Interprofessional Education for Collaborative RelationalCentred Practice: - PowerPoint PPT Presentation

Loading...

PPT – Interprofessional Education for Collaborative RelationalCentred Practice: PowerPoint presentation | free to view - id: 88a42-ZDc1Z



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Interprofessional Education for Collaborative RelationalCentred Practice:

Description:

1st cohort Dentistry, Medicine, Pharmacy, Phys Ed & Health (Bachelors 4yr) ... Commission on the Future of Health Care in Canada.(2002) ... – PowerPoint PPT presentation

Number of Views:189
Avg rating:3.0/5.0
Slides: 95
Provided by: SP78
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Interprofessional Education for Collaborative RelationalCentred Practice:


1
  • Interprofessional Education for Collaborative
    Relational-Centred Practice

A Wind of Change
2
Susan J. Wagner
  • Faculty Lead Curriculum PlacementsOffice of
    Interprofessional Education andCoordinator of
    Clinical EducationDepartment of Speech-Language
    PathologyUniversity of Toronto

3
  • Brian Simmons
  • Faculty Lead Assessment
  • Neonatologist
  • Ivy Oandasan
  • Director, Office of IPE
  • Family Physician
  • Sylvia Langlois
  • Academy Associate
  • Occupational Therapist

4
Agenda
  • Welcome and Introductions
  • Getting to Know You
  • Setting the Stage
  • History
  • Theory, Definitions and Model
  • Evidence
  • Best Practice Model
  • Interprofessional Education
  • Interprofessional Collaborative
    Relational-Centred Practice
  • Your Context
  • Summary

5
Objectives
  • Define and discuss interprofessional education
    (IPE) and collaborative relational-centred
    practice (CRCP) with respect to their history, a
    current model and current evidence.
  • Describe an innovative best practice model and
    foundational core competencies for IPE and CRCP
    that crosses the academic/clinical interface.

6
  • Explain perspectives on and strategies for
    promoting IPE and CRCP, informed by theory,
    practice and group discussion, that you may apply
    to your own context.

7
Setting the Stage
8
History of IPE
  • Began in the 1960s in North America and Europe
  • Parallel interprofessional movements developed in
    different professions
  • E.g., with evolution and grouping of allied
    health professions in educational and work
    settings
  • Focus on teamwork to deliver improved service

9
  • More recent focus at universities in the 1990s to
    prepare students for the reality of practice
  • Recognized need to move beyond uniprofessional
    educational silos and integrate curricula and
    practice

10
History of CRCP
  • Collaboration has existed between/ among
    professions whenever there has been a need
  • Therefore, much longer history

11
Why do IPE?
  • To
  • Modify negative attitudes and perceptions
  • Remedy failures in trust and communication
    between professions
  • Reinforce collaborative competence
  • Secure collaboration to implement policies,
    improve services and effect change

12
  • Cope with problems that exceed the capacity of
    any one profession
  • Enhance job satisfaction and ease stress
  • Create a more flexible workforce
  • Counter reductionism and fragmentation as
    professions proliferate in response to
    technological advance
  • Integrate specialist and holistic care
  • (Barr, 2002)

13
  • In fact, IPE is mandated by the government in the
    U.K.
  • All health professionals should expect their
    education and training to include common learning
    with other professions at every stage from
    pre-registration courses throughout continuing
    professional development.
  • (Barr, 2002)

14
General Theory of IPE
  • the application of principles of adult learning
    to interactive, group-based learning that relates
    collaborative learning to collaborative practice
    within a coherent rationale informed by
    understanding of interpersonal, group,
    inter-group, organisational and
    inter-organisational relations and processes of
    professionalisation.
  • (Barr, 2002)

15
Definition of IPE
  • Occurs when two or more professions learn about,
    from, and with each other to enable effective
    collaboration and improve health outcomes.

( WHO, 2008)
16
IPE Model
HEALTH PROFESSIONAL COLLABORATOR
COMPETENCIES KNOWLEDGE roles of other health
professionals SKILLS communicating with
others reflecting upon my role and
others ATTITUDES mutual respect willingness to
collaborate openness to trust
DAmour, Oandasan, 2004
17
Definition Interprofessional Collaborative
Practice
  • The provision of comprehensive health services
    to patients/clients by multiple health care
    providers who work collaboratively to deliver the
    best quality of care in every health care
    setting.

  • Health Force Ontario, 2008

18
CRCP Model
Patient/Provider/ Organizational/System
Outcomes PATIENT Clinical outcomes
Quality of care Satisfaction PROVIDER
Satisfaction Well-being ORGANIZATION
Efficiency Innovation SYSTEM
Cost effectiveness Responsiveness
Patient Task Complexity
DAmour, Oandasan, 2004
19
(No Transcript)
20
Collaborative Client/Patient-Centred Practice
  • designed to promote the active participation of
    each discipline in patient care. It enhances
    patient and family-centred goals and values,
    provides mechanisms for continuous communication
    among caregivers, and optimizes staff
    participation in clinical decision making within
    and across disciplines fostering respect for
    disciplinary contributions of all professionals.
  • Health Canada, 2007

21
Relational-Centred Care
  • captures the importance of the interaction among
    people as the foundation of any therapeutic or
    healing activity.relationships are critical to
    the care provided by nearly all practitioners
    (regardless of discipline or subspecialty) and a
    source of satisfaction and positive outcomes for
    patients and practitioners.
  • Pew-Fetzer Task Force,
    2000

22
Four Dimensions of Relational-Centred Care-
Pew-Fetzer Task Force (2000)
  • Patient/Client Practitioner Relationship
  • Community-Practitioner Relationship
  • Practitioner-Practitioner Relationship
  • Clinician Relationship to Self

23
Other Professions
YOU
Community
Uniprofessional
Patient / Client
24
Health Care Assumptions/Realities
  • Aging Population
  • Increasing Acuity, complexity chronicity of
    illnesses
  • Sub-specialization of all health professionals
  • Lack of access contributed by

25
A Looming Health Human Resource Crisis
  • Interprofessional Collaborative Practice
  • is one solution proposed to address the
    resource shortage

26
IPE Landscape in North America
  • New attention being paid at the federal,
    state/provincial and local levels
  • Cost-effectiveness believed to follow

27
In U.S.A.
  • Institute of Medicine reports (2000 2001)
    heightened nationwide interest in health care
    safety and quality
  • IPE and CRCP seen as solutions for both issues

28
  • In 2003, Committee on the Health Professions
    Education Summit for the Board of Health Care
    Services of the Institute of Medicine noted
  • there is a major disconnect between isolated
    professional education and increasing
    expectations for interdisciplinary team-based
    care.

29
  • Focused on five areas and noted their
    interrelationship in a vision
  • All health professional should be educated to
    deliver patient-centered care as members of an
    interdisciplinary team, emphasizing
    evidence-based practice, quality improvement
    approaches, and informatics

30
In Canada
  • Health Canada interprofessional education for
    collaborative patient-centred practice (IECPCP)
    initiative
  • National interprofessional student association
    (NaHSSA www.nahssa.ca) formed with support of
    Health Canada and University of British Columbia
  • Provincial e.g., Health Force Ontario Strategy

31
  • Accreditation
  • Professional Standards
  • Institutional Standards
  • Payors

32
A New Vision
  • If health care providers are expected to work
    together and share expertise in a team
    environment, it makes sense that their education
    and training should prepare them for this type of
    working arrangement. Commission on the
    Future of Health Care in Canada, 2002

33
Evidence
  • Mounting evidence exists that Collaborative
    Practice improves Patient Outcomes in specific
    populations studied to date.
  • Geriatrics, ER care for abused women, STD
    screening, Adult immunization, fractured hips
    neonatal ICU care
    (Zwarenstein et al,
    2005)

34
  • Improved Health Professional Satisfaction
  • (Cohen Bailey, 1997)
  • Collaboration reduces stress amongst health care
    providers and it increases efficiencies and
    innovations.
    (DAmour et al, 2005)
  • Improved Patient Safety
  • (U.S. Joint Commission on Accreditation of
    Health Care Organizations and Baker, R., 2006)

35
Effectiveness of IPE
  • there is no published evidence that
    Interprofessional Education promotes
    interprofessional collaboration or improves
    client relevant outcomes
  • Zwarenstein et al, 2005

36
  • No evidence of effectiveness
  • is not evidence of ineffectiveness
  • (Hammick, 2000)

More research is needed
37
Interprofessional Collaboration as an
Enabler for
  • Enhanced Patient-Centred Care
  • Improved Patient Safety
  • Optimization of health human
    resources (HHR)
  • Health Provider Satisfaction

38
  • Interprofessional education is a key enabler for
    IPC on new ways of education and training.

39
Best Practice Model
40
IPE at University of Toronto
  • Stand alone, linked and marquee sessions since
    1990
  • IPE curriculum in rehabilitation sciences
    (OT/PT/SLP) overlaid on discipline-specific
    curricula since 2003
  • Office of Interprofessional Education
    created in January 2006

41
IPE Initiatives
  • University of Toronto (UT) and Toronto Academic
    Health Sciences Network (TAHSN), along with other
    educational and community institutions, working
    collaboratively to ensure IPE for IPC
  • Innovative best practices model
  • Overcoming challenges to produce effective
    integration across the academic/clinical
    interface

42
University-Wide IPE Curriculum at University of
Toronto
  • Building upon rehabilitation sciences IPE
    curriculum
  • Monies obtained from Ontario Ministry of Health
    and Long-Term Care

43
  • Mandatory IPE curriculum by 2009 for all ten
    health science professions to allow graduation as
    competent collaborators in health care

44
  • Dentistry
  • Medical Radiation Sciences Michener Institute
  • Medicine
  • Nursing
  • Occupational Therapy
  • Pharmacy
  • Physical Education and Health
  • Physical Therapy
  • Social Work
  • Speech-Language Pathology

45
1st cohort Med Rad Sc (BSc-3yr)
2nd cohort Med Rad Sc (BSc 3yr)
3rd cohort Med Rad Sc (BSc 3yr)
1st cohort Dentistry, Medicine, Pharmacy, Phys
Ed Health (Bachelors 4yr)
2nd cohort Dentistry, Medicine, Pharmacy, Phys
Ed Health (Bachelors 4yr)
1st cohort Nursing (BScN), OT, PT,
SW, SLP ( Masters -2yr)
3rd cohort Dentistry, Medicine, Pharmacy, PhysEd
Health (Bachelors 4yr)
2nd cohort Nursing (BScN), OT PT, SW,
SLP (Masters 2yr)
3rd cohort Nursing (BScN), OT, PT, SW, SLP (
Masters 2yr)
4th cohort Nursing (BScN), OT PT, SW,
,SLP (Masters 2yr)
46
Organizational Structure
47
Curriculum Overview
  • Mandatory competency-based longitudinal
    curriculum
  • Woven within each uniprofessional curricula

48
  • Completion of four core and a number of elective
    IPE approved learning activities staged over the
    length of program
  • Flexible IPE curriculum with a menu of learning
    activities to choose from

49
IPE Curriculum Components
50
Curriculum Framework Core Competencies
  • Current popular model of education -
    competency-based curricula and assessment
  • Core competency development thus essential
    foundational step

51
  • Competence
  • Evidence of the development of the necessary
    skills/behaviours, knowledge and/or attitudes to
    successfully engage in entry-level
    interprofessional collaborative practice

52
Key Features
  • Foundational values
  • Entry-to-practice focus
  • Learning continuum
  • Evidence-based
  • Measurable

53
  • Levels
  • Exposure introduction
  • pre-placement
  • Immersion development - interprofessional
    placement
  • Competence entry-to-practice

54
  • Hierarchy of constructs
  • Values and Ethics
  • Communication
  • Collaboration

55
  • Specific competencies aligned with constructs
  • Knowledge
  • Skills/Behaviours
  • Attitudes
  • Within a larger educational and professional
    context

56
(No Transcript)
57
(No Transcript)
58
Values and Ethics Competence
59
Communication Competence
60
Collaboration Competence
61
Learning Activities
  • Four Core
  • Year 1 Session - Introduction to
    Interprofessional Relational-Centred Care
  • Conflict in Interprofessional Life
  • Case-Based Session (e.g., Pain Curriculum)
  • IPE Component in a Clinical Placement

62
  • Complementary elective learning activities\
  • Build upon IPE learning activities in existence
  • Emergency Preparedness
  • Global Health
  • Maternity Care
  • Palliative Care
  • Dying and Death
  • Patient Safety
  • Wellness and Prevention

63
(No Transcript)
64
  • Assessment
  • Evaluation
  • Faculty Leadership

65
Critical Structures
  • Human resources devoted to IPE
  • Development of IPE leaders across university
  • Comprehensive diverse curriculum implemented in
    elective format and integrated into existing
    curricula
  • Curriculum slot for IPE

66
  • Integration and links with collaborative practice
    clinical sites
  • Departmental curriculum committees
  • IP Healthcare Student Association supporting IPE

67
  • University IPE Office collaborating with and
    integrating efforts across university, clinical
    sites, professional regulatory bodies and
    government to promote IP education, practice and
    policy

68
What U of T Students Say About Their IPE
Experiences
  • Teamwork is important and the patient and
    family are part of the team.
  • Our health care system is changing, and we need
    to know where we fit in and how we can make a
    difference
  • "It opened me up to new ways of thinking, new
    ideas and thoughts and what roles are to be
    played in the future."

69
  • Each profession has a unique role to play in
    patient care.
  • By understanding each others professions,
    goals, ideals and feelings towards people with
    illnesses and/or disabilities we will be creating
    a strong team of professionals dedicated to
    assisting the clients in each and every sphere of
    health care.

70
CRCP - TAHSN
  • Monies received from Ontario Ministry of Health
    and Long-Term Care to catalyze and sustain
    communities of collaboration around IPC
  • Focus on learning environment in teaching
    hospitals
  • Creating an interprofessional foundation for
    collaboration

71
(No Transcript)
72
Key Components
  • Leadership
  • Led by Centre for Faculty Development, Faculty of
    Medicine and Office of IPE, UT
  • Teams from each TAHSN hospital took an
    interprofessional leadership course
  • Focus on learning and applying principles within
    home institutions

73
  • Principles focused on
  • coaching,
  • mentoring,
  • organizational change and
  • interprofessional collaboration
  • Ask the Experts follow-up sessions
  • Created a Community of Collaboration

74
  • Mentorship
  • Led by St. Michaels Hospital
  • Created a skilled and knowledgeable cadre of
    leaders and champions promoting and engaging in
    ICP, IPE and research Community of Mentorship
    Professionals Assisting and Supporting
    Students/Staff (COMPASS)
  • Developed LinkHealthPro on-line mentorship
    networking tool

75
  • Preceptorship
  • Led by Toronto Rehabilitation Institute
  • Created preceptorship manual and tools for
    structured IPE placements
  • Goal to increase number and quality of structured
    IPE clinical placements

76
  • Coaching
  • Led by the University Health Network, Sunnybrook
    Health Sciences Centre and Mount Sinai Hospital
  • UHN focused on coaching and mentorship provided
    to leaders and teams in emergency and general
    internal medicine

77
  • Sunnybrook focused on dissemination of Best
    Practice in Emergency Elder Care
  • Mount Sinai developed core resource teams within
    targetted areas of the hospital for IPE/IPC

78
  • Evaluation
  • Led by the Wilson Centre for Research in
    Education, UT
  • Evaluation of project overall

79
  • Integration and Change Management
  • Expert support provided to change culture
  • Common element across initiatives

80
  • The Interprofessional Mentoring Preceptorship
    Leadership and Coaching (IMPLC) Super Toolkit
    created from initiatives
  • Available on-line from Office of IPE, UT

81
(No Transcript)
82
Critical Structures
  • Leadership
  • Resources
  • Communication structure
  • Process orientation

83
Your Context
84
Think-Pair-Share
  • What are some of the challenges and strategies
    you have found, employed or anticipate in
    developing and promoting IPE/CRCP in your
    university/college/ institution?

85
Challenges
  • Perceived value
  • Commitment and resources
  • Time and logistics
  • Implementation
  • Integration
  • Evaluation
  • Sustainability
  • Recognition

86
  • The problem of changing the curriculum is
    analogous to moving a graveyard. Its not moving
    the graveyard thats the problem its the friends
    of the dead.
  • (John Gilbert, Principal College of Health
    Disciplines, UBC, 2004)

87
Implementation Strategies to Promote Integration
  • Resources
  • Initiative - Champions
  • Collaboration
  • Value
  • Support
  • Model
  • Time and logistics

88
  • Clear process
  • Equality
  • Applicability
  • Flexibility
  • Creativity
  • Evaluation
  • Persistence!
  • Fun!

89
References
  • Barr H. (1998). Competent to collaborate
    Towards a competency-based model for
    interprofessional education. Journal of
    Interprofessional Care 12(2), 181 187.
  • Commission on the Future of Health Care in
    Canada.(2002). Building on values The future of
    health care in Canada. Ottawa Health Canada.
  • DAmour, D. Oandasan, I. (2005).
    Interprofessionality as the field of
    interprofessional practice and interprofessional
    education An emerging concept. Journal of
    Interprofessional Care, 19 (Supplement 1), 8-20.

90
  • Hammick, M. (2000). Interprofessional education
    Evidence from the past to guide the future.
    Medical Teacher, 22(5), 461-467.
  • Health Canada. (2007). Interprofessional
    education for collaborative patient-centred
    practice. Retrieved April 22, 2008, from the
    world wide web http//www.hc-sc.gc.ca/hcs-sss/hhr
    -rhs/strateg/interprof/index_e.html
  • Health Force Ontario. (2008). Interprofessional
    care. Retrieved April 22, 2008, from the world
    wide web http//www.healthforceontario.ca/WhatIs
    HFO/AboutInterprofessionalCare.aspx

91
  • Institute of Medicine. (L.T. Kohn, J.M. Corrigan
    M.S. Donaldson (Eds)). (2000). To Err is Human
    Building a Safer Health System. Washington,
    D.C. National Academies Press.
  • Institute of Medicine. (2001) Crossing the
    Quality Chasm A New Health System for the 21st
    Century. Washington, D.C. National Academies
    Press.
  • Institute of Medicine. (A.C. Greiner E.
    Knebel. (Eds)). (2003). Health Professions
    Education A Bridge to Quality. Washington,
    D.C. National Academies Press.

92
  • Oandasan, I., DAmour,D. et al. (2004).
    Interprofessional education for collaborative
    patient-centred practice Research findings
    report. Ottawa Health Canada.
  • Oandasan, I. Reeves, S. (2005). Key elements
    for interprofessional education. Part 1 The
    learner, the educator and the learning context.
    Journal of Interprofessional Care, 19(Supplement
    1), 21-38.

93
  • Pew-Fetzer Task Force on Advancing Psychosocial
    Health Education. (2000). Health professions
    education and relationship-centred care. Pew
    Health Professions Commission and the Fetzer
    Institute.
  • Zwarenstein, M., Reeves, S. Perrier, L. (2005).
    Effectiveness of pre-licensure interprofessional
    education and post-licensure collaborative
    intervention. Journal of Interprofessional Care,
    19(Supplement 1), 148-165.

94
www.ipe.utoronto.ca
  • For more information
  • susan.wagner_at_utoronto.ca
About PowerShow.com