1. Care Management for Persons with Comorbid Severe Mental Illness, Substance Use, and Chronic Disease: An Interprofessional Clinical Elective
Mandy Peacock, RN, DNP, AGPCNP-C
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2. Objectives
Discuss the interprofessional clinical elective project and receive feedback
Logistics of scheduling multiple professions
Precepting and oversight of different professions
Evaluation tools
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3. Innovations Proposal
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4. Background Progress Foundation
Interprofessional Primary Care Outreach for Persons with Mental Illness (IPCOM)
UCSF Interprofessional Education
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5. Specific Aims
To design, implement, and sustain an IP clinical elective where AGPCNP, PMHNP, Pharmacy, and Physical Therapy (PT) learners
Apply IP knowledge and skills gained throughout the UCSF IP curriculum in order to accomplish Interprofessional Education Collaborative (IPEC) competencies (Interprofessional Education Collaborative, 2016)
Examine the impact of social determinants of health and enhance students' processing of their feelings toward, and understanding of, mental health and substance use
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6. Methods: Who? 1st year PMHNP & AGPCNP students
2nd/3rd year physical therapy students
4th year pharmacy students
Faculty (SON, Pharmacy, PT)
Counselors and providers at
Progress Foundation
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7. Methods: What? Weekly 4-hour immersive clinical experiences
Huddles
Client visits
Debriefs
Group education for clients
Students learn with, about, and from each other.
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8. Methods: When? 6-8 week elective 1 cohort per quarter 2018-2019
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9. Methods: Where?
Rypins (Seniors) - a 6-bed Progress Foundation house serving adults > 60 years
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10. Evaluation: Interprofessional Collaboration and teamwork
Collaborative Practice Assessment Tool (CPAT)
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11. Evaluation: IP competencies
Interprofessional Education Reflection Worksheet
What was your reaction to this experience? What did you enjoy? What might you have changed if you could repeat the experience?
Provide examples of knowledge, skills, or attitudes that you or a team member applied or gained from the IPE experience.
Which will you reapply?
How has (or will) this training improve delivery of patient care?
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13. Plan for Sustainability
Process evaluation will be ongoing - refine
Create a unique course number that will increase visibility and be applied toward the UCSF IPE passport
Apply for funding from Macy Foundation, RWJF, HRSA, etc.
Continue cycling cohorts and improving
Additional cohorts, placements?
Evaluation of client outcomes
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14. Current status
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15. Since Innovations Funding Approval
IRB approved as ‘exempt’
Team meetings scheduled (6/19, 7/17…)
Recruitment plan:
Word of mouth, narrative by student
Met with team members of previous clinical elective
Scheduling discussion ongoing
Supervision discussion ongoing
Course creation
Next team meeting…
What we found meeting with team members of previous elective – barriers, facilitators, what worked well, what didn’t.
Scheduling – evenings? Dyads, triads vs. four students at a time
Supervision – NPs can be supervised by any NP, MD and NPs will be primary preceptors. What can PT/pharm students do without direct supervision by faculty? Teleprecepting?
Course creation – same process for PT and pharmacy as previous clinical elective. Folded into clinical practicum (PMHNP and AGPCNP) for this pilot and then looking to create separate course number as part of sustainability plan.

16. Barriers and Facilitators Identified
Competing schedules
Oversight
Some students will be early in IPE curriculum
Time
Facilitators
Faculty with expertise in IP education/practice
Longstanding relationship with community partner
Technology
Need for clinical placements
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17. Remaining Questions
Who can provide oversight – to whom? In what capacity?
What role can ‘teleprecepting’ play?
What day/time works best for faculty and learners?
Evaluation
What is the optimal timing/load of evaluation?
Are these the best instruments to measure our outcomes?
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18. Next Steps
Follow-up with pharmacy contact regarding supervision, scheduling
Meet with Progress Foundation stakeholders to update and get feedback on plan
Reach out to director, counselor, NPs at selected program
Course schedule and syllabus
Recruit students
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19. Questions and Feedback
Thank you!
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