Seamless Care: Interprofessional Education for Innovative Team-Based Care

Continuing Medical Education

Advisory Committee

March 8, 2006

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Overall Project Goal

• To prepare pre-licensure health professional learners from Dalhousie University to become competent collaborative practitioners by creating an innovative model of care for patients with key health conditions who are transitioning from acute care to the community

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Health Canada Model

Health Canada’s IECPCP Model

IECPCP=Interprofessional Education for Collaborative Patient-Centred Practice

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Participating Faculties

• Medicine

• Health Professions -Nursing

-Pharmacy

• Dentistry -Dentistry

-Dental/Hygiene

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Participating Clinical Sites

• Centre for Health Care of the Elderly

• Endocrinology Clinic and Diabetes Management Centre

• Heart Function Clinic

• Capital Health Integrated Palliative Care Service

• Acute Stroke Program

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Patient/Consumer Representation

• Gerontology Association of Nova Scotia

• Heart and Stroke Foundation of Nova Scotia

• The Canadian Diabetes Association—NS Region

• Family member survivor of Palliative Care

• CDHA ‘Patient Representative’ staff member (pending)

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IP

Patient and Family

Clinical Site

Home

CommunityPractitioners

The Seamless Care Environment

DP

DP

DP

DP

Dentistry

Medicine

Pharmacy

Nursing

DP

Dental Hygiene

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Project Objectives

1. Develop an innovative approach to interprofessional education

2. Demonstrate the benefits of the project

3. Demonstrate positive patient outcomes

4. Prepare both educators and health care delivery settings to support a sustainable IPL program for collaborative transition care

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Seamless Care Focus

• The Learner: Develop core competencies in interprofessional learning and patient-centred collaborative practice

• The Educator: Prepare and support faculty/preceptors to support and guide students

• The Patient: Facilitate the patients’ central role in managing their illness

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Project Participants (in each of 2 years)

Learners: 8 teams of 5 senior students (one each from medicine, nursing, pharmacy, dentistry and/or dental hygiene

Faculty/Preceptors: Integrative Preceptor at each clinical site to guide student team; Discipline Preceptor from each program to provide program support to their student

Patients (and/or family/caregiver): 8 patients, i.e. 1 per student team

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Evaluation Plan (*Kirkpatrick Model)

Element*Student/Learner

Faculty/Preceptor Patient

Reaction Reflective ExFocus Grp

Reflective ExFocus Grp

Semi-structure Int

Modification of Attitudes

RIPLS RIPLS --

Knowledge & Skill Modif

Self-efficacy (IPL)

Self-eff (IPL)

Knowledge

Self-efficacy

(self-mgmt)

Behavioural

Change

SYMLOG (team scan)

SYMLOG (team scan)

Semi-structure Int

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Approach Adopted to Implement

Oct 2005 Initial Steering Committee & Management Committee meetings

Dec 2005-Apr 2006

Delivery of faculty development & student orientation

Jan-Apr 2006 8 student teams work with patients from clinical sites

Jan-Aug 2006 Evaluation of first ‘round’ of student teams

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Approach Adopted to Implement

Nov 2006-Apr 2007

Delivery of faculty development & initial student orientation

Jan-Apr 2007 8 student teams work with patients from clinical sites

Jan-Aug 2007 Evaluation of second ‘round’ of student teams

May 2006-March 2008

Research & dissemination of resultsDevelopment of sustainability model

March 2008 Project ends

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Expected Outcomes

1. Knowledge Transfer, Networking and Dissemination

2. Improved self-efficacy of students, faculty in interprofessional learning

3. Improved self-efficacy of patients with regard to self-management

4. Improved understanding of patient needs during transition period

5. Understanding of appropriate faculty and student development approaches

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Progress to date

• Ethics approval

• Orientation to project

• Preparation of sites

• Recruitment of students/patients/preceptors

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Ongoing opportunities and challenges

• Communication– Language– Information – to sites, programs, faculty and students

• Recruitment– Patients

• Roles– Integrative preceptors– Discipline preceptors

• Sustainability