An Environmental Scan of Interprofessional Collaborative

Practice and Education By: Evan C. Marlatt

Thank You to my Committee Members

• Dr. Melinda Noonan, RN, DNP, NEA-BC (Chair)

• Dr. Tricia Johnson, PhD

• Dr. Steven Rothschild, MD

• Additional Support

• Rush Center for Interprofessionalism (RCI) Steering Committee

2

Background / Introduction

• 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

1972-IOM-Educating for

the Health Team

1999-IOM-To Err Is Human

2008-Berwick-The Triple Aim

2010-WHO-Framework for IPE/IPCP

2001-IOM-Crossing the

Quality Chasm

• Interprofessional Collaborative Practice

• “When multiple health workers from different professional backgrounds work together with patients, families, care(givers), and communities to deliver the highest quality of care.” – WHO, 2010

2013-RCI Convenes

2014-IP Incorporated in Rush

Strategic Themes

3

2003-IOM-Health Professions Education:

A Bridge to Quality

2011-IOM-The Future of Nursing: Leading Change,

Advancing Health

Research Question

• In what ways are healthcare programs aligned with the WHO Framework for Action on Interprofessional Education and Collaborative Practice?

4

IPCP

Conceptual Model

IPE Present &

Future

Health

Workforce

Collaborative

Practice-Ready

Health

Workforce

5 (WHO, 2010)

Optimal

Health

Services

IPCP

Institutional Support

Mechanisms

Working Culture

Mechanisms

Environmental Mechanisms

Conceptual Model

IPE

Educator Mechanisms

Curricular Mechanisms

Present &

Future

Health

Workforce

Collaborative

Practice-Ready

Health

Workforce

6 (WHO, 2010)

Optimal

Health

Services

Methods • Surveys

• IPE – 16 items

• IPCP – 26 items

• Descriptive Statistics

• Multiple Choice

• 4-Point Likert Scale

• Strongly Disagree

• Disagree

• Agree

• Strongly Agree

• Sample

• IPE – ASAHP – 68 respondents

• IPCP – UHC – 40 respondents 7

Methods – Survey Question Format

• IPE:

• IPCP:

8

IP Education – Demographics Athletic Training

2% Clinical Nutrition

9%

Health Administration 9%

Medical Lab Sciences 11%

Medicine 2%

Nursing 7%

OT 14%

PA 4%

PT 23%

Public Health 5%

SLP 14%

9

IPE

Educator Mechanisms

Curricular Mechanisms

0%

20%

40%

60%

80%

100%

LeadershipCommitment

(n=66)

SupportivePolicies (n=66)

Champion -Leading (n=67)

LearningOutcomes (n=66)

Staff IPE Training(n=66)

Funding (n=61)

% Agreeable % Disagree % Strongly Disagree

10

IP Education – Educator

IPE

Educator Mechanisms

Curricular Mechanisms

0%

20%

40%

60%

80%

100%

Adult Learning (n=61) IP CommunicationAssessment (n=59)

Equal Incentives (n=53) Universal Schedule (n=61)

% Agreeable % Disagree % Strongly Disagree

11

IP Education – Curricular

IPE

Educator Mechanisms

Curricular Mechanisms

IP Education – Curricular

0.0%

20.0%

40.0%

60.0%

80.0%

InteractiveWorkshop(s)

Sim LabExercise(s)

RequiredCoursework

ElectiveCoursework

None Other

(n=65)

Offers Requires

12

IPE

Educator Mechanisms

Curricular Mechanisms

IP Practice – Demographics

Yes 92%

No 8%

Member of the Acute Care Leadership Team (n=39)

13

CEO, 3

CMO, 11

CNO, 9

COO, 7

CQO / CSO, 6

Other, 4

Position (n=40)

IPCP

Inst. Support

Working Culture

Environ-mental

0%

20%

40%

60%

80%

100%

Senior LeaderRole Models

(n=34)

IP Teams atDept. Level

(n=33)

Unit LevelPartnerships

(n=32)

LearningOpportunities

(n=39)

IP Valued inCompensation

Philosophy(n=32)

Equality inTeam Leads

(n=31)

% Agreeable % Disagree % Strongly Disagree14

IP Practice – Institutional Support

IPCP

Inst. Support

Working Culture

Environ-mental

IP Practice – Staff Development

0%

20%

40%

60%

80%

100%

Joint Training - Medical/ Nursing Residents

(n=31)

Evaluation -Cooperation (n=31)

Evaluation - Impact &Effectiveness (n=32)

Allocates Time for StaffIP Participation (n=31)

Yes - Hospital-Wide Yes - Specific Specialties Only No15

IPCP

Inst. Support

Working Culture

Environ-mental

IP Practice – Communication Processes

0%

20%

40%

60%

80%

100%

IP Plans of Care (n=39) IP Rounds (n=40) IP Daily Huddles (n=39) EMR IP Documentation(n=39)

Yes - hospital-wide Yes - specific specialties only No16

IPCP

Inst. Support

Working Culture

Environ-mental

0%

20%

40%

60%

80%

100%

Culture EnablingQuick Change

(n=40)

Staff Trained forConflict Resolution

(n=40)

Climate of Trust(n=40)

Equality inDecision Making

on IP Teams(n=39)

StaffEmpowerment to

Halt UnsafeProcess (n=38)

% Agreeable % Disagree % Strongly Disagree17

IP Practice – Working Culture

IPCP

Inst. Support

Working Culture

Environ-mental

0%

20%

40%

60%

80%

100%

Care Team Input (n=37) Patient Input (n=36) Designated Space for IPCollaboration (n=37)

Daily Patient, Nurse,and Physician

Collaboration (n=37)

% Agreeable % Disagree % Strongly Disagree18

IP Practice – Environment

IPCP

Inst. Support

Working Culture

Environ-mental

Challenges

Sample

Identifying Organization

Representative (ASAHP)

Limited Live Survey Time

(UHC)

Number of Respondents

Not Representative

of Front Line Staff

19

Challenges

Implications

20

Ensure IP Efforts are Operationalized

Expansion of Current IP

Management Front Line and Mid-Level IP Perspectives

Bridging IPE and IPCP

Future Studies

Questions?

21

References

• Berwick, DM; Nolan, TW; Whittington, J. (2008). The triple aim: care, health, and cost. Health Affairs. Retrieved October 7, 2014 from http://www.ncbi.nlm.nih.gov/pubmed/18474969

• Institute of Medicine. (1972). Educating for the health team. Washington, D.C.: National Academy of Sciences.

• Institute of Medicine. (2000). To err is human: Building a safer health system. Washington D.C.: National Academy Press.

• Institute of Medicine. (2001). Crossing the quality chasm. Washington D.C.: National Academy Press.

• Institute of Medicine (2003). Health Professions Education: A Bridge to Quality. Washington, DC: National Academy Press.

• Institute of Medicine (2011). The Future of Nursing: Leading Change, Advancing Health. Washington, DC: National Academies Press.

• Speakman E, Arenson C (2015). Going Back to the Future: What is All Buzz About Interprofessional Education and Collaborative Practice? Nurse Educator.

• World Health Organization (WHO). (2010). Framework for action on interprofessional education & collaborative practice. Geneva: World Health Organization. Retrieved September 1, 2014 from http://whqlibdoc.who.int/hq/2010/WHO_HRH_HPN_10.3_eng.pdf

• Back to the future

22