Collaborative Healthcare Education: Innovation & Leadership

Mary Switzer Lecture

October 24, 2013Dr. Karen Pardue

Dr. Shelley Cohen KonradUniversity of New England

Mary Switzer (1900-1971) was an interprofessional collaborative leader before her time. She supported

cross-disability programs and was active in drafting the constitution of the World Health Organization. She was an advocate and global voice for people with disabilities

and for those who served their rehabilitative and recovery needs.

World Health Organization (2010)“Once students understand how to work

interprofessionally, they are ready to enter the workplace as a member of the

collaborative practice team.”•

•

WHY IPE IS IMPORTANT?

To advance the aim of improving health of the population, enhancing patient care and controlling costs

To close the gap between health education and practice settings by aligning their needs and interests

IPE – Guiding Principleshttp://www.aacn.nche.edu/education-resources/IPECReport.pdf

World Health Organization

Canadian Interprofessional

Health Collaborative

U. S. Interprofessional

Expert Panel

Institute of Medicine

“It is clear that how care is delivered is as important as what care is delivered.” (IOM, 2001)

___________________________________________

ContentDiscipline Expertise

ProcessIP Communication

Caring Practice

WHAT

HOW

Roles & Responsibilities• Communicate one’s roles and responsibilities • Engage diverse healthcare professionals to meet the needs

of patients, families and populations. • Use unique and complementary abilities of all members of

the team, to optimize patient care.

Vocational

Emotional

Occupational Physical

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.

Communication• Use respectful and appropriate communication in all

situations.• Listen actively and encourage ideas and opinions of

all team members.

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.

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.

Patient Centered Care

Patient-Practitioner

Complementary Expertise

Family/Community

Centered

CooperationCoordinationCollaboration

ConnectionCompassion

Communication

Trust

Contact Hypothesis - Framework

Attitudinal Change is fostered when students learn together

• Cooperation• Teamwork• Reduction of Stereotypes• Enhanced Role Understanding• Mutual Respect

(Allport, 1979; Hewstone & Brown, 1986)

Contact Hypothesis- Conditions

• Equal Status• Positive Cooperative

Atmosphere• Active work towards

common goal• Discovery of Similarities

& Differences• Faculty Modeling • Expressed Institutional

Value

Contact Hypothesis- Methodology

• Learning with Others reduces assumptions, stereotypes and misunderstanding

• Resolves cognitive dissonance

• Relationships & Friendships

• Emotional Connection• Role Empathy

I have seen significant changes in attitudes from the students who are working in teams. I have heard each student say “ I NOW value the role of …..X…” in patient care…..I NOW understand my ability to work more closely with ….X”. I think this change could have profound impact in the future. DM-Faculty

Contact Hypothesis TestingUndergraduate H/P Students

Before & After Enrollment in IPE Course

Statement(N=167 matched pair)

PreM

Post M

t p value

Learning w/ students from other h/p is likely to facilitate future working relationships

2.09 1.86 2.80 .006

Learning w/ other h/p students is likely to overcome stereotypes that are held about the different professions

2.01 1.72 3.53 .001

Learning w/ students from other h/p is a positive learning experience

1.76 1.61 2.13 .035

Learning w/ students from other h/p is likely to improve service for the patient/client

1.80 1.57 3.18 .002

Pollard et al., 2004. University of West England IPQ

IPE Initiatives - Students

The University will have integrated educational, research, science and service programs that are based on

collaborative, interdisciplinary partnerships. UNE will continue to be the primary educator of healthcare professionals for the state of Maine.

Health science programs will embrace and promote a patient-centered

approach to educating osteopathic physicians and healthcare

professionals. Interprofessional programs promote learning in

integrative ways.

UNE Vision 2017

IPE Curriculum

Undergraduate IPE Core Geriatric Education (IGEP) Online Learning

Simulation Spring Symposium

Extra- & Co-Curricular IPE

IPEC Event Series IPE & the Arts IPE Case Conference

IP Student Advisory Team Scholarship & Research

IPE Service LearningGhana Immersion Learning Jail Project

Riverton Clinic Homeless Health

IPE Initiatives – Innovative Models

UNE is committed to providing continuing education and training opportunities in interprofessional education and care for campus-

based faculty, clinical preceptors, and community partners.

Learning about, from and with each other ensures that educators

and practitioners appropriately practice and model IPE principles

and values

Faculty/Practitioner Opportunities

TeamSTEPPS Not Left to Chance Community Partnerships

National Consultants IPE Scholarship National Collaborations

Building Pat’s Story

Meet Pat Chalmers

Patricia Chalmers, 31Patricia (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.

Questions

1. What do we know about Pat?2. What health professions might contribute to

Pat’s rehabilitation and recovery?3. How can Pat’s case be used to educate health

professions students in IPE competencies?4. How can Pat’s case be used for health

professions faculty development?

Occupational Therapy

Applied Exercise Science/Athletic Training

Physical Therapy

The NexusThe next step forward is to increase the link between

future healthcare employers and campus-based interprofessional educational initiatives.

Interprofessional Practice Settings

Shared Assignments &

Didactics

6 Week Shared Rotations

Cross-professional

preceptorships

Common Patient Panel

Student ReflectionWorking in an interprofessional health system is not only beneficial to the patient, but also to everyone on the team… each professional learns from the other and they also can discuss their roles and responsibilities. … having various roles and responsibilities, they are able to work together with a common goal of providing the utmost care and maintaining the well being of a patient. Having a collaborative work environment with involvement from different health care professionals allows for a solution to any problem that may arise in a healthcare setting.

Jeby Mathew, Pharmacy Student fall 2013

Faculty Reflections“The more we work interprofessionally, 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.”

Jan Froehlich, OT Faculty

Mary Switzer: Agent for Culture Change

“She was extraordinary and she … was indefatigable and a political courtesan with tremendous powers of persuasion. She had charm …

she was bright and decisive.” (Verville, 2009)

Social Work

Rehabilitative Medicine

Mental Health

Public Health

Comments & Questions

Shelley Cohen Konrad PhD, LCSWKaren Pardue, PhD, RN, CNE, ANEF University of New England716 Stevens AvenuePortland, ME 04103scohenkonrad@une.edukpardue@une.edu