Introductions. Learning Objectives. Financial Disclosure FORGING NEW MODELS: THE IN DEPTH INTERDISCIPLINARY TEAM (IDT) CARE COORDINATION MEETING

Transcription

1 FORGING NEW MODELS: THE IN DEPTH INTERDISCIPLINARY TEAM (IDT) CARE COORDINATION MEETING Introductions Presenters Suzanne Cast, MSW, LCSW Social Worker Lisa Kish Pittman, MSW, LCSW Social Worker Ana Jacobsen, MM, MT BC Music Therapist Jenny Carson, BSN, RN, CCCTM Nurse 2 Financial Disclosure We have no relevant financial or nonfinancial relationships in the products or services described, reviewed, evaluated or compared in this presentation. Learning Objectives 1) The participant will be able to state rationale for an IDT to engage in In Depth IDT Care Coordination 2) The participant will be able to identify preparation and reflection work essential to operations of In Depth IDT meeting, including self evaluation of the therapeutic relationship, progression towards goals, and level of patient/family engagement 3) The participant will be able to differentiate between Interdisciplinary and Multidisciplinary teams and identify such teams within healthcare structures across the continuum of care 3 4 1

2 The Butterfly Program Who We Are Medical Director Clinical Manager Nurse Social Worker Art Therapist Music Therapist Chaplain Bereavement Therapist Intern Volunteer Coordinator The Butterfly Program Who We Serve 5 6 Care Coordination Systems Multidisciplinary Team Whole Person Care School Community Services Behavioral Health Neurology Primary Care Patient/Family Specialists Butterfly Team Oncology Pulmonology Multidisciplinary Team Interdisciplinary Team Genetics 7 8 2

3 Interdisciplinary Team Whole Person (Family) Care Nursing Family Music Therapy Bereavement Emotional Physical Social Work Spiritual Care Social Spiritual Art Therapy 9 10 Models Informing Our Work Interdisciplinary Model Transdisciplinary Model Music Therapy Social Work Nursing Family Bereavement Spiritual Care Art Therapy Family Music Therapy Social Work Nursing Art Therapy Spiritual Care Bereavement Traditional IDT Meeting Format Attended by all members of Butterfly staff with invited guests (primary care providers, case managers, inpatient staff) Bi weekly run through of entire patient census Brief sharing of most pertinent updates Priority system (red, yellow, green) Timed per patient (3 or 4 minutes)

4 What Are the Gaps in IDT? There s a lack of TIME for: Processing Problem Solving Discussion Staff frustration around challenges Advance care planning Sharing successes and stories What s the Fix? A recurring team meeting with ample time for in depth patient and family discussions, where staff have an opportunity to: Define challenges Reflect and process Explore new ideas Modify approaches and plans Share successes and stories Quantify progress Next Steps 1) Assessed team interest in concept 2) Gathered team input to develop a working model 3) Created a one page proposal with early stage ideas 4) Submitted proposal to our manager PDSA/PDCA Cycle We Decided to Call This Concept In Depth IDT

5 Team Member Agreements Preparation and Reflection Work Preparation Page for Quarterly In Depth IDT Arrange our schedules around In Depth IDT quarterly meetings Name Time Time Of Home or On Death Hospital Service Plan How is family progressing toward goals? Your satisfaction level about your work with family Stage of Engagement Accomplishments Challenges or Concerns Plan Moving Forward Participate in each patient/family discussion Come prepared with worksheet (approximately minutes to complete) Team Member Roles Facilitator Reserves meeting space Sends out scheduling reminders Keeps the meeting on track Recorder Enters and tracks the data Reviews changes over time and shares with team as we discuss each patients Time Observer Keeps time to help plan for future meetings Considering how we might analyze time data in the future Our In Depth IDT Specifics Quarterly meeting from 9am 3pm Discuss approximately half of our census each meeting Chosen by last name alphabet May also include new patients and complex or challenging cases Allows average of minutes per patient Extremes have been as few as 4 minutes and as many as 29 minutes

6 What Are We Tracking? Defining Goal Progression How is this family progressing toward goals? How is this family progressing toward goals? What is the clinician s satisfaction level working with this family? How engaged is this family with The Butterfly Team member? Defining Work Satisfaction What is the clinician s satisfaction level working with this family? Defining Family Stage of Engagement How engaged is this family with The Butterfly Team member? 2017 The Energy Project. All Rights Reserved

7 Defining Family Stage of Engagement Butterfly Sibling Retreat Format of the In Depth IDT Meeting 1) A primary clinician provides a brief summary of the patient being discussed: name, age, family members, diagnosis, start of care 2) Scores are submitted to the recorder who enters them into a spreadsheet 3) Recorder reads the averages for the patient in all three categories Preparation and Reflection Work Format of the In Depth IDT Meeting Preparation Page for Quarterly In Depth IDT Name Time Time Of Home or On Death Hospital Service Plan How is family progressing toward goals? Your satisfaction level about your work with family Stage of Engagement Accomplishments Challenges or Concerns Plan Moving Forward 4) Each team member explains their scores, accomplishments, challenges and concerns 5) Open discussion 6) Note families in red and create or revise a plan moving forward

8 Data Collection Sheet GOAL PROGRESS WORK SATISFACTION ENGAGEMENT RN LCSW CHAP MT ATR AVERAGE RN LCSW CHAP MT ATR AVERAGE RN LCSW CHAP MT ATR AVERAGE Qualitative Data Positive outcomes are being seen for: Individual clinicians The Butterfly Team Patients and families Qualitative Data Individual Clinicians This meeting allows me to deal with the challenging realities of my work in a productive way, rather than pretending all is well, or being swallowed by negativity. Hearing the perspective of my colleagues and understanding what was working for them gave me the opportunity to change my perception and approach. I ve benefitted from processing my feelings and feeling validated for what I was seeing. 31 Qualitative Data Butterfly Team This meeting allows the team to constantly improve our cohesive work style. It deepens our relationships in ways that allow honesty and trust to ground our work. We don t always have time to hear the details of the work others are doing during IDT and having the freedom to do that in in depth IDT allows us to encourage and appreciate each other more. In depth IDT has been a valuable use of time for our team. Hearing from the supportive disciplines, like art therapy, music therapy and our chaplain, gives me more of an understanding of the patient and family. It allows our teamwork to shine. 32 8

9 Qualitative Data Patients and Families Team Feedback These meetings lead to consistency in our approach with families and decrease our frustration towards families we believe have stalled. There are two families, in particular, that I ve found more patience with than I had in the past. One of the families I previously struggled with seems more engaged. I largely attribute this to the fact that my satisfaction in working with them has increased since gaining a better understanding through In depth IDT and I am meeting the family s needs in a way that is more helpful for them What We Predict 700.0% What We re Learning: The Data Percentage Change Over Time 600.0% Percentage Change 500.0% 400.0% 300.0% 200.0% 100.0% 0.0% Level of Engagement Level of Satisfaction Progress toward Goals % 200.0% Patients

10 Insights In depth IDT provides an opportunity for clinicians to: Cultivate authenticity Feel cared for Be all in Participate in peer supervision Improve their quality of work Lower rates of compassion fatigue 38 It s not about you, but really it is Suzanne Cast Further Work to be Done Translate this information into our electronic record Gather more data How is In Depth IDT generalizable to a variety of settings and systems? How may different systems adopt In Depth IDT? IRB Submission to Centura Publish! Questions? Lisa Kish Pittman lisakish pittman@centura.org Suzanne Cast suzannecast@centura.org Ana Jacobsen anajacobsen@centura.org Jenny Carson jennycarson@centura.org