Workload, Quality, Burnout: Improving the Lives of Patients and - - PowerPoint PPT Presentation

Workload, Quality, Burnout: Improving the Lives of Patients and Providers through Interprofessional Practice

Susan J. Corbridge, PhD, APRN, FAANP

Associate Dean for Practice & Community Partnerships, College of Nursing Clinical Associate Professor, College of Nursing and Division of Pulmonary, Critical Care, Sleep & Allergy Medicine University of Illinois at Chicago sjsmith@uic.edu

OBJECTIVES

• Review the evidence of interprofessional teams
• n workload, burnout & quality of care.
• Provide two examples from our institution of

interprofessional team modeling.

• Recommend strategies for implementing

interprofessional team-based models.

WORKLOAD

• Interprofessional teams decrease workload 1
• Interprofessional practice frees up time for other medical

services (better use of one’s skillset) 1

• Shared knowledge of and investment in the patient 2

– Patients needing unscheduled visits, etc. – Patient with new problem; need for collaboration

1Chomienne M-H et al. 2011. J of Eval in Clini Prac, 17; 282-287. 2 Sinsky et al. 2013. Annals of Fam Med. 11(3) 272 – 278.

BURNOUT

• Increasing job satisfaction decreases burnout
• Relationships are important at all career levels

to increased job satisfaction 1

• Collegial relationships, learning from each other

and development of mutual respect and trust increase satisfaction 1

• Sharing clinical care among a team & having a

high functioning team improves professional satisfaction 2

1Ahmed N et al. 2012. Acad Med.

87(11):1616-1621.

2 Sinsky et al. 2013. Annals of Fam Med. 11(3)

272 – 278.

QUALITY

• Improved patient outcomes

– Earlier diagnosis 1 – Patient quality-of-life scores improved 1 – Increased provider knowledge 1 – Patient satisfaction and willingness to work with

• ther professionals entering in the practice (trust

relationship) 1 – Decreased ICU mortality 2 – Decreased rates of ventilator-associated pneumonia 3

• “Seat at the table” by nurses; more “buy in”

1Chomienne M-H et al. 2010. J of Eval in Clini Prac, 17; 282-287. 2Kim M et al.2010. Arch Intern Med, Feb 22;170(4):369-76. 3Costa D et al. 2016. Am J of Infection Control, 44(10), 1181-1183.

One Model of an Interprofessional, Team-based Sub-specialty Clinic

A Second Model of an Interprofessional, Team-based Primary Care Clinic (Federally Qualified Health Center):

• Nurse Managed Clinic
• Humboldt Park, Chicago’s West Side
• One of Chicago’s most disadvantaged communities
• Department of Corrections partnership
• High need for primary care and mental health services

Behavioral Health Care Manager Psychiatric Consultant

Patient

Medical Assistant DAST-10 PHQ-9 AUDIT-C GAD-7 Primary Care Provider

Collaborative Care Model

RECOMMENDED STRATEGIES

• Individualize an approach to meet specific needs
• Strive for a horizontal model
• Recognize unique expertise of team members
• Leverage diversity for stronger teams
• Advocate top-of-license practice
• Recognize billing and system constraints
• Include administration when appropriate
• Acknowledge that words matter
• Partner with academic institutions
• Address documentation requirements and malpractice

through policy

ADDITIONAL REFERENCES

• Corbridge, S., Tiffen, J., Carlucci, M., & Zar, F. (2013).

Implementation of an Interprofessional Clinical Education Model. Nurse Educator, 38(6), 261-264. http://dx.doi.org/10.1097/01.NNE.0000435271.40151.23

• Archer J, Bower P, Gilbody S, Lovell K, Richards D, Gask L, Dickens

C, Coventry P. (2012). Collaborative Care for People with Depression and Anxiety. Cochrane Review. http://doi: 10.1002/14651858.CD006525.pub2

• Institute for Healthcare Improvement (2018). http://www.ihi.org/
• Waljee, J., Chopra V., & Saint S. (2018). Mentoring Millennials.

Journal of the American Medical Association. Apr 17;319(15):1547- 1548