MOC Should Be a Team Sport

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September 28, 2016 American Board of Medical Specialties MOC Should Be a Team Sport Barbara F. Brandt, PhD, Director Associate Vice President for Education, UMN Academic Health Center The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067. The National Center is also funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation, The John A. Hartford Foundation and the University of Minnesota. 2015 Regents of the University of Minnesota, All Rights Reserved.

Collaborators from whom I learn everyday Brian Sick, M.D. Associate Professor, Departments of Medicine and Pediatrics, University of Minnesota Medical School Interprofessional Academic Deputy, University of Minnesota Academic Health Center Medical Director, Phillips Neighborhood Clinic President, National Student-Run Free Clinic Faculty Association Andrew Olson, M.D., FACP, FAAP Assistant Professor Director, Sub-internship in Critical Care Clerkship Departments of Medicine and Pediatrics University of Minnesota Medical School 2

Topics Today s continuing education system rooted in the 1970s Today s drivers in a changing health care system New learning and certification system design for the future, based upon team-based, collaborative practice Gen-X and Millennial voices from the field 3

National Center Vision We believe high-functioning teams can improve the experience, outcomes and costs of health care. National Center for Interprofessional Practice and Education is studying and advancing the way stakeholders in health work and learn together. National Center Funders Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067 Robert Wood Johnson Foundation Gordon and Betty Moore Foundation Josiah Macy Jr. Foundation John A. Hartford Foundation 4

The Nexus: Our Vision for Health Triple Aim of Alignment Improving quality of experience for patients, families, communities and learners Sharing responsibility for achieving health outcomes and improved learning Reducing cost and adding value in health care delivery and education 5

Interprofessional Education Linked to outcomes Interprofessional education occurs when two or more professions learn with, about, and from each other to enable effective collaboration to improve health outcomes. Adapted from: The Centre for the Advancement of Interprofessional Education, UK, 1987 World Health Organization, Framework for Action on Interprofessional Education and Collaborative Practice, 2010. 6

The Update Model: 1970s Continuing Education Roots Keeping Up Need for New Knowledge / Skills A Professionals Skill Half Life of Knowledge Obsolete in Five Years New Mandatory Legislation New Certification and Subspecialty Individual professions New Information = Competence Individual professional focus The new CE industry was born. 7

What will be the impact on workforce of HHS Secretary Burwell s announcement on value-based payment goals and MACRA? Principles: Incentives to motivate higher value care Alternative payment models Greater teamwork and integration More effective coordination of providers across settings Greater attention to population health Harness the power of information to improve care for patients 8

New Models of Care Require New Models of Learning: Reframing, Retooling, and Retraining Learner Pipeline Today I owe: Health Workforce for New Models of Care Patients, Families & Communities How do we $100K prepare the next generation of health professionals for a transformed health care system while improving experience and decreasing costs? How do we create a health workforce in the right locations, specialties and practice settings that has the skills and competencies needed to meet the demands of a transformed health care system while preventing burnout? How do we improve the patient experience of care, improve the health of populations, and reduce the per capita cost of health care simultaneously? 9

The BIG Question How do we help students, trainees, and practitioners gain the competencies to work in new models of care when we are still practicing in traditional models? 10

An Interprofessional Learning Continuum Model, Institute of Medicine, 2015 11

Tomorrow s Learning System: Engaging Gen-Xrs and Millennials Collaborative learning, working in groups Early digital immigrants and digital natives: social networking and media Many portfolios, documenting their performance in K 12, college and medical schools Continuous assessment: Expectation of performance with feedback and reflection Service learning real-world experience 12

Voices from the Field A family medicine chair, implementing PCMHs and residency programs A pediatric hospitalist team leader A primary care clinic medical director A junior faculty member, implementing patient-centered rounds for all teams in a medical center 13

Multiple Win QI Project UMMC Goal: Improve patient satisfaction Patient Centered Rounding for all teams Patient Satisfaction Unchanged Inpatient Faculty needs scholarship IHI Open School want a meaningful project Conduct survey of patients, physicians and nurses on what they want out of rounds Checklist top 5 things to cover in patient centered rounding Rounding has changed, data collected, publication IPE can help to transform the system by working with our health system partners to solve complex problems and delivery complex care. 14

The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067. The National Center is also funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation, The John A. Hartford Foundation and the University of Minnesota. 2015 Regents of the University of Minnesota, All Rights Reserved.