1 Interprofessional Collaboration Primary care is the central - - PDF document

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Created in 2005

 The European Forum for Primary Care

is situated at the NIVEL institute in the Netherlands.

 Board members from Belgium, UK,

Italy, Sweden, Slovenia, Hungary, the Netherlands, Greece, Latvia, etc

Membership network

 Membership

(110 institutional & 45 individual members) Members from the 3 levels: Policy, Research & Practice

 Membership is multi-professional

Why this Forum?

 Dissemination of expertise and knowledge on

Primary Care systems

 Support to members for implementation  To show the key principles of the World Health

Report 2008: “Primary Health Care Now More Than Ever”!!

• universal coverage (focus of the WHR 2010)
• service delivery
• public policy
• leadership

 And its relevance in relation to the WHO/Europe

emphasis on Health System initiated at the Tallinn 2008 Ministerial conference on "Health Systems, Health and Wealth”

The patient perspective as a starting point for service delivery!

Includes the following values:

 Accessibility  Continuity of care  Coordination of care  Comprehensiveness of services

Advocacy for Integrated and Community Oriented Primary Care including Interprofessional Collaboration (IpC) Quality of primary care: messages for the third millenium

Community Oriented Primary Care

Investing in sustainable health systems combines innovative reforms aimed at improving cost-efficiency and reconciling fiscal consolidation targets with the continued provision of sufficient levels of public services. Page 5: "using financial incentives to encourage patients to register with a general practitioner (GP) or family doctor and using a referral system to define a cost-effective path of care: from GP, to outpatient specialist, to hospital, to emergency care, while encouraging patients to have less recourse to unnecessary care and emergency services;" Suggested measures for Investing in Sustainable Health Systems two clear recommendations for Member States:

• Reducing the unnecessary use of specialists and hospital

care

• Improving primary healthcare services

“Investing in Health - Key Messages”, ; European Commission, DG Health and Consumers; February 2013 .

Health 2020 –reaching higher and broader:

• Going upstream to address root causes such as social

determinants

• Invest in public health, primary care, health protection and

promotion, and disease prevention

• Making the case for whole-of-government and whole-of-

society approaches

• Offering a framework for integrated and coherent

interventions

Health 2020: a new European policy framework for health and well-being; Zsuzsanna Jakab, WHO Regional Director for Europe, 20 March 2013, Riga, Latvia

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Interprofessional Collaboration

Primary care is the central pillar of health care. The increasingly complex health needs of the population and individual patients in a changing society can

• nly be met by promoting interprofessional

collaboration (IpC) within primary care teams.

Improving interprofessional collaboration in primary care: Position Paper of the European Forum for Primary Care

European Observatory: Accessibility of vulnerable groups is key, Primary Care is key! Prof Alan Maynard, University of York: “the re-distribution of income & power of health professionals is key to create solutions for the future”

WHO Oslo conference 17-18 April 2013, Health Systems in Times

• f Global Economic Crisis

All presenting health ministers of Greece, Ireland and Wales started with the need to invest in Primary Care “Chronic Diseases closely related with low SES; need for investment in Human Resources instead of expensive sophisticated technology” stated clearly by EFPC

“EU Summit on Chronic Diseases; European Commission, DG Health and Consumers; April 2014 .

Public consultation on the preliminary opinion on the ‘Definition of a frame of reference in relation to primary care with a special emphasis on financing systems and referral systems’

EU Expert Panel on Effective Ways of Investing in Health (EXPH); April 2014

 Extended Deadline to respond: 18 May 2014

http://ec.europa.eu/health/expert_panel/consultations/primaryca re_en.htm

In this respect Primary Care gets a lot of attention and is seen by Policy Makers as well as Researchers as an area with enormous potential. It is up to the Primary Care providers to make the case In order to achieve this, the different professional groups should share their interests and strive together for a strong Primary Care movement!

But “Can we make sense of multidisciplinary co-operation in primary care”?

Why is it so difficult!? Because it is deeply rooted in the educational system, causing distrust and subsequently income and power inequalities!

• “Although it is widely acknowledged that the complex health

problems of chronically ill and elderly persons require care provision across organisational and professional boundaries, achieving widespread multidisciplinary co-operation in primary care has proven problematic.”

Can we make sense of multidisciplinary co-operation in primary care by considering routines and rules? Arianne M.J. Elissen MSc, Arno J.A. van Raak PhD and Aggie T.G. Paulus PhD; Health and Social Care in the Community (2011) 19(1), 33–42

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Recommendations for Action: Getting the Most out of Interprofessional Primary Health Care Teams

The Conference Board of Canada, March 2014 With 9 recommendations:

• mandate high-quality interprofessional

education and training for all health professionals to support the development and mastering of the core competencies of interprofessional collaboration

http://www.conferenceboard.ca/e-library/abstract.aspx?did=5988 The Interprofessional Curriculum Renewal Consortium, Australia (2013) Interprofessional Education: a National Audit. Report to Health Workforce Australia

Interprofessional Education (IpE)

• Occasions when two or more professions learn from,

with and about each other to improve collaboration and the quality of care. Development of IPE within Australian universities and jurisdictions has been: localised, opportunistic, adaptive and creative, but existing on the margins of the curriculum; minimally resourced and, as a consequence frequently unsustainable; fragmented both within and across universities and the higher education sector; and, without mechanisms to share information, share learning, develop research and build knowledge and capacity.

Promotion of interprofessional and transprofessional education that breaks down professional silos while enhancing collaborative and non-hierarchical relationships in effective teams.

Health professionals for a new century: transforming education to strengthen health systems in an interdependent world

• Prof Julio Frenk et al

What is the reason why this educational system fails to educate Primary Care professionals in a more collaborative way?



Working collaboratively is not something you can learn technically,



You need to practice IpC from the first year onwards,



You need to feel the added value of practicing together,



And the most important: you have to find your peers, crossing professional boundaries, during your basic vocational training! “Being able to work effectively as members of clinical teams during studentship is seen as a fundamental part of learning”

Interprofessional Education Collaborative (2011) Core Competencies for Interprofessional Collaborative Practice: report of an expert panel. Interprofessional Education Collaborative: Washington, DC.

Solutions to be found in:

 New thinking within national/international

professional associations

 New thinking within educational institutions

“The establishment of national health and higher education cross-sectoral mechanisms and arrangements through which national IPE/IPL leadership and coordination can be developed”

Recommendation from the ‘Learning and Teaching for InterProfessional Practice (L-TIPP) project

Institute of Medicine’s Global Forum on Innovation in Health Professional Education

 Aims to apply an ongoing, multi-national, multi-

disciplinary approach to exploring promising innovations in health education.

 The IOM Forum brings together stakeholders

from a variety of disciplines and sectors to engage in dialogue and discussion to illuminate contemporary issues in health professional education.

http://www.iom.edu/Activities/Global/InnovationHealthProfEducation .aspx

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Institute of Medicine’s Global Forum on Innovation in Health Professional Education

 Latest workshop 1/2 May: Scaling up best

practices in Community-based Health Professional Education

http://www.iom.edu/Activities/Global/InnovationHealthProfEducation .aspx

A few examples for IpE:

University of South Carolina

 Student-Run-Clinic

• With more than 200

Students involved

• From 4 different

disciplines

 Medicine  Occupation Therapy  Pharmacy  Physician assistant

A few examples for IpE:

 Public Health Foundation of India, New Delhi

together with

• Symbiosis College of Nursing (Pune) and
• Datta Meghe Institute of Medical Sciences (Sawangi)

 Development and piloting of an interprofessional

training model to develop physician, nursing and public health leadership skills relevant for the 21st century health system in India

http://www.iom.edu/Activities/Global/InnovationHealthProfEducation /Innovation- Collaboratives/~/media/Files/Activity%20Files/Global/InnovationHeal thProfEducation/2012-MAR-08/Zodpey_Innovation- Collaboratives_India.pdf

A few examples for IpE:

South African partnership on Innovation in Health Professional Education

 Theme 1:

• Competencies required for transformational and shared

leadership

• Leadership program for health teams

 Theme 2:

• Competency-based, interprofessional skills building
• Teamwork in community and primary healthcare

settings

http://www.iom.edu/Activities/Global/InnovationHealthProfEducation/Innovat ion- Collaboratives/~/media/Files/Activity%20Files/Global/InnovationHealthProfEd ucation/2012-MAR-08/de-Villiers_Innovation-Collaboratives_South-Africa.pdf

A few examples for IpE:

Common Learning project of the Universities of Southampton and Portsmouth

 Ensuring that students on the different medical

programmes are given the opportunity to learn and work together through an interprofessional model of education.

 This element of the programme will help EQuiP

them to work in teams, in the context of modern health and social care services.

https://www.commonlearning.net/default.asp

A few examples for IpE:

Interprofessional Collaborative Education at the Eastern Virginia Medical School, United States



a 1-credit Interprofessional Collaborative Education course for the 2014-15 academic year. Approximately 200 students representing 6 diverse graduate level programs will convene for six 2-hour sessions that will include didactic learning combined with breakout sessions for 20 groups of 10 students each.



This course will address four key competencies—values, roles, communication, teamwork—using case-based learning and small groups facilitated by faculty. Example to be presented at EFPC Barcelona conf 1/2 Sept

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EIPEN (European Interprofessional Practice and Education Network )

Aims to develop and share effective interprofessional training programmes, methods and materials for improving collaborative practice in health and social care.

 European charter (2011)

• Involvement of professional bodies
• Involvement of educational & clinical institutions
• Interprofessional competencies ratified
• Continuous training
• Regulation by accreditation and financial mechanisms
• Support from health insurance bodies, patient
• rganizations, and supportive networks

 2015 August 26-28: Nijmegen (NL) conference

http://eipen.eu/doc/Charter_for_IPE_in_Europe.pdf

V bi-annual EFPC conference 1/2 September

“Twinning Population Health and Primary Care”

The Future of Primary Care in Europe V

Conference fees

Students € 175 Early bird EFPC members € 275 Early bird Non members € 350 EFPC members € 375 Non members € 450 Early bird ends June 16

http://www.euprimarycare.org

EFPC at the Web

 www.euprimarycare.org

Webbased database on European Primary Care

 LinkedIn discussion group “Primary Care

Forum” Currently >4400 members from all over the world

 Twitter: (@PrimaryCare4um)  Facebook-page: Primary Care Forum Tel: +31 30 272 96 11 E-mail: info@euprimarycare.org