Welcome

Team Health Clinical EducationConsultation Forum

24 August 2011

2

Forum Aims

1. To consult with key stakeholders on Team Health’s four programs

2. To consult on ways to better prepare pre and new clinical graduates for work in the NSW public health system

3. To consult on ways to improve the development of interprofessional collaborative practice (ICP) or team-based care

4. To identify any gaps and to highlight opportunities for existing programs that aim to foster teamwork, collaboration and communication

Danielle Byers & Rob Wilkins

Team HealthProgram Coordinators

Clinical Education and Training Institute

4

What are we trying to do?

To improve teamwork, communication and collaboration for safer patient-centred care, and better staff experiences

Why are we trying to do this?

Increased staff motivation, well-being and retentionDecrease in staff turnoverIncreased patient and carer satisfactionIncreased patient safety Increase in appropriate use of specialist clinical resourcesReductions in patient mortality and critical incidentsIncrease in access to and coordination of health services

5

What do we mean by Team Work?

Interprofessional Education (IPE)

Occasions when two or more professions learn from, with and about each other to improve collaboration and the quality of care

Interprofessional Practice (IPP)

Occurs when two or more professions work together as a team with a common purpose, commitment and mutual respect (Freeth et al, 2005).

6

The global context

Global Evidence World Health Organisation Framework for Action on InterprofessionalEducation and Collaborative Practice

International IPL Journals

Research 2 x Cochrane Collaboration Literature Reviewson IPL and professional practice & health care outcomes

Grey Literature Significant national investments: Canada, UKU.S. and South Africa

7

Interprofessional core competencies

http://www.cihc.ca/

8

What is the literature saying?

9

Put simply, the education of health professionals in the 21st Century must focus less on memorising and transmitting facts and more on promotion of the reasoning and communication skills that will enable the professional to be an effective partner, facilitator, adviser and advocate.

The Lancet - December 2010

Julio Frenk et al. Health Professionals for a new centuryTransforming education to strengthen health systems in anInterdependent world. The Lancet v 376 Dec 2010

10

The local context

….I recommend that an Institute of Clinical Education and training be established with a broad mandate to take charge of the training of a new generation of clinicians in interdisciplinary

team-based treatment of patients….

Garling ReportSpecial Commission of Inquiry into Acute Care Services in NSW Public Hospitals

11

Bureau of Health Information. (May 2010) Insights into Care: Patients Perspectives on NSW Public Hospitals

This first report from the Bureau of Health Information shows clearly that patients are calling out for improvements and that improvement in staff teamwork, between doctors and nurses, is the action most likely to change a fair or poor patient care experience to an excellent one.

The patient perspective…

Patients who felt their quality of care was excellent were likely to have experienced excellence in staff teamwork.

12

What works?

Multi-faceted strategies

e-Learning modules across professional groups

On-site coaching, debriefing and facilitation

Curriculum that structures formal and informal interactions and is designed to facilitate enquiry

Clinical placements and particularly rural clinical placements

Champions in both health and education sectors

Interdisciplinary program governance

Links with other programs (Established international movement)

13

What we learned from our last Consultation in June 2011

• Directors of Workforce Development & Clinical Governance

• Managers of Learning and Development and Clinical Redesign

• Clinical Excellence Commission, Bureau of Health Information, Agency for Clinical Innovation and NSW Health Department Representatives

14

What we learned from our last Consultation in June 2011

• Continue to engage with LHDs from program inception

• Coordinate and promote efforts with the CEC, ACI and BHI

• Need to address organisational barriers that hamper team-based approaches

• Localised sub-committees for the governance of education and training be established in LHDs and report to LHD Boards

15

What we learned from our last Consultation in June 2011

• Need to map and build on what’s already out there (Universities, LHDs, proprietary programs)

• Ensure curriculum is clinically-relevant and clinically-based (ie work determines the curriculum or case studies used)

• Consult with senior clinicians and educators involved with teaching, learning and supervision

Team Health: Conceptual Model

•Embed IPL/IPP into emerging policy statements and implementation plans e.g. Delirium and Dementia Services Framework, End of Life Decision-making, Falls Prevention

•Link and align Team Health initiatives with other CETI portfolios e.g. Hospital Skills Program, Allied Health Education

•Link and align with Department of Health, CEC, ACI, BHI initiatives

•Embed IPE/IPL /IPP into undergraduate university programs, including IPL clinical placements

•Dedicated program targeting new graduates

•Supported by e-learning, simulation case scenarios

•Align curriculum with Garling recommendations and policy directives

•Focus: Policy into practice

•A systems approach to redesign ward/unit team communication and culture

•Core modules to include rationale, evidence, redesign methodology, facilitation tools, benefits

•Establish a state-wide network of IPL facilitators

Clinical Team Education Modules

Right Start Program

Policy Development

System Integration

Team Health: Deliverables

• Policy metadata incorporates staff competency and training and education implications for implementation

• Governance structure for Team Health implementation

• Participant and Facilitator Networks

• Pre-graduation e-learning modular package for universities

• E-learning modular package

• Simulation case scenarios

• Discipline-specific ‘How to guide’

• Facilitator’s package

• Team toolkit

Clinical Team Education Modules

Right Start Program

Policy Development

System Integration

Team Health: Partnerships Strategy

• LHD/CETI/DoH• Embed Team Health

principles into NSW Health policy

• Ensure training and education implications are considered

• LHD/CETI/Education Providers• Governance structure for

Team Health implementation

• Participant and Facilitator Networks

• Pre-graduation e-learning modular package for universities

• LHD/CETI• E-learning modular

package• Simulation case scenarios• Discipline-specific ‘How to

guide’

• LHD/CETI/CEC/ACI/ DoH• Team Health Toolkit:• Between the Flags• Clinical Redesign• Essentials of Care• Clinical Handover Clinical Team

Education Modules

Right Start Program

Policy Development

System Integration

Baseline data Monitoring Program Outcomes

Program Recommendations

CETI & BHI

19

Rob Wilkins9844 6564

Danielle Byers9844 6527

any questions?

Learning & Teaching Program Coordinators