Interprofessional Education Initiative - University of Manitoba

bracechumpInternet and Web Development

Feb 5, 2013 (4 years and 5 months ago)

282 views

Interprofessional Education Initiative

Redefining Teamwork with Interprofessional
Education and Practice:

The Academic and Clinical Realities

Ruby Grymonpre, PharmD

Professor, Faculty of Pharmacy

IPE Coordinator, UofM

January 11, 2012

Interprofessional Education Initiative

Session Outline

By the end of this presentation, you will be able to:


Describe the drivers for interprofessional education &
collaborative practice (IPE&P)


Define key terms related to IPE&P


Outline the systems approach being used in Manitoba to
implement IPE&P


Articulate the key goals and actions for WRHA and UofM with
respect to IPE&P


Interprofessional Education Initiative

Health and Wellness of Individuals


55% of Canadians suffer 1 or


more chronic conditions


89% of deaths each year


due to chronic disease


Chronic disease costs over $100 billion in Canada


Prevention and management of chronic disease in
individuals has become health care priority

http://www.ocdpa.on.ca/docs/OCDPA_EconomicCosts.pdf

accessed May 27, 2010

http://www.queensu.ca/sps/publications/press/intros_tocs/EmergingApproaches_Intro.pdf

accessed
May 27, 2010

Interprofessional Education Initiative

Health and Well
-
being



Health is a state of complete physical,
mental and social well
-
being and not
merely the absence of disease or infirmity




(World Health Organization, 1948)

Interprofessional Education Initiative

The problem


Dependent on expensive
new technologies


Hospital is central


Provider
-
centred: patients
come to us


Interprofessional Education Initiative

The problem


emergency room overcrowding


difficult access to the necessary
care


poor record on patient safety


long wait times


inconsistent quality


high costs with poor outcomes


Interprofessional Education Initiative

The problem


Health professions have evolved
in parallel with very different
traditions for education and
clinical service


Professionals have poor
understanding of expertise and
scope of practice of colleagues


Reimbursement systems have
fostered competition over
collaboration between
disciplines


Interprofessional Education Initiative

The problem

estimated worldwide shortage of
almost 4.3 million health
workers


aging workforce

poor working conditions

job dissatisfaction

http://www.who.int/hrh/professionals/en/

Accessed Jan 11, 2012

Health Human Resource
Crisis

Interprofessional Education Initiative

Interprofessional

Education

Collaborative
Person Centred
Practice

IPE&P

Interprofessional Education Initiative

Where

s the evidence for IPE&P?


Increased access to health care

• Improved outcomes for people with chronic
diseases

• Less tension and conflict among caregivers

• Better use of clinical resources

• Easier recruitment of caregivers

• Lower rates of staff turnover

Canadian Health Services Research Foundation.
Teamwork in Healthcare: Promoting Effective Teamwork in Healthcare in
Canada.
Ottawa, ON: CHSRF; 2006.
http://www.chsrf.ca/SearchResults.aspx?search=Teamwork%20in%20health%20care


Accessed January 11, 2012

Lemieux
-
Charles L, et al. What do we know about health care team effectiveness?
Med Care Res Rev
2006;63(3):263

300

Interprofessional Education Initiative

Cochrane Review (2008)

4 of 6 studies found that IPE resulted in:


improved working culture in ED and patient satisfaction;


decreased errors in ED


improved management of the care delivered to domestic
violence victims


improved knowledge and skills of professionals providing
care to mental health patients

2 of these 4 studies found mixed results

2 of 6 studies found that IPE had little to no effect

Reeves S et al. IPE: Effects on professional practice and health care outcomes.

Cochrane Database of Systematic Reviews
2008, Issue 1. Art. No.: CD002213. DOI:
10.1002/14651858.CD002213.pub2
.

Interprofessional Education Initiative

WHO statement


After almost 50 years of enquiry, the World
Health Organization and its partners
acknowledge that there is sufficient evidence to
indicate that effective interprofessional
education enables effective collaborative
practice.




Collaborative practice strengthens health systems
and improves health outcomes.



Framework for Action on Interprofessional Education and Collaborative Practice, 2010

http://whqlibdoc.who.int/hq/2010/WHO_HRH_HPN_10.3_eng.pdf


p 7 accessed January 11, 2012

Interprofessional Education Initiative

WHO Statement


Once students understand how to
work interprofessionally, they are
ready to enter the workplace as a
member of the collaborative practice
team. This is a key step in moving
health systems from fragmentation to
a position of strength.



http://whqlibdoc.who.int/hq/2010/WHO_HRH_HPN_10.3_eng.pdf

p 10


Interprofessional Education Initiative

Sydney Interprofessional Declaration



All users of health and human services shall be entitled to fully integrated,
interprofessional collaborative health and human services.


All health and human services work to create and strengthen a culture that promotes
the delivery of contextual opportunities for interprofessional learning and collaborative
team training. Interprofessional education and training for collaborative practice
should be a core element of continuing professional development.


Health worker education and training prior to practice
shall contain significant core elements/learning domains
of interprofessional education. These core
elements/learning domains shall contain practical
experiences, for example simulation. These core
elements/learning domains for interprofessional
education will be formally assessed.


Between ATBH5 and ATBH6 the global interprofessional community will undertake to
develop a globally agreed upon set of definitions and descriptions that capture
interprofessional education, learning, practice and care.


The global interprofessional community will work with the World Health Organization
to implement the Framework for Action on Interprofessional Education and
Collaborative Practice.

http://www.cihc.ca/files/The%20Sydney%20Interprofessional%20Declaration.pdf


Interprofessional Education Initiative

Health Canada

Building on Values: The Future of Health Care in Canada


…the direction of our health care system must be shaped
around health needs of individual patients, their families
and communities.




-

CPCP
-


If health care providers are expected to work together and
share expertise in a team environment, it makes sense
that their education and training should prepare them for
this type of working arrangement.


-

IPE



November 2002, Commissioner Roy J. Romanow, Q.C.

http://www.hc
-
sc.gc.ca/hcs
-
sss/hhr
-
rhs/strateg/romanow_e.html

Accessed January 12, 201

Interprofessional Education Initiative

Health Canada


HHR Strategy

Health Human Resource Planning

ensuring we have enough of the
right types of health
-
care providers to meet the needs of Canadians;

Recruitment and Retention

encouraging more people to enter the
health
-
care field and improving working conditions to keep them there;
and

Interprofessional Education for Collaborative
Patient
-
Centred Practice [IE(CP)
2
]

changing
the way we educate health providers so
Canadians will have better and faster access to
the health
-
care provider they need when they
need it, ultimately boosting the satisfaction of both
patients and health
-
care providers.


http://www.hc
-
sc.gc.ca/hcs
-
sss/hhr
-
rhs/strateg/index_e.html


Accessed January 12, 2012

Interprofessional Education Initiative

Reality check in Manitoba


there appears to be no active program
of interprofessional learning at that
centre [University of Manitoba]

.



Cook D.

䵯摥汳l潦o䥮瑥牤楳捩灬楮慲I 䱥慲湩湧


Report
to Health Canada. February, 2004 page 25

Interprofessional Education Initiative

2

1

1

1

1

3

7

1

3

Total of 20 Health Canada funded projects across Canada

Interprofessional Education Initiative

IPE Offices/Initiatives in Canada

Ontario:

Canadore College

Centennial College

Confederation College

George Brown College

Humber Institute of Technology &
Advanced Learning McMaster
University

Michener Institute for Applied Health
Sciences

Niagara IP Health Education Institute

Northern Ontario School of Medicine

Queen

s University

Ryerson University

University of Toronto

University of Western Ontario

Nova Scotia:

Dalhousie

Alberta:

University of Alberta

Saskatchewan:

University of Saskatchewan

Quebec:

McGill University

University of Sherbrooke


Manitoba:

University of Manitoba

British Columbia:

University of British Columbia

University of Victoria

Vancouver Community College

Newfoundland:

Memorial University


Interprofessional Education Initiative

Accreditation of Interprofessional
Health Education (AIPHE)


Accreditation Council of Canadian
Physiotherapy

Academic Programs


Canadian Association of
Occupational Therapists


Canadian Council for Accreditation of
Pharmacy

Programs


Canadian Association of Schools of
Nursing


Canadian Association of Schools of
Social Work



Committee on Accreditation of Canadian Medical
Schools


Royal College of
Physicians

and Surgeons of Canada


College of Family Physicians of Canada

Interprofessional Education Initiative

Accreditation of Interprofessional
Health Education (AIPHE)

Phase I


2007
-

2009

Phase II


2010
-
2011



http://www.afmc.ca/aiphe
-
afiss/documents/AIPHE_Principles_and_Implementation_Guide_EN.pdf


Interprofessional Education Initiative

National Health Sciences Students


Association (NaHSSA)



The National Health Sciences Students


Association strives to promote collaborative
patient
-
centred practice and teamwork through
interprofessional education in order to respond
to the evolving health care needs of
Canadians.





MaHSSA


http://www.nahssa.ca

Accessed January 11, 2012

Interprofessional Education Initiative

The systems shake


Interprofessional Education Initiative



Manitoba Health

oversees
provincial health care system
and sets broad policy direction


RHA
s responsible for
assessing/prioritizing needs,
goals and coordinating health
services


11 RHAs in Manitoba


WRHA responsible for health
services for 60% of 1.2 million
MB residents


WRHA encompasess over 200
programs, services, facilities


includes 9 acute & long term
care centres, 16 community
health offices and 39 personal
care homes


36 regional program teams

Manitoba Health Care System

Interprofessional Education Initiative

Advanced Education & Literacy

Council of Post Secondary
Education

oversees allocation
of funds to the province's
seven public post
-
secondary
institutions









University of Manitoba:


27,000 students


13 Academic Units:


Clinical Health Psychology


Dentistry


Dental Hygiene


Human Ecology


Kinesiology & Rec Management


Social Work


Medicine


Nursing


Occupational Therapy


Pharmacy


Physical Therapy


Physician Assistants


Respiratory Therapy



Post
-
Secondary Education in Manitoba

Interprofessional Education Initiative

University of Manitoba

Manitoba Health

COLLABORATIVE PERSON CENTRED CARE

UofM IPE INITIATIVE

Council of Post Secondary Education

Winnipeg Regional Health Authority

Interprofessional Education Initiative

UofM IPE Initiative

Mission


To graduate health professionals prepared to manage
and adapt processes in interprofessional (IP) teams
necessary to achieve
person
-

and family
-

centred
health and wellness outcomes
. This will be achieved
through innovative learning opportunities for students to
learn about, with, and from each other at the University
of Manitoba

Vision


Improved health and well
-
being for Manitobans by
building a culture of interprofessional education and
practice.

Interprofessional Education Initiative

Interprofessional Education Initiative

WRHA Professional Advisory Committee


Senior patient care committee reporting to CEO
and Board with representation from nursing,
allied health, and medical leadership


Focus is on collaborative practice, scope of
practice and evidence informed practice


In 2009, action plan developed to advance
interprofessional education and practice within
the region

Interprofessional Education Initiative

WRHA Collaborative Care









http://www.wrha.mb.ca/professionals/collaborativecare/


Interprofessional Education Initiative

What is Interprofessional Education?


…..occurs when two or more professions learn
about, from and with each other to enable
effective collaboration and improve health
outcomes…



* Professional is an all
-
encompassing term that
includes individuals with the knowledge and/or
skills to contribute to the physical, mental and
social well
-
being of a community.

Framework for Action on Interprofessional Education and Collaborative Practice, 2010
http://whqlibdoc.who.int/hq/2010/WHO_HRH_HPN_10.3_eng.pdf

p 13 accessed Jan 12, 2012

Interprofessional Education Initiative

What does IPE look like?



An educational approach



Requires interaction



Something must be exchanged
that changes how they perceive
themselves and others



Changes must positively affect
clinical practice

http://www.afmc.ca/aiphe
-
afiss/documents/AIPHE_Principles_and_Implementation_
Guide_EN.pdf



Interprofessional Education Initiative

What does IPE not look like?

It is not:

a collective of learners from
different professions sitting in
the same room listening to the
same lecture




-

or
-


learners from one profession
sharing knowledge with one or
more other professions in a one
way exchange



http://www.afmc.ca/aiphe
-
afiss/documents/AIPHE_Principles_and_Implem
entation_Guide_EN.pdf


Interprofessional Education Initiative

Terminology


Uni


professional: occasions when professionals
or students from one profession learn together


Multi


professional : occasions when two or more
professions learn side by side but in parallel
(minimal interaction)


Inter


professional: occasions when two or more
professionals learn about, with, and from each
other to improve collaboration and the quality of
care


Trans


professional: occasions in real practice
where professional boundaries have been crossed
or merged

Carpenter J, Dickinson H Interprofessional Education and Training. Policy Press. Great Britain. 2008. p.3

Interprofessional Education Initiative

What does collaboration look like?


Interprofessional Education Initiative

The 3 C

s

Communication
: the imparting or
interchange of thoughts, opinions, or
information


Cooperation
: parallel activities among
individuals or organizations that associate
informally to accomplish their common
goals


Denise L, Collaboration vs C
-
Three. Innovating 1999(Spring): 7(3)

Interprofessional Education Initiative

Collaboration


...is the process of shared
creation: two or more
individuals with complementary
skills interacting to create a
shared understanding that
none had previously
possessed or could have come
to on their own. Collaboration
creates a shared meaning
about a process, a product, or
an event. In this sense, there is
nothing routine about it.
Something is there that wasn

t
there before.





Michael Schrage,
Shared Minds
, NY: Random House, 1990, p. 140

Interprofessional Education Initiative

Canadian Interprofessional Health Collaborative (CIHC)

www.cihc.ca/resources/publications


Interprofessional Education Initiative

Here Now: Getting it Wrong
-

The Problem
with Words

Interprofessional Education Initiative

Patient

Consumer

Client

Service user

Customer

Recipient

Expert by experience

Participant

Individual

Family

Caregiver

What

s in a name?

Person

Interprofessional Education Initiative

Clinical placement

What
s in a name?

Practicum

Clerkship

Rotation

Interprofessional Education Initiative

UofM IPE Curriculum Blueprint

Guide and monitor implementation of IPE


a

balance


of competencies are addressed
through a student

s university education


learning occurs along a continuum


by graduation, learning around all competencies
has been accomplished

To ensure IPE:


strategic, transparent, uses common terminology


explicitly states/addresses ≥ 1 learning objective


is assessed (students) and evaluated (session)



Interprofessional Education Initiative

The University of Manitoba IPE Curriculum Blueprint

Interprofessional Education Initiative


Understanding Roles and Responsibilities


Exposure:

Knowledge


Articulate your professional role in the care of
individuals


Articulate the roles and scopes of practice of
other members of the IP team and identify areas
of responsibility overlap

Attitudes:


Reflect on personal values/beliefs regarding
scopes of practice and role overlap

Interprofessional Education Initiative

Understanding Roles and Responsibilities

Immersion:

Skills/Behaviours
:


During an IP shared care planning session
negotiate responsibilities/actions based on role
constraints, overlap, and discipline
-
specific
legal/ethical practice standards.

Interprofessional Education Initiative

Understanding Roles and Responsibiliti
es

Mastery:

Has sufficient confidence in and knowledge of:


one

s own discipline to work effectively with
others in order to optimize person centred care


others


professions to work effectively with
others in order to optimize outcomes for
individuals


Interprofessional Education Initiative

Curriculum Overload


Interprofessional Education Initiative

Guiding Principles



We
value
interprofessional

education (IPE) and foster its
existence where and when two or more professions are
involved.


We value IPE that is integrated in University of Manitoba
curricula and foster its development through:


We
value IPE in which its uniqueness is a well
understood identity within the university culture through:


We
value a common understanding of IPE among all
faculty, in which:


We value evaluation of and scholarship in
UofM

IPE
Initiative in which:


Interprofessional Education Initiative