THE ESSENTIAL ROLE OF THE ACADEMIC- PRACTICE PARTNERSHIP IN INTERPROFESSIONAL CLINICAL EDUCATION

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THE ESSENTIAL ROLE OF THE ACADEMIC- PRACTICE PARTNERSHIP IN INTERPROFESSIONAL CLINICAL EDUCATION Leslie G. Portney, DPT, PhD, FAPTA Dean, School of Health and Rehabilitation Sciences, MGH Institute of Health Professions Patricia Fitzgerald, RN, MSN, NE-BC Nursing Director, Massachusetts General Hospital Mary Knab, DPT, PhD Director, IMPACT Practice MGH Institute of Health Professions Collaboration Across Borders VI October 2, 2017 Ann Jampel, MS, PT Physical Therapy Center Coordinator of Clinical Education, Massachusetts General Hospital Carmen Vega-Barachowitz, MS, CCC-SLP, FASHA Director, Department of Speech, Language, and Swallowing Disorders Massachusetts General Hospital 1

The Challenge Mandate to focus on IPP for safety and quality in the provision of patient-centered care. IPE is essential to prepare a collaboration ready workforce Difficult to translate IPE into IPP connecting didactic information directly to clinical practice Critical to develop collaborative partnerships between academic institutions and clinical sites 2

Interprofessional Collaboration Roles/Responsibilities Teams & Teamwork Ethics and Values Interprofessional Communication Role clarification Team functioning Collaborative leadership Patient/client-centered care Interprofessional communication Interprofessional conflict resolution

Objectives Discuss the impact of academic-practice partnerships and leadership for creating strong interprofessional clinical relationships. Discuss strategies to address challenges to implementing interprofessional clinical education that strengthens academic and clinical environments. Develop ideas for building a strong academic-clinical partnership to support interprofessional clinical experiences in your own settings. 4

MGH Institute of Health Professions (IHP) School of Health and Rehabilitation Sciences Communication Sciences and Disorders Occupational Therapy Physical Therapy Physician Assistant PhD in Rehabilitation Sciences School of Nursing BSN (post-baccalaureate) MS (NP) RN to MS Doctor of Nursing Practice 5

Massachusetts General Hospital Founding member of the Partners HealthCare System 1,050 bed medical center in Boston Teaching hospital affiliated with Harvard Medical School Patient Care Services Commitment to interprofessional patient-centered care 6

Alignment & Timing Leadership with a vision and commitment to IPE & IPP 2011 IPEC competencies Interprofessional initiatives Collaborative Governance IHP IMPACT program Emerging focus on IPE mandates for accreditation 7

Building a Collaborative Relationship Shared commitment to exemplary professional practice and student success Established discipline-specific academicclinical partnerships over many years Established leadership relationships through various initiatives at all levels Relationships placements Shared incentives and resources 8

Common Interests Common Values Common Goals 9

Interprofessional Education at IHP School of Health and Rehabilitation Sciences School of Nursing Communication Sciences and Disorders Occupational Therapy BSN (post-baccalaureate) MS (NP) Physical Therapy Physician Assistant PhD in Rehabilitation Sciences RN to MS Doctor of Nursing Practice 10

History of Dedicated Education Units First DEU, 1990 Exclusive academicpractice partnership Nursing model Addressing nursing faculty shortages Involving nursing staff as clinical instructors Increasing capacity for clinical education Focus on nursing knowledge and skills 11

Evolution of the IPDEU 12

For video: www.mghihp.edu/overview/interprofessional-education 13

THE IPDEU JOURNEY 14

Initial IPDEU Model 12 half day sessions/semester- 12 students In IMPACT simultaneously, early in programs Assigned to a nurse clinical instructor Student dyads assigned to follow to one patient Disciplinary and IP objectives Clinical Faculty Coordinators (CFCs) 1 hr debriefing Brief orientation Rich experiences 15

IPDEU First Iteration Challenges Required over-staffing- productivity & st Lack of interprofessional focus CIs struggled with new teaching role Dual learning objectives Insufficient CI training Some disengaged students & faculty IPDEU experience seen as extra work Logistics and scalability 16

IPDEU Considerations for Revision Cost neutral and patient-centered Clinical faculty had to maintain productivity Develop interprofessional teaching strategies Focus on IPEC competencies only Add additional units Accommodate more students Student and instructor workload CI title 17

IPDEU Current Model Three units Two ½ day sessions (over two consecutive weeks) - -16 students every 2 weeks/unit Increased students from 12 to 144 per semester Interprofessional Practice Instructors (IPIs) IPIs maintaining responsibilities in real time No discipline-specific clinical skills Revised teaching model and IPI training 18

IPDEU: Process for Revisions From Steering Committee to Leadership Team From quarterly to bi-weekly meetings From CI to Interprofessional Practice Instructor Focus groups Revised training Creation of a new model Grant funding 19

High Resource Old Model New Model Low Resource Low Impact High Impact 20

High Resource Over staffing Decreased productivity Low Resource No additional staffing Maintain productivity Low Impact High Impact 21

High Resource CIs not skilled in IPE IPI training Low Resource Low Impact High Impact 22

High Resource ~200 students/ semester Low Resource 24 students/ semester Low Impact High Impact 23

High Resource Low Resource Low Impact IPE and discipline objectives IPE objectives only High Impact 24

High Resource CFC and IPI Effort Low Resource Active observation Low Impact High Impact 25

High Resource 1 hour debriefing ½ hour debriefing Low Resource Low Impact High Impact 26

IPDEU STRUCTURE 27

IHP Provost Mass General Senior VP for Patient Care Director of IMPACT Practice Academic Deans SHRS /SON Clinical Faculty Coordinators (CFCs) Rehab Directors Executive Director Institute for Patient Care Nursing Unit Directors IPIs Nursing and Rehabilitation IPDEU Structure Student Dyads Patients 28

IHP Provost Mass General Senior VP for Patient Care Director of IMPACT Practice Academic Deans SHRS /SON Clinical Faculty Coordinators (CFCs) Rehab Directors Executive Director Institute for Patient Care Nursing Unit Directors IPIs Nursing and Rehabilitation Student Dyads Patients 29

IHP Provost Mass General Senior VP for Patient Care Director of IMPACT Practice Academic Deans SHRS /SON Clinical Faculty Coordinators (CFCs) Rehab Directors Executive Director Institute for Patient Care Nursing Unit Directors IPIs Nursing and Rehabilitation Student Dyads Patients 30

IHP Provost Mass General Senior VP for Patient Care Director of IMPACT Practice Academic Deans SHRS /SON Clinical Faculty Coordinators (CFCs) Rehab Directors Executive Director Institute for Patient Care Nursing Unit Directors IPIs Nursing and Rehabilitation Student Dyads Patients 31

IHP Provost Mass General Senior VP for Patient Care Director of IMPACT Practice Academic Deans SHRS /SON Clinical Faculty Coordinators (CFCs) Rehab Directors Executive Director Institute for Patient Care Nursing Unit Directors IPIs Nursing and Rehabilitation Student Dyads Patients 32

IHP Provost Mass General Senior VP for Patient Care Director of IMPACT Practice Academic Deans SHRS /SON Clinical Faculty Coordinators (CFCs) Rehab Directors Executive Director Institute for Patient Care Nursing Unit Directors IPIs Nursing and Rehabilitation Student Dyads Patients 33

Overcoming Challenges Together Costs and productivity Scalability Scheduling and Logistics Training interprofessional practice instructors Making IPP visible and valued Curriculum considerations Sustainability C 34

Future Directions Exploring outcomes for different stakeholders Expand visibility of health professions across the institutions Additional grant funding Identify future opportunities for collaboration 35

What are your goals for IPE/IPP partnerships? What are your opportunities? What are your potential barriers? What are potential strategies? 36

High Resource Low Resource Low Impact High Impact 37