Faculty Medicine, Dentistry & Health Science

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1 Faculty Medicine, Dentistry & Health Science Orientation Information IPE Placement Outpatients SCGH 2013

2 Introduction Interprofessional Education is a critical component of education in terms of students learning with, from and about each other. Interprofessional learning (IPL) embraces a life-long, active learning process between different cultures and healthcare disciplines (1) IPL philosophy supports health professionals working collaboratively in a health care setting, though a purposeful interaction with service users and carer, to produce quality patient centered care. All students should have reviewed the UWA FMDHS IPL handbook and pre-readings on the relevant unit Learning Management System (LMS- The handbook describes the learning outcomes for the placement and the expected capabilities that are required as an outcome of the placement. In addition to the specific IPE capabilities this placement will also provide learning opportunities for the development of skills and practice important for your future medical, nursing and pharmacy careers. Ambulatory Care The majority of patient care in hospitals is delivered in the outpatient setting as this is an advantage for patients in terms of social dislocation and hospital acquired infections associated with inpatient care. Most community based care is provided by GPs and community services such as Silver Chain. Being able to adapt clinical assessments to chronically ill patients, often with multiple problems, rather than acutely ill ward patients is vital. Many allied health professionals are involved in the care of patients accessing services in outpatients to ensure best patient care is delivered and to bridge the gap between community and hospital. This placement will provide opportunities to experience an ambulatory care setting and model of care, engage as a member of an interprofessional team and also gain discipline specific knowledge and skills. Placement Program: The orientation for the IPE placement will be held in the Respiratory Outpatients clinic, Ground floor B block Hovea street at on the first day of your placement (see appendix 1 below). The timetable for the placement is provided in appendix 2 and further explanation will be given at the outpatient orientation. Learning Outcomes of the IPE Outpatient Placement Specific learning outcomes for students engaged in interprofessional clinical attachments that assist the development of the UWA interprofessional capabilities are to: 1. Discuss the importance of team work to delivery of effective patient care 2. Compare the different professional roles of team members 3. Compare and contrast the different skills of team members 4. Discuss the importance of handover and techniques for effective handover 5. Discuss the importance of placing the patient s views at the centre of care planning and team working 6. Engage in a review of the management of an individual patient with members of their own/other profession(s)

3 By the end of the placement the student will: Improve general clinical skills (knowledge, practical & presentation skills) Gain confidence in performing full patient assessment within a short time frame Gain an understanding of the role of outpatients and the patient pathway through the system, including understanding the roles of General Practitioners, community and hospital based nursing and allied health professionals and medical specialists. Develop awareness of both patient and referrer wishes/expectations Improve communication skills with patients, colleagues and community (verbal & written) Understand the importance of and participate in patient education These outcomes can be achieved through: Active involvement at each clinic (direct patient contact/assessment, organising and following up investigations, taking responsibility for letters to GPs, referrals, allied health) Time spent with multiple allied health professionals (in OP and community settings) Regular opportunities for feedback, debriefing, presentation and case discussion Reflective and self-directed learning Appraisal and assessment throughout the attachment (CPAT, ICAT, PSL or DoCs) Specific Clinic Information and Learning Outcomes Pleural Clinic: The focus of this clinic is the investigation and management of pleural disease. Gain knowledge of different pleural pathologies and their investigation Increase confidence with CXR recognition and interpretation Understand how to approach management and care of pleural effusion Practical experience of thoracocentesis and indwelling pleural catheters

4 Cystic Fibrosis Clinic: This clinic is the centre for management of Cystic Fibrosis in WA. Most patients are referred from PMH for ongoing treatment. This is a multi disciplinary team and consists of medical staff, nurses, physiotherapist, dietician, occupational therapist, pharmacist and social work. Understand the pathophysiology behind the genetic abnormality in CF Understand and assess for complications of CF Become familiar with CF medications Understand the importance of multidisciplinary care Understand importance of patient education and patient led care Interstitial Lung Disease Clinic: This clinic focuses on the investigation and management of a range conditions which cause inflammation and scarring to the lung lining. Be able to assess and investigate patients presenting with breathlessness Be able to interpret pulmonary function tests and 6 Minute Walk test Know the common causes of ILD Gain experience of appropriate management strategies, in particular oxygen therapy Gain insight into living with chronic/disabling disease Monitoring of oxygen therapy Lung Cancer Clinic: The focus of this clinic is the investigation, diagnosis and management of lung cancer. Develop an organised approach to investigating patients with an abnormal CXR Gain experience in reviewing abnormal CXR Gain confidence in effective communication & experience breaking bad news Understand the patient pathway (from referral to diagnosis) Asthma Clinic/Asthma Educator: The focus of this clinic is the education and management of patients with Asthma Identify and understand different inhaled therapy Be able to perform spirometry, peak expiratory flow measurements and interpret the results Assess adequacy of patient s inhaler technique and educate patients on best practice Gain in depth knowledge of managing acute and chronic airway disease

5 Gain experience in Respiratory Assessment Diabetic Clinic/Diabetic Nurse Educator: This clinic is a multi-disciplinary clinic providing a broadly based diagnosis and management service. The unit has access to excellent facilities in the area of diabetes education, dietetics and podiatry, and is active in diabetes research and in teaching, including nurse educators. Be able to take a problem orientated, comprehensive history and perform physical examination on a diabetic patient Perform and interpret BGL Have a framework for assessing diabetic patients covering current control, complications and co-existing risk factors Understand why and when different hypoglycaemic agents are used Assess patients technique of self administering insulin, provide education on best practice Initiate patient education (BM monitoring, nutrition, insulin therapy) Pain Management Department This clinic is a multi-disciplinary clinic comprising staff from medical, nursing, physiotherapy, clinical psychology and occupational therapy clinical streams and supported by an administrative staff of six (including HSA) officers. The clinic provides outpatient and inpatient services accepting 1200 referrals a year to the service from General Practitioners, Specialists and Inpatient sources. The Department is accredited by the Faculty of Pain Medicine of the Australian & New Zealand College of Anaesthetists for advanced training in pain medicine. The Department offers medical training for anaesthetic trainees studying for Fellowship of the Australian & New Zealand College of Anaesthetists and provides support for them during module 10 of their training. UWA, Curtin and Murdoch Universities regularly place advanced trainees in Clinical Psychology in the Department. The Pain Management Department regularly welcomes and hosts visiting staff from within the SCGH campus, state-wide, national and overseas visitors to gain knowledge and experience in ways to manage chronic pain The Pain Management Department has 6 procedure sessions per week primarily run as a day procedure clinic where patients are admitted and discharged on the same day but with enough flexibility to cope with additional inpatients as required. Intrathecal Pump refill patients are also admitted as day patients for refilling of their pump and medical review by their treating Consultants on their respective procedure session Review of inpatient consultation requests are attended on a daily basis whenever possible by one of the clinical fellows on a rotational basis. Written ward consults average per week but telephone consultations re inpatients would average per week. If patients need a procedure they can generally be added into a routine procedure list within the week.

6 Tips for seeing patients in the outpatients department When reviewing a patient in the OPD setting it is useful to consider these points: When is referral to outpatients (or a private specialist) necessary? Why has this patient been referred/what is the purpose of today s outpatient visit? Patients are referred for many reasons e.g.: Referral for a specialist review - to make a diagnosis or plan management Referral for nursing or allied health review (i.e. physiotherapist, speech therapist) Follow up by a specialist of clinical progress, results and planning further treatment Managing patients with complex chronic problems which requires specialist input (i.e. Cystic Fibrosis, transplantation) Management of complex problems that require an Interprofessional team Does this patient need to continue to be seen in outpatients and who should provide follow-up care?

7 IPE Assessment Requirements Assessment for the Interprofessional placement is the Interprofessional Capability Assessment Tool. The ICAT assessment is to be completed by the end of the clinical placement by you and your IPE facilitator. Students are required to complete reflective entries that show evidence of having met the interprofessional capabilities and IPE facilitators will complete a rating of capability according to the rubric in the assessment. Placement Evaluation As part of an ongoing educational evaluation strategy we encourage all students to participate in evaluation activities. All students have been forwarded a link to a survey (via Survey Monkey). Please complete the pre-test Interprofessional Socialisation and Valuing Survey prior to starting this attachment. In order to measure a change in knowledge, attitudes and behavior with regard to interprofessional capabilities you will also be asked to complete post-test Interprofessional Socialisation and Valuing Survey on completion of your placement. Key Contacts for Placement : If you require any further information during the placement please contact the discipline specific coordinator as per below or contact the unit coordinator as per LMS information. Rachel Latham/Helen Dugmore (Nurse Educator) Elisabeth Feher (Medical Education Registrar) Natalia Forrest (Pharmacist) or pg 4242 through SCGH switch, Respiratory Clinic, Ground floor, B Block Consultant lead: Fiona Lake Contact through SCGH switch Respiratory Nurse Practitioner: Sue Morey Respiratory Homelink: Barbara Stubber Diabetes Clinic, Level 1, Main OPD, E block Consultant lead: Joey Kaye Contact through SCGH switch Diabetes Nurse Educator: Gwen Babel Pain Management Clinic, Lower Ground Floor, G Block, Next To Podiatry (Via The Green Lifts) Head of Department: Dr Mark Shultze Contact through SCGH switch Clinical Nurse Manager: Denise Fairclough Contact through SCGH switch

8 Appendix 1: SCGH Map

9 Appendix 2: Placement Program Program 1 Respiratory and Diabetes AMBULATORY CARE STUDENT PLACEMENT PROGRAM 1 Student 1 MONDAY Week 1 (Resp) Week 2 (Diabetes) Orientation; Introduction to the IPE team, overview of IPE, Team building activity, site tour and introduction to key staff Pleural clinic (Prof Lee) Diabetic clinic Dietician(Level 1 OP) CF clinic Diabetic Nurse Educators Specialty tutorial (MS only) Specialty tutorial (MS only) TUESDAY Meet with IPE facilitators, discuss objectives for clinical attachment, concerns, other info Home Visiting with Barb Stubber WEDNESDAY ILD clinic (Prof Lake) PGME meeting (Joske Level 8) Lung Cancer clinic (M. Phillips) Intern teaching (Joske room) Intern teaching (Joske room) Asthma clinic (Prof Thompson) Free: Reflective learning Student Tutorial Student Tutorial General Respiratory clinic Interventional bronchoscopy Theatres. If no cases join in the General respiratory clinic THURSDAY Bronchoscopy (Ward G75) Asthma Educator (S. Coleman) CF clinic Diabetic nurse educators seek advice from each other where required for management or referral FRIDAY seek advice from each other where required for management or referral Lung Cancer Multi-disciplinary team Lung Cancer Multi-disciplinary team meeting meeting Lung Ca F/U clinic (M. Phillips) Lung Ca F/U clinic (M. Phillips) Respiratory radiology meeting Respiratory radiology meeting Student Tutorial/Debrief Student Tutorial/Debrief

10 Program 2 Diabetes and Chronic Pain Service AMBULATORY CARE STUDENT PLACEMENT PROGRAM 2 Student 2 MONDAY Week 1 (Diabetes) MONDAY Week 2(CPS) Orientation; Introduction to the IPE team, overview of IPE, Team building activity, site tour and introduction to key staff Diabetic clinic Dietician (Level 1 OP) Orientation to CPS with Denise Fairclough (CNM) Diabetic Nurse Educators Introduction to Pain Management (IPM) program - coordinated by Lisa Olsen (OT) Specialty tutorial (MS only) Specialty tutorial (MS only) TUESDAY Meet with IPE facilitators, discuss objectives for clinical attachment, concerns, other info ILD clinic (Prof Lake) TUESDAY Education Meeting PGME meeting (Joske Level 8) Physiotherapy with Bri Tampin or Jan Mountford (NS Triage) Lung Cancer clinic (M. Phillips) Multidisciplinary Case Conference WEDNESDAY Physiotherapy and Neurosurgeon clinic WEDNESDAY Intern teaching (Joske room) Intern teaching (Joske room) Free: Reflective learning Interventional pain management procedures Student Tutorial Student Tutorial Interventional bronchoscopy Theatres Pain Management Outpatients Clinic (Dr Goucke) If no cases join in the General respiratory clinic THURSDAY THURSDAY Asthma Educator (S. Coleman) NSG: Interventional pain management procedures MED: Bronchoscopy (Ward G75) or interventional pain management procedures Diabetic nurse educators NSG: Pain Management Outpatients Clinic (Dr Majedi) MED: CF clinic or Diabetes nurse educator seek advice from each other where required for management or referral FRIDAY seek advice from each other where required for management or referral FRIDAY Lung Cancer Multi-disciplinary team meeting Lung Cancer Multi-disciplinary team meeting Lung Ca F/U clinic (M. Phillips) Free: Reflective learning Respiratory radiology meeting Respiratory radiology meeting Student Tutorial/Debrief

11 Program 3 Chronic Pain Service and Respiratory AMBULATORY CARE STUDENT PLACEMENT PROGRAM 3 Student 3 MONDAY Week 1(CPS) MONDAY Week 2 (Resp) Orientation; Introduction to the IPE team, overview of IPE, Team building activity, site tour and introduction to key staff Pleural clinic (Prof Lee) Orientation to CPS with Denise Fairclough (CNM) Introduction to Pain Management (IPM) CF clinic program - coordinated by Lisa Olsen (OT) Specialty tutorial (MS only) Specialty tutorial (MS only) TUESDAY TUESDAY Education Meeting Home Visiting with Barb Stubber Physiotherapy with Bri Tampin or Jan Mountford (NS Triage) Multidisciplinary Case Conference Physiotherapy and Neurosurgeon clinic WEDNESDAY WEDNESDAY Intern teaching (Joske room) Intern teaching (Joske room) Interventional pain management procedures Asthma clinic (Prof Thompson) Student Tutorial Student Tutorial Pain Management Outpatients Clinic (Dr General Respiratory clinic Goucke) THURSDAY NSG: Interventional pain management procedures MED: Bronchoscopy (Ward G75) or interventional pain management procedures NSG: Pain Management Outpatients Clinic (Dr Majedi) MED: CF clinic or Diabetes nurse educator seek advice from each other where required for management or referral FRIDAY THURSDAY Bronchoscopy (Ward G75) CF clinic seek advice from each other where required for management or referral FRIDAY Lung Cancer Multi-disciplinary team meeting Lung Cancer Multi-disciplinary team meeting Free: Reflective learning Lung Ca F/U clinic (M. Phillips) Respiratory radiology meeting Respiratory radiology meeting Student Tutorial/Debrief

Patient Pathway Journey through health and social care. A toolkit to support your inter-professional experience (IPE)

Patient Pathway Journey through health and social care A toolkit to support your inter-professional experience (IPE) Introduction This tool is designed to encourage learners to gain an insight into the