The Webinar will begin at 12:00 p.m. CST Workforce Redesign for - - PowerPoint PPT Presentation

The Webinar will begin at

12:00 p.m. CST

Workforce Redesign for Interprofessional Education and Collaborative Practice: Using Simulation to Create Interprofessional Team across health care settings

Monday, November 21

Moderator & Presenter

Sara Shrader, PharmD, FCCP, BCPS, CDE Clinical Associate Professor, University of Kansas School Of Pharmacy Photo

Presenters

Erika Erlandson MD Assistant Professor, Physical Medicine and Rehabilitation, University of Kentucky Director, Interprofessional Education, College of Medicine, University of Kentucky Photo

Disclosure

The National Center for Interprofessional Practice and Education has a conflict of interest policy that requires disclosure of financial interests or affiliations with organizations with a direct substantial interest in the subject matter of their program. Erika Erlandson, MD Does not have a vested interest in or affiliation with any corporate

• rganization offering financial support or grant monies for this

interprofessional continuing education activity, or any affiliation with an

• rganization whose philosophy could potentially bias her presentation.

Workforce Redesign for Interprofessional Education and Collaborative Practice: Using Simulation to Create Interprofessional Team across health care settings

Erika Erlandson, MD Julia Blackburn,MSN RN Lynne Jensen, PhD, APRN-BC Jimmi Hatton-Kolpek, Pharm D

Objectives

• Describe the background and

landscape of the state of Kentucky and Stroke

• Review the gaps in the current

transition of care process

• Summarize the simulation

experience

• Assess the effectiveness of

simulation on collaboration

Background

• Stroke population in the state of

Kentucky presents a unique cohort where the continuum of care coordination is essential to

• ptimize outcomes
• 200 transitions of care for stroke

patients in 2014 from acute care to acute rehabilitation

Background

• Kentucky remains 10th nationwide for

mortality related to stroke1

• Stroke health outcomes are affected by

efficient and effective care across the continuum 2

• Poor transitions of care ultimately

influence the cost of healthcare, patient satisfaction, and health outcomes3

Phases of KCATS

Phase I: Baseline Transition of Care Process Phase II: Simulation and Tool Development Phase III: Implementation and Evaluation

• f KCATs tool

Phase I

• Population: Chart review of 40 patients

transitioning from acute care to acute rehabilitation

• Reviewed data exchanged in current

handoff process

• Comparison: Discharge summary from

acute care and admission documentation to acute rehabilitation for accuracy, completeness, and congruence of data

• Outcomes: Contributing factors related to

common complications post stroke

• Unable to run any statistical testing due

to the large amount of missing information

Overall Risk of Complication

Aspiration Pneumonia

Risk of Aspiration Pneumonia: Contributors include Modified Barium Results which did not cross the transition 80% of the time. The solid and liquid diet component was present 50% but revealed 17.5% non-congruence

• f information

during transfer

Urinary Tract Infection

Risk of UTI: Contributors include bladder continence, bowel continence where more than 50%

• f the information did

not make it across the

• transition. 100% of the

information regarding toileting status was absent from the transfer.

Fall Risk

Summative Fall Risk: Transfer Status + Comprehension + Expression: 84% was lost in the transition of care

Phase I: Conclusions

• This chart review highlights the

need for process improvement

• Creating an interprofessional care

transition handoff tool may improve communication, effectiveness, and lower risk factors affecting health outcomes following stroke

Phases of KCATS

Phase I: Baseline Transition of Care Process Phase II: Simulation and Tool Development Phase III: Implementation and Evaluation

• f KCATs tool

Simulation

Simulation of CURRENT acute care to rehab transition Focus group with interprofessional teams

KCATs tool development Beta testing of KCATs tool

ICAR assessment

Refinement and Implementation

Simulation

• Prospective, non-randomized before

and after investigation

• Interprofessional teams from

different care facilities

• Participation in simulation re:

transition of care for patient with stroke

• Develop a collaborative handoff tool
• Identified interprofessional members
• f the stroke care team in acute care

and acute rehab

Simulation Participants

• Physical Therapy
• Occupational Therapy
• Speech and Language Pathology
• Nursing
• Pharmacy
• Psychology
• Dietary
• Medicine
• Case management
• Social work

Methods

• The interprofessional teams simulated

the current handoff process (Nursing phone call + Medical Documentation)

• Following, they implemented a model of

enhanced communication, problem solving, and planning of care with the team to improve the handoff of patients with stroke by developing an interprofessional transition of care tool model.

Outcome Measures

• Pre and post simulation modified

Interprofessional Collaborator Assessment Rubric1

• Pre and post simulation evaluation
• f beliefs on professions who

should be part of the interprofessional team and evaluation of simulation as a learning tool.

1Curran, V., Hollett, A., Casimiro, L., McCarthy, P., Banfield, V., Hall, P., & Lackie, K. (2011).

Development and validation of the interprofessional collaborator rubric. Journal of Interprofessional Care, 25, 339-344.

Simulation Results- Comments

6 9 1 2 3 4 5 6 7 8 9 10 Very Satisfied Satisfied Unsatisfied Very Unsatisfied

How Satisfied are You with the Current Transition of Care Process?

3 12

Do You Think the Current Transition of Care Process for Patients with Stroke is Comprehensive?

Yes No

Modified ICAR

1 1.5 2 2.5 3 3.5 4 PRE SIM POST SIM 1 POST SIM 2

Share evidence-based or best practice discipline-specific knowlege with others?

Share best practice with others

* *

*p<0.05

Next Steps

• The tool will be further modified

using a Delphi method.

• The final version will then be piloted

in the transition of care process and triple aim outcomes will be assessed for the stroke population

• Placed into the electronic medical

record and integrated into workflow

References

1. Kentucky Heart Disease & Stroke Prevention. State Action Plan 2011-2016. http://chfs.ky.gov/NR/rdonlyres/90E41C2D-45EF- 47EB-ABFD-60FBE326F59D/0/KYStatePlan_LowResFinalv6.pdf 2. Cameron, J.I., Tsoi, C., Marsella, A. (2008). Optimizing Stroke Systems of Care by Enhancing Transitions Across Care

• Environments. Stroke 2008;39;2637-2643; originally published
• nline Jul 17, 2008; DOI: 10.1161/STROKEAHA.107.501064

3. Naylor, M., Keating, S. A. (2008). Transitional Care: Moving patients from one care setting to another. Am J Nurs. 2008 September ; 108 (9 Suppl): 58–63. doi:10.1097/01.NAJ.0000336420.34946.3 4. Curran, V., Hollett, A., Casimiro, L., McCarthy, P., Banfield, V., Hall, P., & Lackie, K. (2011). Development and validation of the interprofessional collaborator rubric. Journal of Interprofessional Care, 25, 339-344.

Questions?

AIHC Membership

Join us as a charter affiliate of this exciting new professional society – the first member-based

• rganization in the growing field of

interprofessional practice and education.

• Go to Our Website: http://www.aihc-us.org/

Save the Date

Developing and implementing interprofessional faculty development programming at academic medical centers: Identifying strengths, barriers, and opportunities

Presented by David R. Topor, Ph.D, MS-HPEd. Friday, December 9 11:30 A.M.–12:30 P.M. Central Time

Thank you!

Please visit us at www.aihc-us.org for more information on future AIHC Webinars.