Learning Together to Practice Together

Transcription

1 Learning Together to Practice Together Jann T. Balmer PHD RN Director, Continuing Medical Education University of Virginia School of Medicine Faculty Disclosure Conflict of Interest I (and/or my spouse/partner) do not have a personal or professional financial relationship or interest with any proprietary entity producing healthcare goods or services. Objectives/Learning Outcomes Describe the urgency and changing landscape for healthcare practice Define what interprofessional learning is and is not Provide a forum to discuss differing perspectives on the impact of interprofessional education in medical education and practice Historical Trends in Continuing Medical Education Focused on knowledge acquisition in areas of specialization or practice- Directed to individual practitioners Up to date with recent developments in the field/specialty

2 Quality of Care and the Lack of Effectiveness of Continuing Education (CE) Healthcare today harms too frequently and routinely fails to deliver potential benefits. Doctors, nurses, pharmacists and other health professionals are not being adequately prepared to provide the highest quality and safest medical care possible, and there is insufficient assessment of their ongoing proficiency. Today s professional health workforce is not consistently prepared to provide high quality health care and assure patient safety. One contributing factor to this problem is the absence of a comprehensive and well-integrated system of continuing education in the health professions. Systemic Issues In Healthcare The fragmentation of healthcare delivery compromises patient and increases cost Inadequate coordination of care that doesn t incorporate a patient-centric focus in care Proliferation of systems that support the healthcare system that may not be directly related to improved patient Contributing Factors to Changing Expectations Continuing rise in the cost of healthcare Prevalence of medical errors Wavering public trust Stakeholder demands for evidence of competence physicians, nurses, pharmacists, healthcare teams. Affordable Care Act New financial reimbursement structure associated with wellness, patient-centric approaches Fosters incentives for healthy behaviors Shift in patient responsibility/payment Physician Payment Sunshine Act

3 Accountable Care Organizations Patient safety and Continuous Quality Improvement core features Link care improvement with evidence-based strategies that are based on evidence/standards of care Create an environment where practitioners have a vested interest in the success of the organization Reimbursement is tied to quality of evidencebased care ACGME CLER Program Sets standards for resident training and performance in the clinical setting Incorporates interprofessional performance as a core value/standard of care Outlines expectations for mentorship and patient-centric care Is the issue lack of transfer? CME to CPD Clinical Practice Focus on Clinical Practice Borrowed and adapted from Marijke Kehrhahn s keynote address at Alliance for CME 2011 Transition from exclusively Knowledge-based to IPE & Team-based learning

4 Mechanisms for regulating and monitoring CPD From AMA PRA Category 1 credit Alignment of credit systems MOC points (maintenance of certification) MOL requirements (maintenance of licensure) Joint Commission and other options Role of CME/CPD/CE professionals Roles and responsibilities of CE professionals is now expanded to go beyond recent advances and disease-oriented topics to include performance improvement, and public health topics/issues. Now are expected to assess, create and measure educational and performance improvement efforts that are central to healthcare provider and team competence. Skills for CE Professionals What is interprofessional education (IPE)? Education developed by the team, for the team AND Learning from, with and about each other to enable effective communication and improve health Interprofessional Education Consistent with IOM reports and Consensus report for Core Competencies for Interprofessional Collaborative Practice Redesigning Continuing Education in the Health Professions (IOM) CE efforts should bring health professionals from various disciplines together in carefully tailored environments A new comprehensive vision of professional development is needed to replace culture in CE

5 IPE why now? Improved team performance = better patient Reimbursement models Affordable Care Act Pay 4 Performance Never Events Triple Aim High quality High patient/family satisfaction Reduced cost Operational efficiency = cost savings Increased revenue by increasing learner pool Matrix for Continuing Professional Development Values/Ethics for Interprofessional Practice Roles/Responsibilities Interprofessional Communication Teams & Teamwork Physicians Nurses Pharmacists Themes in Transformation of CME to CPD Shift in expectation from time-based credit to measurement that infers competence in performance Increased focus on interprofessional education (IPE) to augment profession-specific CE Integration of continuing professional development (CPD) with quality improvement Linking professional development to patient safe performance Educational context needs to be consistent with workplace/ practice settings Requires multiple strategies that incorporate profession-specific CE with IPE that is patient centric/systems based Profession-specific CE should address required performance elements/competencies for each profession Interprofessional CE - clarifies roles and responsibilities of each team member, communication and overall team work

6 Effective Interprofessional Education: A Chain Reaction Impact of interprofessional education designed to improve interprofessional collaborative practice Creates Positive Interaction EFFECTIVE INTERPROFESSIONAL EDUCATION Engenders Mutual Trust and Support Barr, Koppel, Reeves, Hammick, Freeth, 2005 Encourages Collaboration Between Limits Professions Demands On Any One Profession REDUCES STRESS Enhances Job Satisfaction Improves Recruitment and Retention Benefits Workers Improves Client Care Evaluating the quality of interprofessional educational activities PROMOTES PARTNERSHIP FOR HEALTH

7 Interprofessional education is a minority component of the educational activity Emphasis on interprofessional collaboration dominates the educational activity Joint Evaluation Team (JET) Classification of Interprofessional Educational Outcomes Level 1 Reaction Level 2a Modification of attitudes/perceptions Level 2b Acquisition of knowledge/skills Level 3 Behavioral change Level 4a Change in organizational practice Level 4b Benefits to patients/clients The Interprofessional Education Spectrum Barr, Koppel, Reeves, Hammick, Freeth, 2005 Moore s CME Outcome Model