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Interprofessional
Learning
Meeting at the
Crossroads of Care
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?
What does collaborative learning & practice
look like in your institution?
Interprofessional collaboration promotes the
achievement of goals that cannot be reached when
individual professions learn or act on their own
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.
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
WHAT STUDENTS TELL US
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
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.
BIG Picture
IPE – Guiding Principles
http://www.aacn.nche.edu/education-resources/IPECReport.pdf

World Health
Organization

Canadian
Interprofessional
Health Collaborative

Institute of
Medicine

U. S.
Interprofessional
Expert Panel
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
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
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.
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.
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
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.
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.
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
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
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
Qualities of Patient-Centeredness
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.
Change
Workplace Learning
“People don’t learn by looking in the mirror. They learn
by talking with people who have different points of
view.”
Ronald Heifetz (1995)
Definition: Bi-Culturalism
Dual Identities
• Shared vision and
common goals for
health and health
practice
• Respect for
Distinctions between
professions and value
for the differential
roles played by
members of the team

Bi-Cultural Competencies
• Knowledge of Roles &
Responsibilities
• Communication
• Collaborative Teamwork
• Shared Values & Ethics
Culture Change
• A process of
institutional-systems
socialization (Ideas,
language, values, &
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
“We meet monthly to
discuss successes and
needed changes, which
allows us to know what
others value and how they
see their roles as educators.
Such knowledge allows us
to be expansive and
inclusive in our own
disciplines.”

“The more we work together
the more apparent it becomes
that we face tremendously
challenging health care issues
that can only be solved
through collaboration and
teamwork. There is
momentum to our
interprofessional efforts that
appears unstoppable.”
Learning from Pat’s Story

Mutual Support
Communication
Respect

Caring
Relationship
IP Collaboration
Patient Safety
Patricia Chalmers, 31
Patricia (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.
Pat describes herself as having been a caretaker since adolescence. It is
therefore difficult for her to acknowledge her own needs or to seek
others for help.
Pat is tired of people commenting on her weight, diet, and need to
exercise. She avoids health care 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. “But I’ve tried everything
and nothing works. I’ve accepted my size and would like others to
respect that.”
Pat found herself in the ED with a broken ankle several months ago.
The break was significant enough to require surgery. Labs revealed
elevated glucose levels and surgery was put off until further tests could
be done to determine whether Pat might have diabetes. When asked
about this possibility, Pat reacted strongly. “I don’t have the time or
money for diabetes,” she explained.
Huddle
1. What do we know about Pat?
2. What professions might be important to Pat’s team?
3. What can we learn from other professions to improve the
quality of Pat’s care?

Social Work & Behavioral Health

Primary Care

Oral Health

Nursing

Support Staff

Rehabilitation
The Nexus
The next step forward is to increase the link between
future healthcare employers and campus-based
interprofessional educational initiatives.
Shared Learning Environments
Crossprofessional
preceptorships

6 Week Shared
Placements

Common
Client/Patient
Panel

Shared
Assignments
& Didactics

Clinical-Public
HealthSystems Health
“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.”
Shared Learning:
The Strategic Advantage
“Investment in IPE makes health professions programs
more competitive within the university”
•Increased understanding of other
departments and programs (internal
education)
•Leads to understanding of the valueadded by collaboration (e. g. shared
programming in common curriculum)
•Opportunities for large
interdisciplinary grants (HRSA)
•Enhances recruitment by
distinguishing program options from
other similarly designed institutions
•Opportunities for joint appointments
and creative hires
•Support for Scholarly productivity
and successful faculty
reappointment/tenure
Institutional Benefits
• Enhances the reputation of educational
institutions by creating a niche and
showing currency with health reform
• Increases potential for collaboration
between previously siloed programs and reduces costs to
the institution
• Increases opportunities for service learning and
community partnerships
• Attracts vibrant and innovative faculty
• Attracts interest of external funders
• Prepares students for workplace hires
Communicating IPE Messages
If you have IPE programming:
– Include IPE in recruitment materials
– Work to get internal and external press
– Find champions outside of IPE
– Publish
– Include IPE in your annual performance report
– Give Deans regular outcome-driven reports
– Give Deans “good news” to be shared
– Meet with Dean/Leadership about IPE return on investment
(ROI)
Communicating IPE Messages
If you are not yet engaged but are working to develop
IPE:
– Make sure to create clear vision and mission statements
and IPE principles
– Involve leadership early
– Invite national IPE educators to campus
– Gather literature and exemplars from other
similar institutions
– Provide evidence of ROI
– Have patience and don’t give up – Changing culture is a
process
Thank you
Shelley Cohen Konrad
PhD, LCSW
University of New
England

Director
Interprofessional
Education
Collaborative
Associate
Professor, School
of Social Work

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Interprofessional Learning Meeting at the Crossroads of Care

  • 2. 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?
  • 3. What does collaborative learning & practice look like in your institution? Interprofessional collaboration promotes the achievement of goals that cannot be reached when individual professions learn or act on their own
  • 4. 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.
  • 5. 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
  • 7. 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
  • 8. 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.
  • 10. IPE – Guiding Principles http://www.aacn.nche.edu/education-resources/IPECReport.pdf World Health Organization Canadian Interprofessional Health Collaborative Institute of Medicine U. S. Interprofessional Expert Panel
  • 11. 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
  • 12. 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
  • 13. 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.
  • 14. 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.
  • 15. 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
  • 16. 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.
  • 17. 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.
  • 18. 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
  • 19. 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
  • 20. 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
  • 21. Qualities of Patient-Centeredness 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.
  • 23. Workplace Learning “People don’t learn by looking in the mirror. They learn by talking with people who have different points of view.” Ronald Heifetz (1995)
  • 24. Definition: Bi-Culturalism Dual Identities • Shared vision and common goals for health and health practice • Respect for Distinctions between professions and value for the differential roles played by members of the team Bi-Cultural Competencies • Knowledge of Roles & Responsibilities • Communication • Collaborative Teamwork • Shared Values & Ethics
  • 25. Culture Change • A process of institutional-systems socialization (Ideas, language, values, & 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
  • 26. “We meet monthly to discuss successes and needed changes, which allows us to know what others value and how they see their roles as educators. Such knowledge allows us to be expansive and inclusive in our own disciplines.” “The more we work together the more apparent it becomes that we face tremendously challenging health care issues that can only be solved through collaboration and teamwork. There is momentum to our interprofessional efforts that appears unstoppable.”
  • 27. Learning from Pat’s Story Mutual Support Communication Respect Caring Relationship IP Collaboration Patient Safety
  • 28. Patricia Chalmers, 31 Patricia (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. Pat describes herself as having been a caretaker since adolescence. It is therefore difficult for her to acknowledge her own needs or to seek others for help. Pat is tired of people commenting on her weight, diet, and need to exercise. She avoids health care 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. “But I’ve tried everything and nothing works. I’ve accepted my size and would like others to respect that.” Pat found herself in the ED with a broken ankle several months ago. The break was significant enough to require surgery. Labs revealed elevated glucose levels and surgery was put off until further tests could be done to determine whether Pat might have diabetes. When asked about this possibility, Pat reacted strongly. “I don’t have the time or money for diabetes,” she explained.
  • 29. Huddle 1. What do we know about Pat? 2. What professions might be important to Pat’s team? 3. What can we learn from other professions to improve the quality of Pat’s care? Social Work & Behavioral Health Primary Care Oral Health Nursing Support Staff Rehabilitation
  • 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.”
  • 34. “Investment in IPE makes health professions programs more competitive within the university” •Increased understanding of other departments and programs (internal education) •Leads to understanding of the valueadded by collaboration (e. g. shared programming in common curriculum) •Opportunities for large interdisciplinary grants (HRSA) •Enhances recruitment by distinguishing program options from other similarly designed institutions •Opportunities for joint appointments and creative hires •Support for Scholarly productivity and successful faculty reappointment/tenure
  • 35. Institutional Benefits • Enhances the reputation of educational institutions by creating a niche and showing currency with health reform • Increases potential for collaboration between previously siloed programs and reduces costs to the institution • Increases opportunities for service learning and community partnerships • Attracts vibrant and innovative faculty • Attracts interest of external funders • Prepares students for workplace hires
  • 36. Communicating IPE Messages If you have IPE programming: – Include IPE in recruitment materials – Work to get internal and external press – Find champions outside of IPE – Publish – Include IPE in your annual performance report – Give Deans regular outcome-driven reports – Give Deans “good news” to be shared – Meet with Dean/Leadership about IPE return on investment (ROI)
  • 37. Communicating IPE Messages If you are not yet engaged but are working to develop IPE: – Make sure to create clear vision and mission statements and IPE principles – Involve leadership early – Invite national IPE educators to campus – Gather literature and exemplars from other similar institutions – Provide evidence of ROI – Have patience and don’t give up – Changing culture is a process
  • 38.
  • 39. Thank you Shelley Cohen Konrad PhD, LCSW University of New England Director Interprofessional Education Collaborative Associate Professor, School of Social Work

Editor's Notes

  1. The goal of interprofessional education is to provide health professions students with integrated and interactive learning opportunities that translate into knowledge, skills, and attitudes for collaborative healthcare practice.
  2. Set up with website
  3. Shelley or Jen
  4. 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
  5. The National Center for Interprofessional Practice & Education at the University of Minnesota is leading the national effort
  6. Nursing may be familiar with these guidelines
  7. Describe someone who exemplifies strong leadership. What qualities do they possess?
  8. Modified from: Orchard, C, Shaw, L, & Culliton, S. Client-Centred Collaborative Care: From the patients’ perspective. Journal of Interprofessional Care 2011.
  9. If the goal is to teach students to better collaborate the critical first step is to engage faculty-practitioners to do the same. Such learning must be intentionally designed and delivered. At its best, IP faculty development must be responsive and sensitive to faculty workload, commitments to their own professional curriculum, and open to variations in the way IPE will be brought into their cultures. Although one hopes that interprofessional collaboration is a natural or intuitive tendency for caring health professionals, the literature and our own lived experiences have not shown this to be the case. Faculty grow and are supported when strategies for IPE are intentionally taught. They thrive when opportunities to creatively and productively engage with each other are made available. Such opportunities not only advance knowledge, they change culture.
  10. Modified from John Kotter’s 8-step change model.
  11. Thank you to Dean Anna Scheyett from the University of South Carolina.