Interprofessional cooperation and generic competences for HPs in Rheumatology- the EULAR perspective

Transcription

1 Interprofessional cooperation and generic competences for HPs in Rheumatology- the EULAR perspective Thea Vliet Vlieland Leiden University Medical Center Rijnlands Rehabilitation Centre, Leiden Sophia Rehabilitation, The Hague

2 Outline 1. EULAR HPR 2. European perspective on HPs qualifications 3. EULAR project Core Competencies of HPR

3 EULAR EULAR is the organisation which represents the people with rheumatic and musculoskeletal diseases, health professional and scientific societies of rheumatology of all the European nations..to reduce the burden of rheumatic diseases on the individual and society and to improve the treatment, prevention and rehabilitation of musculoskeletal diseases.

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5 Essential role of HPR Enabling people with RMDs to reach and maintain their optimal physical, sensory, intellectual, psychological and social functional levels. Providing them with the tools they need to attain independence and self-determination. Definition of rehabilitation WHO:

6 Access to a team of HPs with various professional backgrounds is an internationally accepted standard of care in the management of RMDs Eumuscnet Patient versions Do I have the opportunity to receive support if needed from health professionals such as rheumatologist, dietician, general practitioner, nurse, occupational therapist, physiotherapist, psychologist and social worker?

7 HPR Multidisciplinary Team First EULAR HP Newsletter, 2007

8 EULAR definition of HPR A professional involved in the care for people with RMDs Not a registered medical practitioner Eligible to become a member of the organization through which a country has become a EULAR HPR member

9 Current HPR Structure within EULAR

10 HPR Standing Committee Agnes Kocher

11 Vice president and Chair Vice president 1997 Jana Korandova 2002 Jill Lloyd 2005 Peter Oesch 2009 Kare Birger Hagen 2013 Christina Opava 2017 Tanja Stamm Chair Annette du Thurah

12 HPR Standing Committee -Subcommittees 1995 Scientific Subcommittee 2014 Educational Subcommittee 2014 Communication München, December 2016

13 Scientific Achievements From 2003: HPR Research Grant (yearly) From 2012: EULAR recommendations/points to consider: The role of the nurse in inflammatory arthritis Patient Education Non-pharmacological core management of hip and knee osteoarthritis HPR undertaking musculoskeletal ultrasound for RMDs Promotion of physical activity Core competencies of HPR in Rheumatology

14 Educational Achievements Individual From 2004 Group Educational Visit Grants 1995 First course organising grant Rheumatology Action for Eastern Europe. HPR teaching and practise courses 2008, 2009, 2012 HPR Teach the Teacher courses Leiden, Brno

15 Educational Achievements 2015-present EULAR HPR Online Courses Els van den Ende 2016 HPR Mentoring Programme Jo Adams 2017 HPR Classroom EULAR School of Rheumatology Thea Vliet Vlieland, Els van den Ende, Keegan Knittle, Sarah Ryan, Eda Tonga

16 HPR Classroom Innovative educational offerings Tailored to HPR needs (varying per country; English language barrier) Based on agreed upon core competencies

17 Communication Kate Betteridge

18 Outline 1. EULAR HPR 2. European perspective on HPs qualifications 3. EULAR project Core Competencies of HPR

19 2005: EU Directive on professional qualifications In practice, the recognition of professional qualifications laid down in Directive 2005/36/EC enables the free movement of professionals within the EU

20 Recognition Automatic recognition for professions with harmonised minimum training conditions (relevant for RMDs: nurses, doctors) General system for the recognition of qualifications Individual application submitted to and reviewed by the host country

21 The RMD multidisciplinary team and the EU Regulated Professions Database Profession Doctor of Medicine 1415 Nurse 105 Second level nurse 26 Physiotherapist 38 Social Worker 62 Psychologist 43 Occupational therapist 26 Dietician 28 Chiropodist/ Podiatrist 23 No. regulated professions Example Physiotherapist Netherlands: Fysiotherapeut Oefentherapeut Mensendieck Oefentherapeut Cesar

22 Challenges in HP mobility

23 The most mobile professions Profession Number Doctor of Medicine Nurse Second level nurse Physiotherapist Social Worker Psychologist Occupational therapist Dietician Chiropodist/ Podiatrist 699

24 Basic and Postgraduate training HPR Variability within and among countries regarding basic training of most non-medical professions, except nurses. Basic curricula from HPs from some countries are insufficient and additional education is required. Variability roles and responsibilities in the diverse healthcare delivery systems. T. Vliet Vlieland. Health Professionals in RMDs: Competences, professional standards and mobility; EULAR conference EU Parliament 2015

25 Basic and Postgraduate training HPR Highly skilled and experienced HPs are needed in a specialty such as RMDs. The availability of adequate postgraduate education contributes, together with work-based supervision and training, to their competencies. T. Vliet Vlieland. Health Professionals in RMDs: Competences, professional standards and mobility; EULAR conference EU Parliament 2015 T. Vliet Vlieland et al. RMD Open 2016;2:e doi: /rmdopen

26 Basic and Postgraduate training HPR Need for more similarity in the (postgraduate) training of HPs regarding the management of RMDs: Uniform qualifications specifically for the management of RMDs for most HPs. International standards for education on RMDs for HPs. T. Vliet Vlieland. Health Professionals in RMDs: Competences, professional standards and mobility; EULAR conference EU Parliament 2015

27 HPR s Educational Needs RMD Open 2016;2:e doi: /rmdopen

28 Postgraduate education 17 countries 28 Insert > Header & footer 11-sep-17

29 1041 Responses Individual HPR Europe Spain 261 France 163 Italy 142 Germany 82 Switzerland 75 Netherlands 66 Other

30 Characteristics 1041 European HPR

31 Preferred mode of delivery (0-10) Face-to-face 4.6 (3.2) Face-to-face plus Teachthe-teacher Mean (SD) 4.3 (3.2) Practical Workshop 4.7 (3.4) Online course 5.7 (3.2)

32 Main Anticipated Barriers EULAR offerings (0-10) Mean (SD) Lack of resources (costs) 7.2 (2.8) English language 5.8 (3.4) Lack of time 5.8 (2.9) Lack of information 5.5 (2.9)

33 Conclusions There is a lack of postgraduate rheumatology education for HPs in most countries. The educational needs of HPs vary considerably across countries. Main barriers for participation in education are lack of resources and time and limited mastery of English. Considerable interest in online courses and face-to-face courses, preferably in own country.

34 Outline 1. EULAR HPR 2. European perspective on HPs qualifications 3. EULAR project Core Competencies of HPR

35 Development of EULAR Recommendations/Points to Consider for the generic core competencies of Health Professionals in Rheumatology Thea Vliet Vlieland, on behalf EULAR SC HPR Annamaria Iagnocco, EULAR SC Education and Training Lisa Edelaar, research fellow Methodologist

36 Objectives To develop EULAR-endorsed Points to Consider/Recommendations for Generic Core Competencies of Health Professionals in Rheumatology. Base for systematic development of HPR postgraduate educational offerings Transparency of level and quality of HPR postgraduate education Mobility of HPR across Europe Quality of care delivered by HPR

37 Target groups Focus on: Nurses Physical therapists Occupational therapists Stakeholders: HPR, patients, rheumatologists and their (inter)national organizations; (Inter) national organizations providing undergraduate and postgraduate education for HP; Other, e.g. health insurers, policy makers in the field of rheumatology and HP education.

38 Methodology Updated EULAR Standardised Operating Procedures (SOPs) Constitution of a Task Force Preliminary search of the literature and other information sources First Task Force Meeting October, Zürich Definition of Research Questions Definite search of the literature and other information sources; Categorization of evidence where applicable Second Task Force Meeting, including definition of Strength of Recommendations External evaluation among stakeholders Preparation of a manuscript Van der Heijde D, Aletaha D, Carmona L, et al Update of the EULAR standardised operating procedures for EULAR-endorsed recommendations. Ann Rheum Dis 2015; 74:8-13.

39 Task Force Project team: convenors, methodologist, fellow (junior HP-researcher) Health professionals (representing: Nurses, physical therapists, and occupational therapists) Patients Rheumatologists / Clinical experts (including 2 EMEUNET members/rheumatologists) Educationalist EUMS representative

40 Preliminary Literature Search Focus of Search Strategy General Competency Frameworks relevant for Health Professionals Information Domains Sets of general competencies for HPs preferably on the European level (not HPR-specific; e.g. ESNO competences for clinical nurse specialists) Sets of competencies for HPs in Rheumatology Domains and general HP competencies Rheumatologyspecific competencies

41 General Competency Frameworks Health Care Medical expert Professional Communicator Collaborator Manager Health Advocate Scholar

42 Sets of general competencies for HPs: Example CNS The Nurse Specialist (NS) is an advanced practice Nurse prepared as a specialist within a clinical specialty at the master s, post master s or doctoral level CANMEDS Medical expert Professional Communicator Collaborator Manager Health Advocate Scholar Generic competencies CNS ESNO Clinical role Patient relationship Patient teaching / coaching Mentoring Research Organization and management Communication and teamwork Ethic and decision making Leadership /policy making Prevention

43 Sets of Rheumatology Specific HP Competencies DOI: /annrheumdis-2015-eular.4627

44 Ann Rheum Dis 2012;71: doi: /annrheumdis

45 6 out of 10 address specific roles or competencies Ann Rheum Dis 2012;71: doi: /annrheumdis

46 Musculoskeletal Care. 2017;1 12

47 Methods Focus Groups Delphi Rounds

48 Categories and key topics 11-sep-17

49 Set of HPR competencies - UK

50 Conclusions Variation education and roles and responsibilities of HPR within and among countries Need for the definition of postgraduate core competencies of HPR on the European level Base for systematic development of HPR postgraduate educational offerings Language, Costs and time are important barriers EULAR Standing Committee of HPR and HPR Classroom School or Rheumatology

51 Thank you for your attention!