VA Centers of Excellence in Primary Care Education Janet V. Willis, RN, BSN August 2017
7 Centers of Excellence in Primary Care Education (CoEPCE) Academic Partners: Gonzaga University School of Nursing, University of Washington School of Medicine and Idaho State University School of Pharmacy and Northwest Nazarene University for undergraduate RN program Required Trainees - Physician Residents - Nurse Practitioner Students - Nurse Practitioner Residents - Psychology Fellows - Pharmacy Residents Academic Partners: Fairfield University School of Nursing, Quinnipiac University School of Nursing, University of Connecticut School of Medicine and Nursing and Yale University School of Medicine Academic Partners: Baylor College of Medicine, Nelda C. Stark College of Nursing at Texas Woman's University, University of Texas School of Nursing Required Faculty/Leadership - Physicians - Nurse Practitioners - Psychologists - Pharmacists - RN Care Manager and Evaluation Academic Partners: Case Western Reserve School of Medicine, Frances Payne Bolton School of Nursing at Case Western Reserve University, Cleveland Clinic Foundation, The Breen School of Nursing at Ursuline College Academic Partners: University of California at San Francisco Schools of Medicine and Nursing Academic Partners: UCLA David Geffen School of Medicine, UCLA School of Nursing, USC School of Medicine Academic Partners: University of Washington Schools of Medicine and Nursing 2
CoEPCE Purpose Foster transformation of clinical education by preparing graduates of health professional programs to work in, lead and improve patient-centered interprofessional teams Develop and evaluate the impact of new interprofessional educational approaches and models on health professions education and workforce outcomes within and beyond VA Improve primary care instructional strategies with emphasis on clinical, workplace learning Influence education and practice for VA and the Nation 3
Background High quality team-based primary care is key solution to improving health care and lowing costs (Patient Centered Primary Care Collaborative) Comprehensive team of care providers accountable for physical and behavioral health to include prevention and wellness Accessible access to same-day care, weekends, and afterhours. Options for tele-visits, secure electronic messaging and shared medical appointments Coordinated care is organized across all elements of the broader health care system to include specialty care, inpatient, home health and emergency room care 4
Patient Aligned Care Teams (PACT) PACT model of care is Synonymous with Patient Centered Medical Home (PCMH) Originated in 1960 s- pediatricians Patient Centered Primary Care Collaborative formed 2005 Initial VA grant for 5 sites 2011, added 2 sites 2015 and extended grant 4 more years Interdisciplinary Academic Patient Aligned Care Teams (IAPACT) 5
Trainees Numbers and Types of CoEPCE Trainees, AY12 AY16 Profession AY 11-12 AY 12-13 AY 13-14 AY 14-15 AY 15-16 Total Medicine 79 104 121 120 127 551 NP Students 19 25 29 26 19 118 NP Residents 3 8 12 19 17 59 NP Psych-MH 1 1 2 2 2 8 Pharmacy 14 17 25 25 25 106 Psychology 7 8 16 15 14 60 Social Work 1 1 1 1 3 7 Dietary 1 1 3 2 1 8 RN Student/VALOR Total 0 2 3 3 3 11 125 167 212 213 211 928
Outcomes Trainee commitment to consider working in VA increased from 50% at beginning of last AY when started to 78% near the end of the AY Trainee commitment to working in primary care increased 4-7% as a result of COE experiences Curricula at all sites have significantly increased use of workplace learning strategies Curricula at all sites increased emphasis on team development and communication Trainees report high frequency of using newly taught skills in the workplace Trainees satisfied: 70% rate experience as excellent or very good 7
RN Care Manager RNCM Primary role in the PACT Model is: Chronic Disease Management Hypertension protocols Diabetic registries Opioid Registries Care Management Tool CoE RNCM Functional Statement sent as attachment 8
Questions 9