APNA 29th Annual Conference Session 2014: October 29, 2015 Developing - - PDF document

APNA 29th Annual Conference Session 2014: October 29, 2015 Peterson 1

Developing a Roadmap for IPE in Community‐Based Mental Health Sites:

Learning the landscape, signposts, detours, and Reaching The Destination

Barbara Peterson, Ph.D., PMH‐CNS‐BC, RN Merrie Kaas, Ph.D., PMH‐CNS‐BC, FAAN, RN

• Dr. Peterson and Dr. Kaas have no conflicts of

interest to disclose

• Dr. Peterson and Dr. Kaas have nothing to

disclose regarding off‐label use or the potential of off‐label use of drugs/products.

Learning Objectives

Describe the HRSA ANE grant processes for developing agency-tailored, authentic interprofessional clinical education experiential curriculum for PMH DNP, PharmD, and Occupational Therapy students.

Objective 1

Discuss challenges and opportunities associated with incorporating interprofessional learning opportunities at two community-based mental health care agencies

Objective 2

Identify a possible roadmap of learning activities/strategies that prepare clinical staff and faculty to work together to enhance IP learning opportunities in mental health sites.

Objective 3

APNA 29th Annual Conference Session 2014: October 29, 2015 Peterson 2

National Health Care Triple Aim

Improving the patient experience of care (quality and satisfaction) Example Text

Example Text

Improving the health

• f the population

Reducing the per‐ capita cost of health care

The Mandate

Create a “collaborative practice‐ready workforce” in education and practice. Working collaboratively implies a partnership between healthcare providers from multiple disciplines and the patients/families in a coordinated approach to shared decision‐making about patients’ care. World Health Organization (WHO 2010)

Need for IPE model (why ‘silo’ thinking isn’t the future)

Changing health care requires IP Collaboration Preparing students to be "practice ready” New models needed to reach triple aim

APNA 29th Annual Conference Session 2014: October 29, 2015 Peterson 3

Definitions

• Interprofessional education: “When students from two or more

professions learn about, from and with each other to enable effective collaboration and improve health outcomes” (WHO, 2010)

• Interprofessional collaborative practice: “When multiple health

workers from different professional backgrounds work together with patients, families, carers [sic], and communities to deliver the highest quality of care” (WHO, 2010)

• Interprofessional teamwork: The levels of cooperation,

coordination and collaboration characterizing the relationships between professions in delivering patient‐centered care

• Interprofessional competencies in health care: Integrated

enactment of knowledge, skills, and values/attitudes that define working together across the professions, with other health care workers, and with patients, along with families and communities, as appropriate to improve health outcomes in specific care contexts

– Interprofessional Education Collaborative (2011). Core Competencies for Interprofessional Collaborative Practice.

Interprofessional Education and Collaborative Practice (IPECP) occurs when two or more professions…

Learn With Each Other Learn From Each Other Learn About Each Other

…to enable effective collaboration and improve health outcomes

IPECP Competencies Domains

Roles & Responsibilities Interprofessional Communication Teams & Teamwork Values/Ethics for IP Practice

APNA 29th Annual Conference Session 2014: October 29, 2015 Peterson 4

HRSA: Advanced Nursing Education Program for Addressing Health Care Needs of People With Multiple Chronic Conditions Within IPE Model

I D E A

Enhancing Interprofessional Integrative Psychiatric/Mental Health Nurse Practitioner Education to Address Health Care of Persons with Psychiatric Disorders and Other Chronic Conditions (PI: Merrie Kaas, $1.3M/3 years)

First funded IPE project focusing on psychiatric ‐ mental health nursing education

Grant Goals

• enhance the Psychiatric Mental Health NP DNP courses

with evidence‐based integrative approaches for persons with multiple chronic mental and physical health conditions

• create interprofessional educational learning experiences

for PMH NP, PharmD., and Occupational Therapy students, faculty and staff at clinical sites

• design, implement, and evaluate agency‐tailored,

authentic IP clinical education experiences for PMH NP, PharmD., and OT students in partnership with two community based mental health care agencies

Grant Partners

• Faculty from U of MN School of Nursing, OT, and

Pharmacy.

• Faculty from Interprofessional Education Resource

Center (IERC)

• Evaluation Team: Upfront Consulting
• National Center for IPE/CP housed at U of MN
• Hoeppner Designs for media modules
• Academic Health Center at U of MN Interprofessional

Education Resource Center

• Project Manager
• Clinical partners at Wilder Child and Family Guidance

Center and Touchstone Mental Health

APNA 29th Annual Conference Session 2014: October 29, 2015 Peterson 5

Clinical Partners

Wilder Child Guidance Center

“aid and assist the poor, sick and needy people … without…discrimination for any such persons by reason of their nationality, sex, color, or religious scruples or prejudices.”

Touchstone Mental Health – Rising Cedar

“inspire hope, healing and well‐being”

U of M National Center and 1Health

• 1Health: All learners will complete at least one experiential IPE

learning rotation> >Exemplary Interprofessional Learning Environment (EILE). – Pre‐work: Online/hybrid video & reading to gain understanding

• f models of IPE, Triple Aim, QI, and IPCP.

– Rotation: Interprofessional rotation with other students at clinical site to practice/demonstrate understanding of IPCP/participate in IPE activities. – Post‐work: Debrief/assess to integrate and reflect on impact of IPCP and health outcomes.

Promote and develop students and clinical partners ready for IPECP

Pre‐work

Curricular changes incorporated into coursework Multi‐media modules based on IPECP and IMH Simulation for skill development and to explore collaborative approaches & IMH Salons to promote informal conversation among IP students

PMH DNP/NP PharmD OT

APNA 29th Annual Conference Session 2014: October 29, 2015 Peterson 6

July 1, 2013 – June 30, 2016

• Develop/enhance

DNP, Pharm, OT curricula with IPE and IMH content

• Develop clinical

teams

• Develop IPC

environment

• Planning for student

clinical placement

• Get baseline data
• First cohort of

students in didactic and clinical

• Develop IP

simulations

• Operationalizing

IPE and IMH in clinical sites

• Collect data
• Disseminate

beginning findings

• Second cohort of

students

• Refine curricula
• Refine student IPE

and IMH outcome criteria

• Collect final data
• Disseminate findings
• Sustain processes

and outcomes

Year 1 Year 2 Year 3

Identify the three biggest challenges in “…strengthening the inter‐professional education program in your department/at your site.”

Wilder Child Guidance, n=29

Roadblocks

Identify the three biggest challenges in “…strengthening the inter‐professional education program in your department/at your site.”

Touchstone Mental Health, n = 12

Roadblocks

APNA 29th Annual Conference Session 2014: October 29, 2015 Peterson 7

We’ve had staff changes, turnover that confuses our roles definitely changed the team. {Teamwork} Lack of understanding student objectives and expectations {Communication} Each clinician background has different philosophies. {Values} Lack of shared language creating miscommunication {Communication}

Potential Bumps in the Road to IP competency Potential Bumps in the Road to IP competency

No previous exposure to IPE or taught it. {Roles}

Timing for students at clinical site doesn’t match {Teamwork}

Year 1 Developing IPECP Environment

• Understand clinical staff

learning needs

• Agency Self assessment
• Preparing clinical sites

for students

• Pre‐work with students

Culture shifts toward IPE/IPECP Culture shifts toward IPE/IPECP

• IPE 101
• IPE 201
• Embedded faculty at

sites

• Multi‐media modules

based on IPECP and IMH

Year 2 Developing IPECP Environment

• Navigate student

clinical learning needs

• Distinguish between

uni‐professional goals from IPE learning goals

• Understand clinical staff

learning needs Culture shifts toward IPE/IPECP Culture shifts toward IPE/IPECP

• Supervision needs and

requirements

• Clinical site on‐

boarding requirements

• IMH/IPE modules
• IPE discussions
• Coordinating student

schedules

APNA 29th Annual Conference Session 2014: October 29, 2015 Peterson 8

Year 3 It’s not just the Destination: It’s the Journey

• Increase staff

knowledge about IPE and IPC

• Identify language

variance and develop shared language

• Increase staff

knowledge

• Identify champions and

torch bearers of IPE IPE/IPECP Culture IPE/IPECP Culture

• IPE for all students in

the clinical site

• Shared language of

IPE

• Leadership

commitment to IPE

Reaching the IPECP Destination

The Patient is at the center Culture of IPECP

Our band of travelers

Questions

APNA 29th Annual Conference Session 2014: October 29, 2015 Peterson 9

References

• Interprofessional Education Collaborative Expert Panel.

(2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, D.C.: Interprofessional Education Collaborative.

• World Health Organization (WHO). (2010). Framework for

action on interprofessional education & collaborative

• practice. Geneva: World Health Organization. Retrieved April

11, 2011 from http://whqlibdoc.who.int/ hq/2010/WHO_HRH_HPN_10.3_eng.pdf