TEAMWORK TRAINING IN INTEGRATED CARE:

Navigating the Nexus in Real-Time© 2016

The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067. The National Center is also funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation, The John A. Hartford Foundation and the University of Minnesota. © 2015 Regents of the University of Minnesota, All Rights Reserved.

This activity has been planned and implemented by the National Center for Interprofessional Practice and Education.

The National Center for Interprofessional Practice and Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE) and the American Nurses Credentialing Center (ANCC), to provide continuing education for the health care team.

Physicians: The National Center for Interprofessional Practice and Education designates this live activity for a maximum of 1.5 AMA PRA Category 1 Credits™.

Physician Assistants: The American Academy of Physician Assistants (AAPA) accepts credit from organizations accredited by the ACCME.

Nurses: Participants will be awarded up to 1.5 contact hours of credit for attendance at this workshop.

Nurse Practitioners: The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts credit from organizations accredited by the ACCME and ANCC.

Pharmacists: This activity is approved for 1.5 contact hours (.15 CEU) UAN: 0593-0000-16-017-L04-P

The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067. The National Center is also funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation, The John A. Hartford Foundation and the University of Minnesota. © 2015 Regents of the University of Minnesota, All Rights Reserved.

Disclosures

The National Center for Interprofessional Practice and Education has a conflict of interest policy that requires disclosure of financial interests or affiliations of organizations with a direct interest in the subject matter of the presentation.

Gerri Lamb, Lesley Manson, Karen Saewert, Liz Harrell, Glen Nelson, Yvonne Price, Jinnette Senecal, Nina Karamehmedovic

do not have a vested interest in or affiliation with any corporate organization offering financial support or grant monies for this interprofessional continuing education activity, or any affiliation with an organization whose philosophy could potentially bias his/her presentation.

The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067. The National Center is also funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation, The John A. Hartford Foundation and the University of Minnesota. © 2015 Regents of the University of Minnesota, All Rights Reserved.

Interprofessional continuing education credit will be awarded to participants that paid the continuing education credit fee while registering for the Summit.

Those participants that paid the interprofessional continuing education credit fee must do the following for each workshop attended to secure credit for the session:1) Sign the session attendance roster.2) Complete the session evaluation.

GerriLamb

Lesley Manson

Karen Saewert

LizHarrell

Glen Nelson

YvonnePrice

Jinnette Senecal

Nina Karamehmedovic

Nexus through

the Looking Glass

Down the Rabbit HoleA Mad Tea-Party #1A Mad Tea-Party #2

Advice from a CaterpillarAlice’s Evidence

OBJECTIVES1. Prioritize clinician goals for teamwork training in integrated

care.2. Incorporate the Interprofessional Education Collaborative

(IPEC®) and integrated care competencies in teamwork training.3. Design one competency-based active teaching strategy for

teamwork training in integrated care.4. Anticipate and solve challenges in designing and implementing

team training for integrated care.

“Who in the world am I?

Ah, that's the great puzzle.”

Down the

Rabbit Hole

“One day Alice came to a fork in the road and saw a

Cheshire cat in a tree. Which road do I take? she asked.

Where do you want to go? was his response. I don’t

know, Alice answered. Then said the cat, it doesn’t matter. If you don’t know where you are going, any road will get

you there.”

FALLING INTO PLACE

“In another moment down went Alice after it, never once considering how in the world

she was to get out again.”

CONTRACTS IN WONDERLAND

“It would be so nice if something made sense for a

change.”

“Everyone has won, and all must

have prizes.”

CAUCUS-RACE AND LONG TALE

Answer the Call to the Adventure Listen and Learn

Design

Team Collaboration...

Pilot

.... More Team Collaboration Adopt

Distribute

Negotiate

RefineDeliver

Adapt

Integrated Care Competencies

Values/Ethics for Interprofessional Practice

Competency

Roles/Responsibilities Competency

Teams and Teamwork Competency

Interprofessional Communication

Competency

Compare Categorize Align Integrate

MANAGING DIFFERENCES

Engaging StakeholdersCreating Connections

FOCUS GROUP: DEALING ACES Expressed deep commitment to members and to assisting members in

meeting their goals. Described value in working with team members and organizations they

see as creative and forward-thinking. Indicated a desire for and expectation of being active participants in

team training. Recognized changes are needed to achieve integration. Believed the changes are essential to providing quality member care.

FOCUS GROUP: DEALING ACES Described efforts to anticipate challenges and address them early and

constructively. Recommended training topics address what makes teams effective. Emphasized the importance of training for professional growth and

practice improvement. Preferred relevant, practical, interactive, experiential training

embedded in ongoing training schedules to maximize efficiencies and productivity.Wanted to bring their strengths in value-driven care and creativity to

the process of integration efforts.

LISTENING AND LEARNING“It’s about the people and relationships and hope.”

Focus Group Participant | Favorite Aspect of Providing Care to Members

“Being talked to like a person, talked with – not at – feeling heard.”Focus Group Participant | Satisfying Aspect for Members Receiving Care

“The core of teamwork is our belief and value systems that get translated through our behaviors.”

Focus Group Participant | Characteristics of Effective Teams

“We’ll see ourselves as a team and not just a team of behavioral health providers, but a team of people working to get this member healthy.”

Focus Group Participant | Training Need

A Mad Tea-Party

#1

“But I don't want to go among mad people, said

Alice. 'Oh, you can't help that,'

said the cat. 'We're all mad

here.’”

CREATE YOUR BUSINESS PLANDefine CustomerDescribe Audience Identify Program Focus Identify Development Team Estimate Time and Resources Evaluate Support Systems Anticipate Challenges

DEFINE CUSTOMER

Who is going to pay for this program?

DESCRIBE AUDIENCE

Who are the learners?

IDENTIFY PROGRAM FOCUS

What are the customer’s goals for this audience?

IDENTIFY DEVELOPMENT TEAM

Who is going to design and teach the program?

ESTIMATE TIME AND RESOURCES

How much time will this take? What resources are needed?

EVALUATE SUPPORT SYSTEMSWhat business structures are in place? What support systems do you have?

What structures and incentives are in place to support contracting, design, and delivery of the

program?

ANTICIPATE CHALLENGES

What challenges do you anticipate?

OUR POOL OF TEARS

LESSONS LEARNED

Rapidly Changing Context

Diverse Audience

Amount of Time

Contract everything explicitly. Designate a “Keeper of the Contract”. Instructional designers or bust!

A Mad Tea-Party#2

“You're entirely bonkers. But I'll tell you a secret.

All the best people are.”

DESIGN YOUR PROGRAMDefine Focus Select IPEC® CompetenciesChoose Content Areas Brainstorm Teaching StrategiesAnticipate Challenges

DEFINE FOCUS

What topics will your program include?

SELECT IPEC® COMPETENCIESWhich IPEC® competencies?

Values/Ethics for Interprofessional Practice

Roles/ Responsibilities

Interprofessional Communication

Teams/ Teamwork

CHOOSE ONE TO DEVELOP

Which competency is one you are pretty sure you would include?

BRAINSTORM TEACHING AND LEARNING STRATEGIES

What three teaching and learning strategies would you propose using?

ANTICIPATE CHALLENGES

What challenges do you anticipate?

OUR POOL OF TEARS

Make it practical.

Make it fun.

People have to be ready and gain confidence quickly.

LESSONS LEARNED

Chasing Moving Targets and Content Changes

Managing Internal Team Dynamics

Juggling Competing Priorities and Workloads

Advice from a

Caterpillar

“I can't go back to yesterday -because I was a different person

then.”

Why do this?

Alice’s Evidence

“One of the secrets of life is that all that is

really worth the doing is what

we do for others.”

LIVING THE NEXUS: TOP 1010. Never take anything personally, even when it becomes personal.9. Negotiate clear priorities up front. Everything negotiated and

decided upon must be written down and date stamp verified.8. Always remember to laugh!7. Keep focused on goals and achieving outcomes.6. Start before you think you need to, develop project timelines,

and stick to target deadlines.5. Pay attention to your own team dynamics – manage and

nurture.

LIVING THE NEXUS: TOP 104. Explicitly contract everything – develop a “walk away” clause

so that all parties understand the lines in the sand.3. Include the customer in the design process. Build in time for

their feedback and refinements. The customer is part of the team and has a valuable and unique perspective.

2. Context is important; healthcare is changing rapidly and customer priorities will likely change too.

1. “It’s too academic” is not an insult. It’s practice-speak for “we need tools and strategies we can use right now” and a call for good boundary spanners.

QUESTIONS?

FOR FURTHER INFORMATION

© 2016 Arizona Board of Regents for and on behalf of Arizona State University, All Rights Reserved

REFERENCE ACKNOWLEDGMENTSCarroll, L. (1869). Alice’s adventures in wonderland. Boston, MA: Lee and

Shepard.

Carroll, L. (1897) .Through the looking glass: And what Alice found there. Philadelphia, PA: Henry Altemus Company.

Interprofessional Education Collaborative (2016). Core competencies for interprofessional practice: 2016 update. Washington, DC: Author. Retrieved from https://ipecollaborative.org/uploads/IPEC-2016-Updated-Core-Competencies-Report__final_release_.PDF

Tenniel, J. (2015) . John Tenniel (Wikimedia Commons). Retrieved from https://commons.wikimedia.org/wiki/John_Tenniel