Collaborator Curriculum
Transcript of Introductory Lecture
Todd James MD
1. Interprofessional Collaboration, How Do We Get There? Todd James, Indiana University Geriatrics
Welcome everyone. Let’s go around and share our names and where we went to medical school. Today, we will discuss the word Interprofessional and the word collaboration. We will describe why this has been called the IPEC lecture on your monthly schedule.
2. Goal of Mini-Course
As a physician working with other health professionals, the physician will understand, observe and initiate the knowledge, skills and attitudes necessary to be an interprofessional collaborator. We will describe why being an interprofessional collaborator may be something more than what you’ve know about so far.
3. Outline of Session
We will have an Ice breaker, Introductory material, Interprofessional pocket card, Team meeting video observation exercise, Clinical observation exercise, Debrief, and Adjournment.
4. Questions for the Audience
What does Interdisciplinary mean? Please compare and contrast with Interprofessional. What are you thinking? Have any of you been involved with a class or course called interprofessional?
5. What is Interprofessional Practice?
Interprofessional practice occurs when “multiple health workers from different professional backgrounds work together with patients, families, careers and communities to deliver the highest quality of care.” (WHO, 2010) This is similar to the goals we have in creating Patient Centered Medical Homes in primary care clinics.
6. What is Interprofessional Education?
Interprofessional Education occurs when two or more professions learn with, from and about each other to improve collaboration and the quality of care.” (Centre For The Advancement of Interprofessional Education, 2002) Given this definition, are we doing IPE today? Today, we are not including the perspectives, backgrounds and outlooks of other health professions today, since we are all physicians. Thus, we don’t meet the definition.
7. Aren’t We Already Interprofessional?
Crossing the Quality Chasm (IOM 2001)? PCMH? Acute Care for Elders Teams? 30-day Readmits? Home Health Agencies? Pharmacist on my ward team? Many health system activities have been changing. We are widening the services that we give and the professionals we work with. However, I contend that in many ways, though working side-by-side, we are not wholly interprofessional in our activities.
8. Interprofessional
“When I entered medical school, it was all about being an individual expert. Now it’s all about applying that expertise to team-based patient care.” Dr. Darrel G. Kirch, President and Chief Executive, Association of American Medical Colleges - Harris, Gardner, “New for Aspiring Doctors, the People Skills Test” NYT, July 10, 2011. Physicians have not usually been chosen for their team skills, however some believe that this will be foundational for physician effectiveness.
9. Teamwork…Essential Interprofessional
“Teamwork has become so essential to medicine that the school not only chooses its students based on their willingness and ability to collaborate effectively, but also requires students to take teamwork classes.” Virginia Tech Carilion School of Medicine and Research Institute. This is an example of a medical school that has used OSCE’s for skills not traditionally thought to be pivotal for medical school success.
10. New Paradigm(s)
Southwest Airlines vs. Waldorf Astoria Hotel, Starbucks vs. Ruth Chris Steakhouse: The first commercial enterprises represent a leveling of the playing field, away from hierarchy towards focusing on the importance of the consumer’s perspective and goals. Checklist Manifesto vs. Hierarchical Health Services - Gawande, Atul. The Checklist: Manifesto: How to Get Things Right, Henry Holt and Co. Metropolitan Books. 2009
Checklist Manifesto is a surgery checklist and it’s very short – a four to five item check list done before surgery. What’s everyones name? What surgery are we performing? Are we in the right location? Checklist is different from Multidisciplinary and Interdisciplinary – it is a leveler of the playing field so that we might create conditions to access the skills, knowledge and perspectives of each professional discipline.
11. Increase in Older Population
Increase in Complexity, Increase in Chronic Disease. We have high rates of hospital readmission. Current systems are not working. Team based approaches improve outcomes for individual patients and possibly society. Institute of Medicine (IOM). Retooling for an Aging America. Washington, DC: The National Academies Press; 2008.
12. Vulnerable Health Professions
Silos of Education, Silos of Practice, Silos of Regulation, Silos of Licensure, Silos of Professional Societies. The health professions have been structured and have prospered by promoting the creation of independent turfs. However, this may be a detriment to the functioning of the whole system, especially from a patient perspective.
13. Multidisciplinary: Interprofessional
IP is a new word to describe a new paradigm, IP described by competencies, Canadian Interprofessional Health Collaborative (CIHC) & for the US, Interprofessional Education Consortium (IPEC). These competencies have been adopted by numerous professional societies; Within Interprofessional is embedded in concept of professionalism. Many hope that all health professionals will become Interprofessional Collaborators.
14. IPEC Sponsors
Many coordinating and regulating bodies have adopted IPEC competencies. These include the following: American Association of Colleges of Nursing, American Association of Colleges of Osteopathic Medicine, American Association of Colleges of Pharmacy, American Dental Education Association, Association of American Medical Colleges, Association of Schools of Public Health.
15. IPEC/CIHC
Discussion of pocket card – also find copy at OnCourse IP collaborator site. This pocket card follows the CIHC’s six competencies and then maps the overlap with the IPEC competencies.
16. Interprofessional Collaborator
An IP collaborator is a health professional with the skills, knowledge and attitudes for collaborative, comprehensive care for patients. Collaborative abilities are achieved on three levels: the traditional profession specific practice, the individual’s practice within a team and then the total team.
17. IPEC/CICH
Here we’ll review one of the competencies. Example: Make introductions, Identify power gradients, Support participation, Negotiate what is possible, Clarify language, Promote collaborative practice environment.
18. GITT Video Observation Exercise
We will go to this streaming video website and watch the team video. During the observation we will observe the competencies that did and did not occur. There are examples of both positive and less optimal behaviors. While this video may seem somewhat dramatic, you may likely see interactions that mimic these as you rotate through geriatrics teams here at IU Geriatrics or other clinical venues that incorporate teams. http://consultgerirn.org/resources/media/?vid_id=5917313#player_container or http://vimeo.com/5917313 Fulkner T. Hyer K, Flaherty E. Mezey M Whitelaw N., Jacobs MO, Luchi R, Hansen JC, Evans DA, Cassel C., Kotthoff-Burrell E, Kane R, Pfeiffer E., Geriatric interdisciplinary team training program: evaluation results. J Aging Health, 2005 Aug: 17(4):443-70, PubMed PMD: 16020574
19. Clinical Observation
Opportunities for observing or exhibiting these competencies may occur throughout your rotation, including: ACE=Acute Care for Elders, HC=House Calls, HABC=Healthy Aging Brain Clinic, Geri Psych, CSH=Center for Senior Health, GRACE=Geriatric Resources for Assessment and Care of Elders
20. Your Interprofessional Collaborator Observations
Observe and report (min.2x) on the competencies you initiate or observe while you are at IU Geriatrics. Please use the Survey Monkey link in the email which will be sent to you. When you demonstrate IP Collaborator competencies, report them. Remember, don’t give identifiable patient information.
21. Debrief
Course materials will also be found on OnCourse. Any questions? Have we forgotten anything?
22. Adjourn
Enjoy your IU Geriatrics Block Rotation!
23. Thank you!