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Interprofessional education as a mean to improve community health outcomes

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Javier F. Sevilla- M rtir, MD Associate Professor of Clinical Family Medicine, Director Hispanic/Latino Health and International Medicine and Global Health ... – PowerPoint PPT presentation

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Title: Interprofessional education as a mean to improve community health outcomes


1
Interprofessional education as a mean to improve
community health outcomes
  • Javier F. Sevilla- Mártir, MD
  • Associate Professor of Clinical Family Medicine,
    Director Hispanic/Latino Health and International
    Medicine and Global Health, Department of Family
    Medicine, Assistant Dean for Diversity,
  • Indiana University School of Medicine
  • jsevilla_at_iupui.edu
  • NHMA , March 29th,2014

2
Learning Objectives
  • Describe creation of free clinic ,activities,
    programs and outcomes designed to improve access
    to health care services for the Hispanic and
    other Underserved communities of Indianapolis,
    Indiana
  • Discuss learning objectives and activities to
    reflect IPE in an interprofessional team working
    environment

3
Background
A community health needs assessment was conducted
to guide the development of Indiana University
Student Outreach Clinic (IU-SOC) services for the
Near Eastside residents of Indianapolis. The
assessment was completed through the collection
and analysis of primary and secondary data.
Community surveys, focus groups, and key
informant interviews comprised the primary data
while demographic information from the SAVI
database and a chart review of clinic patients
provided secondary data.
4
Background
  • The analysis and conclusions focused on four main
    areas
  • General health
  • Access to care
  • Barriers to optimal health
  • Community interest in health education.

5
The Near Eastside Community
6
The Near Eastside Community
7
Identified specific Needs
  • Mental Illnesses and Addictions
  • Bad Nutrition/Obesity
  • Smoking
  • Poor Access
  • Limited Services

8
Community Concerns
  • Affordable Prescriptions
  • Dental Vision Care
  • Lack of Healthcare Coverage
  • Healthcare System Confusion
  • Accessibility

9
Secondary data Results
A total of fifteen clinic summaries were reviewed
including all of the clinics held between March
14, 2009 and July 18, 2009. During these fifteen
clinics, 112 patients were seen with an average
of seven patients per clinic day (range 12).
10
Secondary data Results
11
Secondary data Results
12
Medications Prescribed
13
Interprofessional Team Approach
  • IU School of Medicine/Public Health
  • Butler University Community Outreach Pharmacy
    (BUCOP)
  • IU School of Dentistry
  • IU School of Law
  • IU School of Social work
  • IU/UOI Schools of Physical and IU Occupational
    Therapy

14
From multi professional to Interprofessional
  • If health care providers are expected to work
    together and share expertise in team environment,
    it makes sense that their education and training
    should prepare them for this type of working
    arrangement Romanow, R (2002)

15
IU Students Outreach Clinic (IUSOC) Learning
Objectives
  • General Learning Objectives
  • Describe and demonstrate effective communication
    skills with patients and with other healthcare
    professionals.
  • Demonstrate an understanding of how to counsel
    and educate patients about their medical care.
  • Describe the flow of a medical clinic and the
    differing roles of the health care team members.
  • Describe the advantages of an inter-professional
    working environment and identify his or her role
    within an interprofessional model.
  • Discuss issues related to the care of the
    underserved, including barriers to health care
    access, common medical conditions, and health
    disparities.
  • Identify major federal, state, and local
    insurance programs for underserved and uninsured
    individuals.

16
IU Students Outreach Clinic (IUSOC) Learning
Objectives
  • Student Leadership Learning Objectives
  • Identify a need related to patient care or
    student education at the clinic and design a
    project to address this need with an
    interprofessional approach.
  • Demonstrate a basic understanding of principles
    of quality improvement projects and/or
    epidemiological, public health and education
    research

17
IPE activities
  • During the Clinic Day
  • 1.Interprofessional Orientation held at the
    beginning of each clinic day to introduce all
    volunteers, explain the clinic model and mission,
    and emphasize the importance of team-based
    education and patient care
  • 2.Interprofessional Roundtable led by medical
    school faculty (who receive CME credits for the
    activity), volunteers from each school discuss
    patient cases that required cooperation of
    several disciplines that day
  • 3.Medical Care Teams pharmacy and dental
    students participate on patient care teams
    directly with the medical students
  • 4.Dental Care Teams medical students serve as
    chair-side assistants for dental students

18
IPE activities
  • Outside the Clinic Day
  • 1.Interprofessional Events all volunteers from
    each school are invited to participate in events,
    ranging from seminars (domestic violence,
    medical-legal partnership, etc.) to socials
  • 2.Partners Subcommittee Meetings student reps
    from each partner work on a common theme (e.g.
    education) to implement clinic-wide initiatives
  • 3.Monthly Partners Meeting designated students
    from each school meet to review and fine-tune
    clinic-wide operations
  • 4.Biannual Partners Retreat student leaders
    from each school meet for long-term strategic
    planning and leadership / fellowship building

19
Committees
  • Operations policies and procedures
  • Volunteers recruitment
  • Promotions Outreach to the community
  • Development Budget and fundraising
  • Supplies inventory and purchases
  • Research/Records medical records and research
    coordination
  • Education community health education and
    integration into curriculum

20
Assessment
  • The assessment of the educational environment of
    this interprofessional service-learning program
    is planned for two phases.
  • Phase I.
  • Preliminary Data From November 2011 to March
    2013, 65 consented students (35 preclinical, 31
    clinical students) have completed the survey, and
    2 focus groups have been held.
  • 100 agreed or strongly agreed that volunteering
    was helpful for their medical education, and that
    volunteering was worth their time.
  • 97 felt that they were a useful part of the
    team. 97 of respondents reporting that they
    learned something new from another volunteer
  • 72 recognizing that they had taught something to
    another volunteer.
  • While only 63 agreed to the statement that they
    had a lot of contact with students of other
    disciplines
  • 82 felt that they had beneficial contact with
    students of other disciplines, while only 3
    disagreed.

21
Assessment
  • Preliminary Data
  • 99 agreed or strongly agreed that the clinic
    impacted their understanding of the social and
    community contexts of health care. The areas of
    communication (99), basic clinical skills (94),
    problem solving (89) and professionalism (85)
    were also impacted.
  • In focus groups, students have cited specifically
    the interprofessional environment, the vertical
    mentoring system, and the community setting as
    providing learning experiences unique to what has
    been offered in the traditional curriculum.
  • Student leaders value learning about the business
    of medicine and have cited their professional
    development through the IU-SOC as their most
    meaningful experience during medical school.

22
Assessment
  • Preliminary Conclusions Students report that the
    IU-SOC provides benefits unique from traditional
    curricula to their medical education.
  • More work remains to understand the impact of the
    interprofessional nature of the clinic on
    students, accounting for how the
    interprofessional program has changed over time.
    Janice L. Farlow, Charles Goodwin, Cristiano
    Piron, Javier Sevilla-Mártir, Tony Ribera, Alison
    Loftus, Steve Kirchhoff

23
IUSOC Future
  • Patient education modules
  • Student education modules
  • Faculty Development Modules
  • Quality Measures and health outcomes
  • Longitudinal Experiences Rosenfield, Oandasan,
    Reeves, (2011)

24
Currently
  • 335 students from IUSM volunteered at the clinic
    and one or two Family Medicine resident per
    Saturday
  • From pharmacy over 150 unique volunteers have
    given time to the clinic or have attended
    training to begin volunteering in Spring 2014.
  • Dental had 161 volunteers this year put in a
    total of 1840 hours.
  • The physical therapy clinic consistently has
    10-15 volunteers/Saturday
  • OT has had 18 volunteers this year.
  • Social work averages around 30 volunteers each
    month.
  • In 2013, medicine saw 1643 patients with a total
    of 2902 diagnoses. Of these patients, about 20
    were new to the clinic and 80 were return
    visits. We referred 175 patients to partners
    such as PT, OT, social work, and dental.

25
Recommendations
  • Be proactive
  • Assess community needs/assets
  • Networking/collaboration/partnership
  • Implement /Evaluate

26
Summary
  • Clinical services to meet the needs of a
    community demands partnerships and collaborations
    with the community as well as curricular
    innovations oriented to better prepare future
    health professionals enhancing their
    understanding and ability to work as a
    interprofessional team to provide better care for
    our underserved communities.
  • Service learning/ community service or civic
    engagement provides and excellent opportunity for
    interprofessional team approach to community
    needs as well as a unique team based learning
    experience

27
GRACIAS
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