great! Team Training!!

3 3 Preventive Medicine Medication Refills Acute Care Nursing Test Results Master Builder DOCTOR Practice transformation away from episode of care Source: Southcentral Foundation, Anchorage AK Behavioral Health Case Manager Medical Assistants Chronic Disease Monitoring Paul Grundy MD MPH IBM Director Healthcare Transformation Director Patient Centered Primary Care Collaborative

4 4 Population Health System Integrator Patient Experience The System Integrator Creates a partnership across the medical neighborhood Drives PCMH primary care redesign Offers a utility for population health and financial management Per Capita Cost Prouctivity 28 Copyright 2011 by IBM Triple Aim Paul Grundy MD MPH IBM Director Healthcare Transformation Director Patient Centered Primary Care Collaborative

5 5 Framework for Action on Interprofessional Education and Collaborative Practice, World Health Organization, 2010 Interprofessional education occurs when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes. Interprofessional education is a necessary step in preparing a collaborative practice-ready health workforce that is better prepared to respond to local health needs. A collaborative practice-ready health worker is someone who has learned how to work in an interprofessional team and is competent to do so. Collaborative practice happens when multiple health workers from different professional backgrounds work together with patients, families, carers, and communities to deliver the highest quality of care. It allows health workers to engage any individual whose skills can help achieve local public health goals.

6 6 Inteprofessional Practice and Education before the Nexus

7 7 Interprofessional Collaborative Practice = About, from & with Primary Care Access to Care Patient Safety / Quality Integrative Health Healthcare/ Medical Homes Service- Learning High functioning teams Teams / Teamwork Acute Care

8 8 Integrated Health care & Higher Ed System Transformation Integrated Health care & Higher Ed System Transformation Access to care Teamwork Patient Safety/Quality Workforce Development Improved Health and Learning Outcomes Driving Costs Out of Systems Getting to know each other IPE: Opportunities for Community-Campus Partnerships linked to Health Community Health Outcomes Brandt, B.F. (2009). IPE: Past, Present & Future. Presentation to HRSA Advisory Committee on Community- based Interdisciplinary Linkages.

9 9 IPEC Competencies Values & Ethics for Interprofessional Practice Roles & responsibilities Interprofessional Communication Teams and teamwork Other Needed Competencies Population Health, including social determinants Patient-center decision-making Evidence-based decision-making Cost-effective practices Quality improvement and safe practice Stewardship Systems Thinking

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11 11 National Center For Interprofessional Practice and Education

12 12 The National Center for Interprofessional Practice and Education

13 13 The Nexus : Education aligned and integrated with the process of care to: 1. Reduce cost and add value to the alignment 2. Improve the quality of the user and learner experience, and to 3. create shared responsibility Leading to Partnerships with A. New System Competencies 1.Team trained and experienced 2. Patient centered decision-making 3. Engaged in evidenced-based decision making, quality improvement and safe practice 4.Knowledgeable in population health, including social determinants 5.Practices in cost-effectiveness, adding value, stewardship and systems thinking B. Strategies for achieving and implementing competent teams C. Organizational models of shared resources, governance, management and accountability D. Value added business case and plan agreed to and implemented Producing Positive Impact on Triple Aim Outcomes 1. Health of the Population Imp roved a. communities engaged in achieving health b. coordinated engagement regarding social determinants of health c. Implemented effective prevention, wellness and disease management programs d. mental health programs developed and implemented e. established metrics and measurement 2. Increasing value apparent a. improved per capita/system quality of care b. reduced per capita cost of care c, established metrics and measurements 3. Individuals, families, communities engaged in achieving health a. individuals behaving as consumers in the marketplace b. Individuals achieving well-being c. easy access to services needed d. ease of access to information e. engaged in the health of the community Vision of the Transformed Approach to Health

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15 15 Stakeholders Have Important Functions in the Transformati on

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18 18 Paul Grundy MD MPH IBM Director Healthcare Transformation Director Patient Centered Primary Care Collaborative

19 19 Public Health Prevention Specialists PCMH in Action Community Care Team Nurse Coordinator Social Workers Dieticians Community Health Workers Care Coordinators Public Health Prevention HEALTH WELLNESS Hospitals PCMH Health IT Framework Global Information Framework Evaluation Framework Operations A Coordinated Health System 35 Copyright 2011 by IBM Paul Grundy MD MPH IBM Director Healthcare Transformation Director Patient Centered Primary Care Collaborative

20 % Drop in hospital days 32.2% Drop in ER use 12.8% Increase Chronic Medication use -15.6% Total cost 10.5% Inpatient specialty care costs down 18.9%Ancillary costs down 15.0%Outpatient specialty down Outcomes of Implementing Patient Centered Medical Home Interventions: A Review of the Evidence from Prospective Evaluation Studies in the US - PCPCC Oct 2012 Smarter Healthcare Paul Grundy MD MPH IBM Director Healthcare Transformation Director Patient Centered Primary Care Collaborative

21 21 Perinatal Safety: Reducing Adverse Obstetric Events A.Perinatal Safety Initiative 1. Evidence-based approach 2. Formalized interprofessional team training with emphasis on communication 3. Standardized, competency documented electronic fetal monitoring 4. High-risk obstetrical emergency simulation program 5. Integrated educational program disseminated among all providers B.Outcomes 1. Eleven adverse outcome measures were longitudinally followed 2. Individual components of the program were evaluated C.Results 1. Within the first year, the Adverse Outcome Index was significantly and meaningfully reduced and maintained throughout the two year study period 2. Significant and meaningful reductions in: a. Rates of return to operating room b. Birth trauma 3. Significant improvements in: a. Staff perceptions of safety b. Patient perceptions of the effectiveness how the team worked together c. Documentation and management of abnormal fetal heart rate tracings d. Documentation of obstetric hemorrhage Wagner B, et al Journal of Healthcare Quality 2011

22 22 IPECP in a Transitional Care Unit Lynn A. Blewett PhD,1 Kelli Johnson MBA,2 Teresa McCarthy MD,3 Thomas Lackner PharmD,4 and Barbara Brandt PhD,5 Improving geriatric transitional care through inter-professional care teams, Journal of Evaluation in Clinical Practice 16 (2010) 57–63 2 Lynn A. Blewett PhD,1 Kelli Johnson MBA,2 Teresa McCarthy MD,3 Thomas

23 23 Interprofessional education: effects on professional practice and healthcare outcomes (update) (Review) Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Reeves S, Perrier L, Goldman J, Freeth D, Zwarenstein M The Latest Cochrane Collaboration Analysis

24 24 Limitations of Traditional Training Variable clinical experience amongst individuals during training Limited experience of managing rare events Ethical considerations of using patients for learning Current environment difficult to discuss and learn from mistakes Limited opportunities to acquire proficiency of skills in procedures Kathleen Gallo Ph.D, MBA, RN, FAAN Senior Vice President Chief Learning Officer North Shore LIJ

25 25 Simulation: Important part of the Solution Use simulation whenever possible for healthcare education Train in teams, those who are expected to work in teams Create new and realistic methods of learning without putting patients at risk Kathleen Gallo Ph.D, MBA, RN, FAAN Senior Vice President Chief Learning Officer North Shore LIJ

26 26 Its Not About the Simulator The power of individual or team training in a simulation environment lies in the integration of validated educational methods into the real simulation experience (Dunn, 2008) Pre-Work Simulation Debriefing Reflection Kathleen Gallo Ph.D, MBA, RN, FAAN Senior Vice President Chief Learning Officer North Shore LIJ

27 27 Advantages of Simulation Deliberate practice of high risk, low incident events Fosters the development of leadership, interpersonal skills and team behaviors Minute by minute video and audio recording for reflective debriefing sessions and immediate feedback Higher level of learning - Teamwork - Communication - Critical Thinking - Technical Skills Kathleen Gallo Ph.D, MBA, RN, FAAN Senior Vice President Chief Learning Officer North Shore LIJ

28 28 Interprofessional Education (IPE) Interprofessional education occurs when learners from the health professions and related disciplines learn together about the concepts of health care and the provision of healthcare services toward improving the effectiveness and quality of healthcare Essential Elements: Collaboration Respectful communication Reflection Application of knowledge and skills Experience in interprofessional teams Kathleen Gallo Ph.D, MBA, RN, FAAN Senior Vice President Chief Learning Officer North Shore LIJ

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