1 EFPC congress Gőteborg 2012 Interprofessional Education for Primary Care Professionals L. van Amsterdam

Interprofessional Education (IPE) 2 Developing EFPC Position Paper Coordination by Jan van Es Institute

3 The importance of interprofessional education (IPE) -support conditions for better population oriented and people centeredness and the outcome and quality of care -challenge how to reconstruct and transform organisations into ones with better collaboration aiming towards more efficiency and effectiveness.

4 problem? urgency? what future demands? -High quality affordable healthcare -For an ageing population -An ageing workforce -Shift from problem orientend to goal oriented primary care

5 Definition IPE Interprofessional education (IPE) occurs when two or more professions learn with, from and about each other to improve collaboration and the quality of care. (CAIPE, 2002)

6 The scope of IPE “...includes all such learning in academic and work based settings before and after qualification, adopting an inclusive view of "professional".

7 The Lancet Report (2010) focuses on ‘ transformative learning ’ as to - prepare not only scientists or professionals, but - also prepare ‘ change agents ’ ‘ triple-loop learning ’ (Argyris) is effective on three levels: -learning from action -learning from thinking -learning from wanting and thus get the feel you are the owner of change.

8 Core competencies for Interprofessional Education en interprofessional collaborative practice (IPEC 2012) (1) - define and teach interprofessional competencies -make it part of the learning process, engage students of different professions in interactive learning with each other

9 Core competencies for Interprofessional Education en interprofessional collaborative practice (2) -build on each profession ’ s expected disciplinary competencies -to work effectively as members of clinical teams while students is seen as fundemental

10 Evidence (Jill Thistlethwaite, 2012) (1) -learning together enhances future working together -IPE fosters positive interaction among different professions -IPE improves attitudes towards other professionals

11 Evidence (2) -IPE initiatives are diverse -good evaluation methodology and data are limited

12 Problems, barriers, solutions (1) -professional accreditation organizations mandate only for their own professions -Make multidisciplinary accreditation for joint efforts possible

13 Problems, barriers, solutions (2) -the way the educational system is constructed -hard to come to agreements on interprofessional and multidisciplinary educational program

14 Problems, barriers, solutions (3) -cultural differences between the professions, each focusing on their own domain (silo) -focus more on communication and collaboration between professionals -make better use of existing integrated settings for IPE (act as change agents)

Some examples Cultural barriers Kazachstan: become ‘friends’ first Netherlands: breaking down hierarchical barriers Albania: experience interference or cooperation Successful examples: Sweden: broadening medical training gp’s & other Netherlands: house of multi-disciplinary practice Legal & financial barriers Hungary: practice nurse, 15 years experience in primary care = still illegal Italy: gp’s & nurses teams for chronic diseases, works fine, financing stopped = teams stopped Switzerland: there must be a need for cooperation = too many patients, not enough doctors 5/11/

16 Definition of professional integration : (Pim Valentijn, JvEI, 2012) “Interprofessional partnerships with shared accountability arrangements for the delivery of services to a defined population”

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18 Paradigmashift and a multi-national approach (1) -develop a shared understanding -gather good examples, practice based evidence -national and international literature

19 Paradigmashift and a multi-national approach (2) -to further identify supportive and detracting indicators -develop mutual power of change -put lessons into practice

How to influence change on the different levels? Cultural / personal level System level: Legal and financial levels Educational level: 5/11/

21 Discussion 1.Tell us your own experience 2.Successful strategy 3.Other fields of exploration

22 Jan van Es Institute: Netherlands Expert Centre for Integrated Primary Care Mission The Jan van Es Institute is the independent centre of expertise of integrated primary care that bridges the gap between science and practice. It focuses on continuously improving, translating and disseminating knowledge, about the organisation of integrated primary and community- oriented health care. The goal is to achieve better coherence in care, in order to obtain better outcomes for patients, professionals and society. Vision The Jan van Es Institute contributes to expand and disseminate existing and new knowledge based on scientific and practical research. Lessons learnt based on practical experience are translated into new research questions and knowledge. The generated knowledge is transformed into practical tools for care providers, purchasers of care, policy makers and patients / consumers. For the international embedding there is a cooperation with the European Forum for Primary Care; wwwl.euprimarycare.org Forum for Primary Care