Core Competencies for Interprofessional Collaborative Practice and Care Coordination Madeline H. Schmitt PhD, RN, FAAN Professor Emerita University of Rochester School of Nursing

IPEC and the Core Competencies Expert Panel Six national health professions education associations (AACN, AACOM, AACP, AAMC, ADEA, ASPH) formed a working group (IPEC) in 2009 to develop a framework of joint activities to support patient-centered team-based care, promote delivery reform, and foster interprofessional learning experiences Jointly implement an Expert Panel in early 2010

IPEC Charge to Expert Panel Recommend common core competencies relevant across the professions to address the essential preparation of clinicians for interprofessional collaborative practice Recommend learning experiences and educational strategies for achieving the competencies and related objectives

Expert Panel Process Full panel face-to-face day long meeting Full panel conference calls Four work groups define & write specific competencies Iterative integration & refinement

Interprofessional Education and Interprofessional Collaboration IPE When students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes (WHO, 2010) IPC When multiple health workers from different professional backgrounds work together with patients, families, careers, and communities to deliver the highest quality of care (WHO, 2010) 5

Professional & Interprofessional Competency Behavioral demonstrations of an integrated set of knowledge, skills, and attitudes that define the domains of work of a specific health profession applied in specific care contexts Interprofessional Competency Behavioral demonstrations of an integrated set of knowledge, skills and attitudes for working together across the professions, with other health care workers, and with patients/families/ communities/populations to improve health outcomes in specific care contexts 6

IOM 5 Core Competencies, adapted to IPEC Expert Panel Work Provide Patient- Centered Care Utilize Informatics Work in Interprofessional Teams “Core Competencies” Employ Evidence- Based Practice Apply Quality Improvement

IP Competencies: General Criteria Patient, Population & Relationship-centered Process-oriented “Common” language Applicable across practice settings across professions Relevant to the learning continuum Outcome driven [performance] Relevant to IOM goals for improvement: patient-centered, efficiency, effectiveness, safety, timeliness, and equity

Core Competencies: Four Domains Roles/ Values/ Responsibilities Ethics Work in IP Teams  Core Competencies Teamwork Processes Communication

VALUES/ETHICS Overall Competency Work with individuals of other professions to maintain a climate of mutual respect and shared values

VALUES/ETHICS Example competencies Place the interests of patients and populations at the center of IP health care delivery Respect the unique cultures, values, roles/responsibilities and expertise of other health professions

ROLES & RESPONSIBILITIES Overall Competency Use the knowledge of one’s own role and those of other professions to appropriately assess and address the health care needs of the patients and populations served

ROLES & RESPONSIBILITIES Example Competencies Recognize one’s limitations in skills, knowledge and abilities Engage diverse health care professionals who complement one’s own professional expertise, as well as associated resources, to develop strategies to meet specific patient care needs

INTERPROFESSIONAL COMMUNICATION Overall Competency Communicate with patients, families, communities and other health professionals in a responsive and responsible manner that supports a team approach to the maintenance of health and treatment of disease

INTERPROFESSIONAL COMMUNICATION Example Competencies Organize and communicate information with patients, families and health care team members in a form that is understandable, avoiding discipline-specific terminology when possible Give timely, sensitive, instructive feedback to others about their performance on the team, and respond respectfully as a team member to feedback from others

INTERPROFESSIONAL TEAMWORK & TEAM-BASED CARE Overall Competency Apply relationship-building values and the principles of team dynamics to perform effectively in different team roles to plan and deliver patient/population-centered care that is safe, timely, efficient, effective, and equitable

INTERPROFESSIONAL TEAMWORK & TEAM-BASED CARE Example Competencies Integrate the knowledge and experience of other professions-appropriate to the specific care situation-to inform care decisions, while respecting patient and community values and priorities/preferences for care Use process improvement strategies to increase effectiveness of interprofessional teamwork and team-based care

Emphasis of Core Competency Framework Focus is on individual competencies for working together Not focused on common or unique clinical or broader [e.g., systems, QI] knowledge bases Builds on professional competencies Principles extend to non-professional team members Report available for downloading at https://www.aamc.org/download/186750/data/core_competencies.pdf

HRSA Invitational Conference February 16-17, 2011 Co-sponsored by Josiah Macy Jr. Foundation, Robert Wood Johnson Foundation, and American Board of Internal Medicine Foundation, along with HRSA and IPEC Two goals-vetting core competencies Developing action plans for next steps Report available for downloading at https://www.aamc.org/download/186752/data/team-based_competencies.pdf

Core Competencies and Care Coordination Competences underpin three core processes of teamwork and team-based care: Cooperation Coordination [within as well as across settings] Collaboration

Linking core competencies and care coordination “Care coordination” is a person-centered, assessment-based, interdisciplinary approach to integrating health care and social support services in a cost-effective manner in which an individual’s needs and preferences are assessed, a comprehensive care plan is developed, and services are managed and monitored by an evidence-based process which typically involves a designated lead care coordinator.” Bold=core competency Blue=specific to care coordination fx or role

Definition contains: Values->Patient/person/family centered; Roles->all team members, care coordinator [vs coordination function] Communication->between team and care coordinator Teamwork->interdisciplinary, comprehensive assessment and planning process

Effective care coordination requires action at all levels# National organizations [standards], Federal gov’t [monitoring system-level performance], State [tracking system performance], Regional/community [tracking system performance], Practice [allocate/manage care coordination function, integrate care, monitor performance], Family [expectations, preferences, coordination role and skill development, feedback] #Antonelli, McAllister, & Popp (2009). Making care coordination a critical component of the pediatric health system: A multidisciplinary framework. The Commonwealth Fund. Publication No. 1277. Retrieved May 17, 2011 from http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2009/May/Making-Care-Coordination-a-Critical-Component-of-the-Pediatric-Health-System.aspx

Collaborating Across Borders III Tucson, AZ November 19-21, 2011 See www.cabarizona2011.org