1. Development and Implementation of a Triple Aim Focused Interprofessional Education (IPE) Curriculum at a Multi-college Academic Health Center
Dr. Jim Bellamy, Ms. Tonya Cook - UAMS College of Health Professions; Dr. Kelly Betts, Dr. Bill Buron, Dr. Cathrin Carithers - UAMS College of Nursing; Dr. Lori Dean - UAMS Graduate School; Dr. Lori Fischbach - UAMS College of Public Health; Dr. Seth Heldenbrand, Dr. Kathryn Neill - UAMS College of Pharmacy; Dr. Laura Sisterhen, Dr. Sara Tariq, Dr. Lee Wilbur - UAMS College of Medicine
Results – Curriculum Model
Background
A 3-phase curriculum (Exposure, Immersion, Competence) was designed and aligned with IPE competency development in each professional program. Elements incorporate the Triple Aim, IPEC Domains, Patient and Family Centered Care, Health Literacy, Social Determinants of Health, and Health Economics. Students complete a cycle of concept learner, practitioner, and junior educator.
The University of Arkansas for Medical Sciences (UAMS) is committed to creating a Triple Aim culture which incorporates IPE competencies to:
improve patient care,
improve population health, and
reduce cost of care.
Creating opportunities for IPE can be challenging for multi-college campuses because of variation in schedules, faculty development needs, and accreditation standards. Triple Aim goals are applicable to all academic units and service lines at UAMS and serve as a unifying framework to build IPE activities.
EXPOSURE (NOVICE)
All 6 colleges
½ day workshop repeated ad lib to accommodate all learners
Content: Triple aim, PFCC, H.lit, Diversity
IMMERSION (INTERMEDIATE)
IPE student groups
Triple aim tracks
Project focused from faculty proposals
Error disclosure simulation
Arkansas health disparities
COMPETENCE (ADVANCED)
IPE student groups
Evaluation of triple aim projects
Service learning – small
½ day workshop
Bridge activity: Common book, Clinical rounds, 12th St Center, reflection
Bridge activity: Evaluation, reflection
EXPOSURE WORKSHOP (~ 4 hours)
The content covered during this introductory ½ day workshop will include an exposure to the key concepts of:
• The Triple Aim
• IPEC Domains: Roles and responsibilities, Effective communication, Values and Ethics, Teamwork.
• Patient and Family Centered Care
• Health Literacy
• Social determinants of health and Arkansas’ most prevalent health disparities
• Cultural competency coordinated by the Office of Global Health
• Health economics: the role of the provider, the payers, and society
Transition (EXPOSURE to IMMERSION):
bridge interprofessional activity (~ 3-4 hours)
Participate in (1) UAMS Common Book/movie , (2) volunteer at the 12th Street Health and Wellness Center or other interprofessional free or reduced cost clinic, or (3) observe interdisciplinary rounds/clinic and complete a reflection.
TRIPLE AIM PROJECT (~ hours)
Learners will be assigned to interprofessional teams (3-8 students). Teams participate in 1 of 3 Triple Aim Tracks:
Patient care improvement;
Population health improvement; or
Health care cost reduction.
Broad solicitation for project ideas from:
(1) UAMS educational and clinical departments;
(2) Community-based organizations in LR & RP communities; and
(3) local businesses with an interest in health care and the triple aim (insurance agencies, corporations with wellness programs, etc).
Students teams develop a structured and complete proposal to meet goals and objectives established by the submitting agency/department. Students present at an event to compete for the best proposal. A Triple Aim Project Presentation Symposium is planned for sharing of superior proposals and project success stories, and announcements are made reflecting proposals that were accepted and/or implemented by the soliciting agency or department.
SIMULATION ACTIVITY (~ 1-2 hours)
Teams participate in an Error Disclosure simulation session.
Transition (IMMERSION to COMPETENCE):
Learners provide peer evaluation of IMMERSION projects. Translating the knowledge and understanding gained during the team project to evaluate other projects/teamwork signals readiness for COMPETENCE.
COMPETENCE WORKSHOP (~ 4 hours)
Summative 1/2-day workshop delivering advanced Triple Aim content relevant to learners entering practice or post-graduate training.
Up to date literature review to support IPC practice, Health Literacy, Patient and Family Centered Care, Cultural competency, and other social determinants of health.
Quality improvement processes and initiatives that exist to affect system change.
Update on successful IMMERSION projects to demonstrate how team-based efforts contribute to meeting the triple aim.
Required “Practice” Activity (~ 2-4 hours)
Completion of a service learning project/activity or high fidelity simulation with an IP team - Health Fair, IP clinic participation, SIM Wars, etc
JUNIOR EDUCATOR ACTIVITY (~ 2-4 hours)
Students “circle back” in the IPE coursework:
Co-facilitators for EXPOSURE or IMMERSION sessions
Mentor students in simulation activities, health fairs, and other events that translate into improved community outcomes with a patient-centered or healthcare focus.
Serve on student advisory board/leader for 12th Street or North Street clinics or similar event.
Objectives
Define the principles of the Triple Aim and IPEC Core Domains.
Describe a 3-phase curriculum that incorporates the Triple Aim, including improving population health, and guiding principles for IPE across Novice, Intermediate, and Advanced stages of learning and practice.
Describe the application of the Triple Aim IPE curriculum to a variety of learners, practitioners, and community partners.
Methods
A 12 member Steering Committee of representatives from all 6 UAMS colleges worked interprofessionally to design a longitudinal curriculum incorporating IPE through learning and practice activities grounded in Triple Aim tracks. The proposed curriculum was presented to each college’s curriculum committee for approval as a campus-wide graduation requirement beginning Fall 2015 (piloted Spring 2015).
Conclusions
The UAMS Triple Aim curriculum minimizes the need for schedule collaboration, provides faculty development opportunities for teaching and practice-based responsibilities, and allows each college to individualize curriculum to meet accreditation standards. Faculty development is provided interprofessionally and is developed by faculty equipped to assist with the three Triple Aim curriculum phases. This curriculum structure is broadly applicable to health science centers of any size and composition.