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Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
Rice ipe presentation r1
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Rice ipe presentation r1

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  • The National Center for Interprofessional Practice & Education at the University of Minnesota is leading the national effort
  • Set up with website
  • Describe someone who exemplifies strong leadership. What qualities do they possess?
  • Modified from: Orchard, C, Shaw, L, & Culliton, S. Client-Centred Collaborative Care: From the patients’ perspective. Journal of Interprofessional Care 2011.
  • Transcript

    • 1. The RICE Project (Rural Interprofessional Clinical Expansion) School of Social Work University of New England February 28, 2014
    • 2. Day’s Objectives Interprofessional Collaborative Practice with Medically Underserved & Vulnerable Populations • Develop a common understanding of what is meant by Teamwork, Collaboration & Interprofessional Education • Provide an overview of national IPE/CP trends and goals • Discuss populations being served by RICE Project Sites • Apply IPE/CP principles to collaborative learning & practice opportunities at community sites • Share methods for improving partnering, networking & team-building skills with clients, systems and each other
    • 3. Small Group Activity 1 How do you define teamwork? 1. Where did you learn about how to be a team member? 2. What skills are needed to build collaborative teambased practice? 3. What are the barriers to working as a team?
    • 4. What does collaborative practice look like in your agency? “… interdisciplinary collaboration is the achievement of goals that cannot be reached when individual professions act on their own” (Bronstein, 2003).
    • 5. Why is collaborative practice important? “Trends in social problems and professional practice make it virtually impossible to serve clients effectively without collaborating with professionals from various disciplines.”
    • 6. 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.
    • 7. Interprofessionality is not • • • • • • Simply sharing electronic health records Sole profession teams (neurologist, pulmonologist, radiologist) Learners hearing a talk about another profession Reporting out at interdisciplinary team meetings Co-location without intentional collaboration Decision-making without client/patient input
    • 8. BIG Picture
    • 9. WHAT STUDENTS TELL US
    • 10. COMMUNITY Landscape Medically Complex Conditions Maine’s Rural Population Maine ranks 3rd in the nation and 1st in New England for food insecurity • Fragmentation of health care is associated with worsening MCCs • Behavioral health disorders (BHD) are associated with worsening MCCs & early death • Transition to continuous care is associated with improved overall health
    • 11. Child Poverty American Community Survey Data Findings: Maine • • • • More than 1 in 5 children (20.9% under 18 years of age) live in poverty More than 1 in 4 young children (26.9% of children under the age of five) live in poverty. Child poverty is getting worse, not better: poverty rates are greater than they were just four years ago in the immediate aftermath of the Great Recession. Maine median household income in 2012 was $46,709, significantly lower than pre-recession levels and significantly lower than in 2008, 2009, and 2010-the immediate aftermath of the recent financial crisis and recession.
    • 12. Maine’s Veterans Maine ranks in the top five states in concentration of Veterans. York, Androscoggin and Kennebec counties are in the top five counties both in terms of actual numbers of Veterans as well as concentration of Veterans in the overall population (Government Accountability Report, 2011)
    • 13. Core Competencies for Interprofessional Collaborative Practice  Values/Ethics for Interprofessional Practice  Roles/Responsibilities for Collaborative Practice  Interprofessional Communication  Interprofessional Teamwork and Team-based Care  Collaborative Leadership  Patient-Centeredness
    • 14. Applying Core Competencies What people and situations come to mind in your practice setting as we explore the competencies?
    • 15. Roles & Responsibilities • Communicate roles & responsibilities • Engage with others to meet the needs of the people & populations served. • Use complementary skills of all team members to optimize care.
    • 16. Values & Ethics • Place the interests of patients and populations at the center of health care. • Respect unique cultural values and perspectives of individuals, populations, and health professionals. The D-P family is, like many Maine families, struggling to make do despite full-time employment. Mr. D-P suffers with severe knee pain. Mrs. D-P is anxious to return to work but hasn’t been able to as both of her children have special needs. Her son has numerous health concerns as well as development delays and behavioral issues that have made it difficult for him to attend traditional day care.
    • 17. Communication • Use respectful and appropriate communication in all situations • Listen actively and encourage ideas and opinions of all team members • Become knowledgeable about the cultures in your system & in the community
    • 18. With Clients/Patients/Families "When I come to Lewiston, not speaking English, not employed, not educated, the gap is already there," she said. When young he spoke French in the home but increasingly spoke English to "fit in." He had heard those who did not speak fluent English referred to as "dumb Frenchmen" and he didn't want to be judged by his language skills.
    • 19. Teams & Teamwork • Work with others to deliver patient-centered, community-responsive care. • Integrate knowledge and experience of other professions to inform effective clinical, ethical, and systems-based decisions. While most recognize the value of collaboration and teamwork they also note many barriers beginning with different definitions of team; lack of systems integration; few policies supporting team practices; and physical separation.
    • 20. Collaborative Leadership • Strong leaders value contributions of all health team members’ and also those of the patient, family, and community. • Leaders facilitate contributions from all team members and build support for working together.
    • 21. Purposeful Leadership Consists of purposive efforts to address social determinants of health which negatively impact people and change specific existing conditions, policies and practices on behalf or with a client group, community, or population. Oandasan, 2014
    • 22. Person-Centeredness • Respect for complementary expertise • Value for clients/patients as a vital members of the team • Trust in each other & in the team • Value for clients’ perspectives and needs • Connection & Compassion • Commitment to shared decision-making process
    • 23. Person/Patient-Centeredness Clinical Providers Invite & empower people to engage with choices & adhere to prescribed treatment protocols, life style changes and medication regimens. Public Health Provide tools to inform & engage consumers in health decision-making, selfmanagement, and health advocacy Persons/ Patients Capacity to think critically & make informed and shared decisions in collaboration with health care teams
    • 24. Qualities of Person-Centered Practice Attitudes o Respect for complementary expertise o Value for patients as a vital members of the team o Trust in each other & in the team o Connection & Compassion Actions o Explicitly invite patients to be part of the health care team o Introduce patients to empowering practice & facilitate skills o Communicate openly, listen actively & respond effectively o Engage patients in care planning & collaborate decision-making o Consider utilization of an ongoing evaluation process Modified from: Orchard, C, Shaw, L, & Culliton, S. Client-Centred Collaborative Care: From the patients’ perspective. Journal of Interprofessional Care 2011.
    • 25. Change
    • 26. Culture Change • A process of institutional-systems socialization (Ideas, language, value s, & attitudes ) • Common vision and mission statements • Preferred workplace/clinical practices • Common definitions of health & principles of health care delivery Step 1: Promote ideas that are meaningful to the workplace & set common goals Step 2: Form an Inclusive Coalition and invite meaningful change Step 3: Create a Common Vision for achievable change Step 4: Walk the Talk – reach out to colleagues Step 5: Appreciate small successes and build on them Step 6: Remove obstacles & sidestep barriers Step 7: Sustain momentum – establish a domino effect Step 8: Anchor change in the workplace
    • 27. Pat Video
    • 28. Patricia Chalmers, 31 Pat Chalmers is a 31-year-old woman who prides herself on self-sufficiency and resourcefulness. She works part-time as a bookkeeper and gets paid to take care of her aging grandmother with whom she lives in a one bedroom apartment. Pat describes herself as having been a caretaker since adolescence. It is difficult for her to acknowledge her own needs or to seek help from others. Pat is tired of people commenting on her weight, diet, and need to exercise. She avoids health systems as much as possible because she knows she’ll be told to lose weight or be blamed for “being fat” (her words). “I know what risks I face” she says. “I’ve accepted my size and would like others to respect that.” She also avoids contact with human services or any resources she sees as linked to “the state.” Pat’s records reveal that she gave birth to a child at 16 who was adopted. Although she rarely talks about this experience she will say that she felt she was given no choices and had to move on. Pat’s grandmother comes to her appointment today. She is 56 but seems much older. Pat brought her along so she wouldn’t “chicken out” talking to a shrink. Pat has experienced depression since middle school and symptoms have worsened since she severely broke an ankle 6 months ago. The break was significant enough to require surgery. At the same time, Pat learned she had Type II diabetes. When asked about this Pat reacted strongly. “I don’t have the time or money for diabetes,” she explained.
    • 29. Patricia Chalmers 1. What do we know about Pat? 2. Reflect upon thoughts and feelings that surface after hearing Pat’s story? Are there assumptions, biases or experiences that might get in the way of working with Pat? 3. Why is it important for you to understand the roles of others that are working with Pat? 4. How can working with others improve the quality and safety of Pat’s care?
    • 30. The Nexus The next step forward is to increase the link between future healthcare employers and campus-based interprofessional educational initiatives.
    • 31. Shared Learning Environments Crossprofessional preceptorships 6 Week Shared Placements Common Client/Patient Panel Shared Assignments & Didactics Clinical-Public HealthSystems Health
    • 32. “One of the best parts of this interaction for me was the ability to learn and share with one another. I was able to share my strengths as a student and learn to appreciate the strengths of student pharmacists. “ “Because we know each other better, our interactions come easier and smoother when it comes to patient care… we feel comfortable to chime in and the visits became integrated in an organic way.” “We have the same goal: to provide excellent patient care, but we approach this goal from very different perspectives.”
    • 33. Karen Pardue PhD, RN, CNE, ANEF Associate Dean for Undergraduate Education, Associate Professor of Nursing Lisa Pagnucco BS Pharm, PharmD, BCACP Assistant Professor RICE Project Team: Nancy Ayer Betsey Gray Amy Coha Danielle Wozniak Shelley Cohen Konrad

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