1. Technical Assistance and Consultation Team’s Approach to Enhancing Interprofessional Learner Experiences in Integrated Care Settings InterProfessional Health Care Summit Savannah, GA Sara Dugan, Pharm.D., BCPP, BCPS April 10, 2015

2. Objective This session is designed to describe the process of an Integrated Care Technical Assistance and Consultation Team in providing assessment, and developing training for integrated care organizations that are interprofessional clinical field placement training sites.

3. Who are we? Integrated care technical assistance and consultation team (TACT)

4. Our TACT Team Nichole E. Ammon, MSEd, PCC-S Jody M. Bell, APP, CPS Sara E. Dugan, PharmD, BCPP, BCPS Lon C. Herman, MA Ron Rett, BA Douglas Smith, MD, DFAPA Janice Spalding, MD John M. Ellis, LISW-S, LICDC, ICCS Vicki Montesano, PhD Not pictured: Laura Riley, CNP Mark R. Munetz, MD

5. MEDTAPP Healthcare Access Initiative This program is partially funded by the MEDTAPP Healthcare Access (HCA) Initiative* and utilizes federal financial participation funds through the Ohio Department of Medicaid The MEDTAPP HCA Initiative partners with Ohio’s colleges and universities to support the development and retention of additional healthcare providers to better serve the Ohio Medicaid population using emerging, interdisciplinary, and evidence-based care models Views stated in this presentation are those of the researchers only and are not attributed to the study sponsors, the Ohio Department of Medicaid or to the Federal Medicaid Program *MEDTAPP HCA Initiative funding supports teaching and training activities associated with this program, and does not support the delivery of Medicaid eligible services.

6. TACT Team Goals Prepare health professions trainees to become effective members of interprofessional, integrated health care teams Specific focus on ensuring trainees receive advanced interprofessional education with an interdisciplinary, team integrated care settings in Ohio MicroSoft ClipArt 2014

7. TACT’s APPROACH to CONSULTATION and TRAINING

8. Step One: Identify and engage a partner agency Organizations that are working towards integration of health care services and plan to utilize integrated care teams – Community Mental Health Center (CMHC) – Federally Qualified Health Center (FQHC) Partner agency must be interested in or currently serve as a training site for students

9. Step Two: Initial Assessment Organizational Assessment – Web-based survey with 54 –items Integrated Health Care Interprofessional Team Based Care Interprofessional Communication Person/Patient Centered Care Interprofessional Education Population management Assessment developed using accreditation standards and nationally recognized competency areas Designed to be completed by agency employees

10. Competency Areas Values and Ethics for Interprofessional Practice Interprofessional Communication Person-Centered Care Teams and Teamwork Roles and Responsibilities Population Management

11. Step Three: Utilize enhance competency areas Identify strengths and areas for improvement based on assessment Provide focused consultation and live, customized training to bolster areas identified by the organizational assessment – Including emphasis on teaching/modeling to end- of-pipeline learners Microsoft Clip Art 2014

12. Step Four: Ongoing Evaluation and Consultation Collaboration and Satisfaction About Care Decisions (CSACD) scale (©J. Baggs, 1992) – Adapted by TACT, with permission, to evaluate integrated care planning among teams 10 – likert scale items – Web-based implementation of test/re-test over time Microsoft Clip Art 2014

13. LESSONS LEARNED

14. Trends of Challenges Communication – Terminology Mental Health vs. Primary Care – Team and system structure Population Management – Shared population – Methods of integration – Number of partners providing care – Role of regulations in different systems Mental Health Primary Care Addiction Medicine

15. Integrating mental and physical healthcare There is not one best model for integrated health care – Communication and Collaboration are foundation Training model may differ from where the graduate will practice

16. Bringing in trainees Interprofessional education – What have the students already had in their curriculum? – Who do they interact with? Who should they interact with? – What do they need to do at the site? What do they need to know to work in this setting?

17. Logistical challenges Time – Productivity = Billable time vs. Productive time – Critical component for communication Daily huddles Teachable moments General communication Team dynamics

18. It is possible! Effective leadership is essential! Each team and agency/site is unique – Establish expectations – Clearly identify roles and responsibilities Productive discussions may include divergent opinions Debriefing and feedback sessions are worth the time

19. What are the unmet needs? Workforce preparation – Quality trainee placement sites and preceptors – Collaboration ready generation of workers – Resources for current workforce and preceptors Data – What do the student actually experience at their practical sites? – How do we evaluate the quality of these experiences? Degree of interaction with other health care providers Delivery of team-based care

20. Next steps Ongoing assessment and feedback – Organizational survey – CSACD Focused Consultations e-Learning Modules Regional Live Training Improve engagement of trainees In development (pilot testing) – Learner Evaluation Tool Survey to categorize what areas of interprofessional, integrated health care the learners are (and are not) gaining exposure to

21. THANK YOU!