Title: Primary Health Care physicians/health workers for the future
1Primary Health Care physicians/health workers
for the future
Prof. Jan De Maeseneer, M.D., Ph D. 1 Chairman
European Forum for Primary Care Secretary General
The Network Towards Unity for Health Family
Physician (part-time), Community Health Center
Ledeberg Ghent Bruno Art, MD 1 1 Department of
Family Medicine and Primary Health Care, Ghent
University (Belgium)
Nicosia, 07.05.09
2For Lou, born at home on 06.05.09
3http//www.primarycare.ugent.be
http//www.wgcbotermarkt.be
http//www.the-networktufh.org
http//www.euprimarycare.org
4Primary Health Care physicians/health workers for
the future
- The changing society
- Community based teaching
- Bridging the gap from theory to practice
- Towards socially accountable faculties and
institutions for higher education - International braindrain and Europe
- Conclusion
5The changing society
a. Demographical and epidemiological
developments b. Scientific and technological
developments c. Cultural developments d. Socio-eco
nomical developments e. Globalisation and
glocalisation
6The future WHO-five star doctor
THE FIVE STAR DOCTOR
- assess and improve the quality of care
- make optimal use of new technologies
- promote healthy lifestyles
- reconcile individual and community health
requirements - work efficiently in teams
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8Physicians competing framework 7 roles
- Medical expert
- Communicator
- Collaborator
- Manager
- Health Advocate
- Scholar
- Professional
9Introduction of a new curriculum
New curriculum
Five Star Doctor
Changing society
10Introduction of a new curriculum
- S tudent oriented
- P atient based
- E vidence based
- C ommunity oriented
Illustration new undergraduate curriculum at
Ghent University
11New curriculum at Ghent University
- Units or blocks
- Lines - Skills
- Problem Solving
- Personal Activity
- Exploration and ethics
- Studium Generale
12The new curriculum
Start 1999
SK Skills training Ps Problem Solving Pa
Personal activity Ex Exploration
13Primary Health Care physicians/health workers for
the future
- The changing society
- Community based teaching
- Bridging the gap from theory to practice
- Towards socially accountable faculties and
institutions for higher education - International braindrain and Europe
- Conclusion
14Community based teaching experiences at Ghent
University
- Year 1 exploration in the health care system
- Year 2-3 exploration with a family
- Year 3 community oriented primary care
15E-line Poster-presentation exploration in the
health care system
16E-line exploration with a family (2 years)
Objectives - family-contact - child
development - communication
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19Poverty index
20Community Oriented Primary Care
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24Proces van gegevensverzameling
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283. Bevolking
- Diverse bevolking, volks karakter
- Kansarmoede en achterstelling
- Dichtbevolkte stadswijk
- 15.000 mensen, kleine oppervlakte
- Dienst stedenbeleid en internationale
betrekkingen
29Mobiliteit (1)
30Woontorens
- Lage woonkwaliteit
- Hoge bevolkingsdichtheid
- Eén lift
- Betonrot,
- Dichtslibbende riolering,
- Slechte vloerbekleding,
- Enkel glas
31Criminality figures
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33Zij kunnen het en jij?
Verbondenheid, nog steeds geen feit.
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36COPCen doe je niet alleen
37Questions on community based teaching
- What is a community?
- What is the teaching capacity of a community?
- How to create a win-win-partnership?
- What about the ethics of community based teaching?
38- 2009 248 students 65 patients 139 health care
professionals 8 neighbourhoods 11 tutors - Art B, DeRoo L, Willems S, De Maeseneer J. An
Interdisciplinary Community Diagnosis Experience
in an Undergraduate Medical Curriculum
Development at Ghent University. Acad Med. 2008
83675683
39Input Department of Family Medicine and Primary
Health Care
Year 3
Start 2001
40Involving the international community
- Student exchange reciprocity
- International programmes ERASMUS - NPHC
- Bilateral
- Multilateral
41Student exchange primary health care
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44Primary Health Care physicians/health workers for
the future
- The changing society
- Community based teaching
- Bridging the gap from theory to practice
- Towards socially accountable faculties and
institutions for higher education - International braindrain and Europe
- Conclusion
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46The social accountability rhomb
COPC Community Oriented Primary Care CBPR
Community Based Participatory Research
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50An example
The university centre for primary health care
Nieuw Gent,a COPC-practice
- An underserved multiproblem area, not much
community - A partnership University Family Physicians
City of Ghent - A building Local Welfare Centre (restaurant
social service child health service community
workers primary health care centre)
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52Nieuw Gent community diagnosis
- 6.400 people on 0,6 km2
- 18 migrants, 68 nationalities
- Problems isolation, poverty, alcohol abuse,
unemployment, psychiatric problems
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54Service
integrated multidisciplinary primary health care
team,with focus on accessibility (capitation
no cost share)
- Family physicians
- Nurses
- Dieticians
- Partnership with social service
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58THE NETWORK TOWARDS UNITY FOR HEALTH (The
Network TUFH)
- A global association of individuals, groups,
institutions and organizations committed to
improving and maintaining health in the
communities they have a mandate to serve
59Membership
- Over 218 member institutions and individuals
(worldwide) - Academic health professionals and teachers
- Multiprofessional health providers and
stakeholders
60Global Map Pinpointing Members
61Mission
- To promote equity in health through
community-oriented education, research and
service
62Strategies
- Create partnerships between academic health
professions institutions and with stakeholders
(communities, health services, health care
providers, professional organizations) - Act locally and internationally
- Share expertise to
- promote change and
- change processes
63 The Partnership Pentagram
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65So, what is Inter-professional Education?
Inter-professional Education is those occasions
when members (or students) of two or more
professions learn with, from and about one
another to improve collaboration and the quality
of care. CAIPE (2002)
66International Policy WHO paper
- World Health Organisation (1988) Learning
together to work together for health. Report of
a WHO Study Group on Multi-professional Education
for Health Personnel. The Team Approach
Technical Report Series 769. Geneva WHO
67Health 21
- is littered with references to the need for
collaborative frameworks integrated approach
co-operation common approaches pooling of
resources common values and, furthermore, it
signals the need to strengthen, adapt and
reconfigure models of health service delivery
based on evidence of best practice and
sustainable strategies - Tope (2007).
68This Framework is a call for action to
policymakers, decision-makers, educators, health
workers, community leaders and global health
advocates to move towards embedding
inter-professional education and collaborative
practice in all of the services they deliver.
WHO (2008) Framework for Action on
Inter-professional Education andCollaborative
Practice
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71Leicester Model
- Adult learning
- Interactive, team facilitation, reflection
- The Leicester Model of Inter-professional
Education - Immersion into practice
- Patient-led
- Potential to challenge, change and improve
quality of care
72Students interview a patient in her home
73The University of Leicester Model
immersion into patient carer professional
experiences
analysis relating professional perspectives,
theory policies
become change agents through feedback
consider solutions to problems identified
74 Learning, especially inter-professionally,
is risky and brings us close to the boundaries of
our comfort zone
(Sills 2005)
75A IPE module INTERPROFESSIONAL COLLABORATION IN
HEALTH CARE (IPCHC)
- Educational module of one week
- 3 plenary sessions
- Groups of 12 to 14 students from 10 different
education programs medicine, nursing, social
work, psychology, speech therapy, physiotherapy,
occupational therapy, dietitics , midwifery - Each group guided by a well trained tutor
76IPCHC
- Interprofessional
- Different disciplines in the groups
- In interaction with each other
- Collaboration
- Work on assignments
- Work on own development of competences
- Help the other with their development of
competences - In Health Care
- Patient seen as member of the team
- Patient-centred
- What you learn today , do it tomorrow
- And keep doing it .
77EDUCATIONAL STRATEGY
- From
- Learning to know each other / professions
- To
- Collaboration in patient-centred care
- Teamwork (relational- en task-directed)developing
a care plan, discussing ethical issues, taking
up different roles in a team,
78ASSESSMENT of the COMPETENCE
79IPCHC
80Primary Health Care physicians/health workers for
the future
- The changing society
- Community based teaching
- Bridging the gap from theory to practice
- Towards socially accountable faculties and
institutions for higher education - International braindrain and Europe
- Conclusion
81Brain drain
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84Towards socially accountable faculties
ACTION IS NEEDED!
ACTION IS NEEDED!
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