Learning About from and With
Each Other
February 12, 2014
CHANNELS Project: Learning Objectives
1. TEAMWORK & COLLABORATIVE PRACTICE
Promote positive teamwork skills (TeamSTEPPS)
U...
Definitions
Interprofessional Education occurs when two
or more professions learn about, from and
with each other to impro...
Function
Interprofessional knowledge and skills promote capacities to
understand the roles of other health providers and i...
WHY IPE IS IMPORTANT?
To advance the
Triple Aim of
improving
population health,
enhancing patient
quality care and
control...
Institute of Medicine

http://www.ahrq.gov/professionals/education/cur
riculumtools/teamstepps/instructor/videos/ts_Sue_Sh...
IPE – Guiding Principles
 Values/Ethics for Interprofessional
Practice
 Roles/Responsibilities for
Collaborative Practic...
Values & Ethics
• Patients and
populations are at
the center
• Cultural and
individual diversity
is acknowledged
and honor...
IOM 6 Aims for Improving Health Care
• Safety: avoid injuries to patients from the care that is
intended to help them
• Ef...
NASW Ethics
• Service aimed to help people in need and address social
problems
• Competent use of best knowledge and skill...
Patient-centeredness
• Invite patients into
healthcare decisionmaking
• Provide information &
context to empower
patients
...
Roles & Responsibilities
• Communicate roles and
responsibilities
• Engage diverse healthcare
professionals in healthcare
...
CHOWs: Community Health Outreach Workers
Community health outreach workers
(CHOWs)

•Deliver health care services to
under...
Communication
• Communicate respectfully
and appropriately in all
situations
• Listen actively
• Encourage ideas and
opini...
Collaborative Leadership
• Value contributions of all
health team and
family/community members
• Facilitate contributions ...
Teams & Teamwork
• Collaborate to deliver
patient-centered,
community-based
care
• Develop shared
principles of care
• Int...
TeamSTEPPS Skills
SHARED VISION & PHILOSOPHY
• SHARED MENTAL MODEL
COMMUNICATION
• SBAR
• TEAM SKILLS: BRIEF, HUDDLE, DEBR...
Shared Mental Model
The perception of, understanding of, or
knowledge about a situation or process that is
shared among te...
SBAR

Introduce

Situation

Background

Assessment

Recommendation
Brief

Huddle Debrief
Communicate clearly
about event

Who is on the team?
Agree on Goals

Problem-solving

Go over detail...
Continuous Communication
CUS
• I am Concerned
• I am Uncomfortable
• There is a Safety issue

Teachback
• Confirmation of
...
Checkback
http://www.youtube.com/watch?v=AKtNLP8jQ7s
CASE EXAMPLE
What are the risks in this scenario?
• What communication was missed?
• How would an interpreter or community...
Interprofessional Collaborative
Practice
“Health care delivered by well-functioning
coordinated teams leads to better pati...
WHY IT MATTERS
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Interprofessional learning crossroads feb 12

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  • Jen introduces CHANNELS Project
  • Jen and/or Shelley
  • Shelley – focus on collaborative practice attitudes, knowledge & skills
  • Shelley or Jen
  • The National Center for Interprofessional Practice & Education at the University of Minnesota is leading the national effort
  • What does the IOM finding mean for us as practitioners? As patients and carers? The status quo is not acceptable and cannot be tolerated any longer – click on Sue Sheridan video.Despite cost pressures, liability constraints, resistance to change and seemingly insurmountable barriers, it is simply not acceptable for patients to be harmed by the same health care system that is supposed to offer healing and comfort
  • Culmination of safety and quality data led to initiative to improve healthcare through collaborative practice principles.
  • Photo: Flickr.com
  • Nursing may be familiar with these guidelines
  • Social work’s ethical domains – have students compare: how are they similar/different?
  • Shelley & Jen
  • Jen & Donna
  • Communication with team members, clients, patients, families, community workers and resources.
  • http://www.cihc.ca/files/CIHC_IPCompetencies_Feb1210.pdfPhoto: www.flickr.com(Toronto, 2008)
  • Photo: www.flickr.com – teamwork at community health fair
  • INTENTIONAL COMMUNICATION – PEOPLE FEEL THEY’RE DOING IT BUT OFTEN NOT BY DESIGN
  • Photos: www.flickr.com; en.wikipedia.org; commons.wikipedia.ogr;
  • Interprofessional learning crossroads feb 12

    1. 1. Learning About from and With Each Other February 12, 2014
    2. 2. CHANNELS Project: Learning Objectives 1. TEAMWORK & COLLABORATIVE PRACTICE Promote positive teamwork skills (TeamSTEPPS) Understand roles & responsibilities of team members 2. CULTURAL AWARENESS & IDENTITY Impact of assumptions, beliefs & biases Awareness of power inequities and disparities 3. CULTURAL KNOWLEDGE Awareness of culturally appropriate resources & skills Knowledge that one is not an expert in another culture 4. HEALTH LITERACY & COMMUNICATION Use of active listening & linguistically appropriate resources Integration of CHOWs as critical team members
    3. 3. Definitions Interprofessional Education occurs when two or more professions learn about, from and with each other to improve collaboration and the quality of care. Collaborative Practice promotes the active participation of relevant cross-disciplinary professions in patient-centered care.
    4. 4. Function Interprofessional knowledge and skills promote capacities to understand the roles of other health providers and implement the workings of teams - regardless of team make-up - with the person’s best interests at the center of care. Mental Health Settings Emergency Care Community Health Environments Operating Theater
    5. 5. WHY IPE IS IMPORTANT? To advance the Triple Aim of improving population health, enhancing patient quality care and controlling costs To close the gap between health education and practice settings by aligning their needs and interests
    6. 6. Institute of Medicine http://www.ahrq.gov/professionals/education/cur riculumtools/teamstepps/instructor/videos/ts_Sue_Sheri dan/Sue_Sheridan-400-300.html The Institute of Medicine’s (IOM) seminal study of preventable medical errors estimated as many as 98,000 people die every year at a cost of $29 billion. If the Centers for Disease Control were to include preventable medical errors as a category, these conclusions would make it the sixth leading cause of death in America. Deaths/Mortality, 2005, National Center for Health Care Statistics at the Centers for Disease Control, viewed at http://www.cdc.gov/nchs/fastats/deaths.htm.
    7. 7. IPE – Guiding Principles  Values/Ethics for Interprofessional Practice  Roles/Responsibilities for Collaborative Practice  Interprofessional Communication  Interprofessional Teamwork and Team-based Care  Collaborative Leadership  Patient-Centeredness
    8. 8. Values & Ethics • Patients and populations are at the center • Cultural and individual diversity is acknowledged and honored • Expertise of other health professions is known and respected
    9. 9. IOM 6 Aims for Improving Health Care • Safety: avoid injuries to patients from the care that is intended to help them • Effective use of scientific evidence to serve all patients • Patient-centered care that is respectful of and responsive to patient preferences, needs and values, and ensuring that patient values guide all clinical decisions • Timeliness and reduction of potentially harmful delays • Efficiency and avoidance of waste of equipment, supplies, and human resources • Equitable care that does not vary in quality because of person characteristics such as age, gender, ethnicity, geographic location and socioeconomic status
    10. 10. NASW Ethics • Service aimed to help people in need and address social problems • Competent use of best knowledge and skills for within scope of practice • Dignity and worth of the person aimed at client selfdetermination and empowerment • Integrity to act honestly and effectively according to the mission and values of the profession • Importance of human relationship that makes effective and efficient use of engagement in the helping process • Social Justice focused on equitable access and quality of service for all people regardless of age, gender, race, ethnicity, and socioeconomics
    11. 11. Patient-centeredness • Invite patients into healthcare decisionmaking • Provide information & context to empower patients Providers • Disseminate information to inform individuals, families & populations • Advocate for quality primary prevention & meeting the needs of the underserved Public Health ATTITIDES Respect for patient knowledge Value patient as team member Trust in each other & the team Trust in system of care • Capacity to think critically & have perspectives honored • Make informed decisions with health team Patients ACTIONS Invite patient into care communication Facilitate empowering practice Communicate openly; Listen actively Respond effectively Evaluate efficacy
    12. 12. Roles & Responsibilities • Communicate roles and responsibilities • Engage diverse healthcare professionals in healthcare development to meet patients’ needs • Optimize complementary abilities of all team members to patient care
    13. 13. CHOWs: Community Health Outreach Workers Community health outreach workers (CHOWs) •Deliver health care services to underserved populations •Are trusted members of their communities •Provide vital links between health systems and communities.1 http://www.maine.gov/dhhs/oma/MulticulturalResource/health.html 1 Whitley et al (2006). Measuring return on investment of outreach by community health workers. J of Health Care for the Poor and Underserved, 17, 6-15. CHOW Roles & responsibilities • Offer culturally/linguistically relevant health education •Mediate between community members and services providers •Provide case management and systems navigation • Offer medical interpretation •Assist with health insurance enrollment •Provide community-based health promotion & prevention activities •Conduct surveys, collect community and health related data •Contribute information on community needs and •needed resources.
    14. 14. Communication • Communicate respectfully and appropriately in all situations • Listen actively • Encourage ideas and opinions of all team members • Recognize differences in experience, expertise, culture, and status that may affect communication • Facilitate conflict resolution to enhance interprofessional working relationships
    15. 15. Collaborative Leadership • Value contributions of all health team and family/community members • Facilitate contributions of all team members • Build support for working together • Apply leadership practices that support collaborative and effective team practice
    16. 16. Teams & Teamwork • Collaborate to deliver patient-centered, community-based care • Develop shared principles of care • Integrate knowledge and experience of other professions to inform care decisions • Respect patients’ perspectives and community values that inform care preferences
    17. 17. TeamSTEPPS Skills SHARED VISION & PHILOSOPHY • SHARED MENTAL MODEL COMMUNICATION • SBAR • TEAM SKILLS: BRIEF, HUDDLE, DEBRIEF • CUS • TEACHBACK (HEALTH LITERACY TOOL) • CHECKBACK
    18. 18. Shared Mental Model The perception of, understanding of, or knowledge about a situation or process that is shared among team members through communication. "Teams that perform well hold shared mental models." (Rouse, Cannon-Bowers, and Salas 1992)
    19. 19. SBAR Introduce Situation Background Assessment Recommendation
    20. 20. Brief Huddle Debrief Communicate clearly about event Who is on the team? Agree on Goals Problem-solving Go over details Roles & Responsibilities Understood Review situation Discuss new & emerging events Were roles & responsibilities understood? Plan of Care What went well Availability Anticipate outcomes & possibilities What should change Access Assign resources Can we improve? Resources Express Concerns
    21. 21. Continuous Communication CUS • I am Concerned • I am Uncomfortable • There is a Safety issue Teachback • Confirmation of understanding • Opportunity to correct miscommunication • Comprehensive:“Tell me in your own words…”
    22. 22. Checkback http://www.youtube.com/watch?v=AKtNLP8jQ7s
    23. 23. CASE EXAMPLE What are the risks in this scenario? • What communication was missed? • How would an interpreter or community health worker improve safety, quality and outcome? • Describe an alternative scenario.
    24. 24. Interprofessional Collaborative Practice “Health care delivered by well-functioning coordinated teams leads to better patient and family outcomes, more efficient health care services, and higher levels of satisfaction among health care providers. We all share the vision of a U.S. health care system that engages patients, families, and communities in collaborative, team-based care.” Dr. Mary K. Wakefield, HRSA
    25. 25. WHY IT MATTERS
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