Post on 19-Nov-2014
description
Learning About from and With Each Other
February 12, 2014
CHANNELS Project: Learning Objectives
1. TEAMWORK & COLLABORATIVE PRACTICEPromote positive teamwork skills (TeamSTEPPS)Understand roles & responsibilities of team members
2. CULTURAL AWARENESS & IDENTITYImpact of assumptions, beliefs & biasesAwareness of power inequities and disparities
3. CULTURAL KNOWLEDGEAwareness of culturally appropriate resources & skillsKnowledge that one is not an expert in another culture
4. HEALTH LITERACY & COMMUNICATIONUse of active listening & linguistically appropriate resourcesIntegration of CHOWs as critical team members
Definitions
Interprofessional Education occurs when two or more professions learn about, from and with each other to improve collaboration and the quality of care.
Collaborative Practice promotes the active participation of relevant cross-disciplinary professions in patient-centered care.
FunctionInterprofessional knowledge and skills promote capacities to
understand the roles of other health providers and implement the workings of teams - regardless of team make-up - with the
person’s best interests at the center of care.
Emergency Care
Operating Theater
Community Health Environments
Mental Health Settings
WHY IPE IS IMPORTANT?
To advance the Triple Aim of improving population health, enhancing patient quality care and controlling costs
To close the gap between health education and practice settings by aligning their needs and interests
Institute of Medicine
The Institute of Medicine’s (IOM) seminal study of preventable medical errors estimated as many as 98,000 people die every year at a cost of $29 billion. If the Centers for Disease Control were to include preventable medical errors as a category, these conclusions would make it the sixth leading cause of death in America. Deaths/Mortality, 2005, National Center for Health Care Statistics at the Centers for Disease Control, viewed at http://www.cdc.gov/nchs/fastats/deaths.htm.
http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/instructor/videos/ts_Sue_Sheridan/Sue_Sheridan-400-300.html
IPE – Guiding Principles
Values/Ethics for Interprofessional Practice Roles/Responsibilities for
Collaborative Practice Interprofessional Communication Interprofessional Teamwork and
Team-based Care Collaborative Leadership Patient-Centeredness
Values & Ethics
• Patients and populations are at the center
• Cultural and individual diversity is acknowledged and honored
• Expertise of other health professions is known and respected
IOM 6 Aims for Improving Health Care
• Safety: avoid injuries to patients from the care that is intended to help them
• Effective use of scientific evidence to serve all patients • Patient-centered care that is respectful of and responsive
to patient preferences, needs and values, and ensuring that patient values guide all clinical decisions
• Timeliness and reduction of potentially harmful delays• Efficiency and avoidance of waste of equipment, supplies,
and human resources • Equitable care that does not vary in quality because of
person characteristics such as age, gender, ethnicity, geographic location and socioeconomic status
NASW Ethics• Service aimed to help people in need and address social
problems• Competent use of best knowledge and skills for within
scope of practice• Dignity and worth of the person aimed at client self-
determination and empowerment• Integrity to act honestly and effectively according to the
mission and values of the profession• Importance of human relationship that makes effective
and efficient use of engagement in the helping process• Social Justice focused on equitable access and quality of
service for all people regardless of age, gender, race, ethnicity, and socioeconomics
Patient-centeredness
• Invite patients into healthcare decision-making
• Provide information & context to empower patients
Providers
• Disseminate information to inform individuals, families & populations
• Advocate for quality primary prevention & meeting the needs of the underserved
Public Health
• Capacity to think critically & have perspectives honored
• Make informed decisions with health team
Patients
ATTITIDESRespect for patient knowledgeValue patient as team memberTrust in each other & the teamTrust in system of care
ACTIONSInvite patient into care communicationFacilitate empowering practiceCommunicate openly; Listen activelyRespond effectivelyEvaluate efficacy
Roles & Responsibilities
• Communicate roles and responsibilities
• Engage diverse healthcare professionals in healthcare development to meet patients’ needs
• Optimize complementary abilities of all team members to patient care
Community health outreach workers (CHOWs) •Deliver health care services to underserved populations•Are trusted members of their communities •Provide vital links between health systems and communities.1
http://www.maine.gov/dhhs/oma/MulticulturalResource/health.html 1 Whitley et al (2006). Measuring return on investment of outreach by community health workers. J of Health Care for the Poor and Underserved, 17, 6-15.
CHOW Roles & responsibilities• Offer culturally/linguistically relevant health education•Mediate between community members and services providers•Provide case management and systems navigation• Offer medical interpretation•Assist with health insurance enrollment•Provide community-based health promotion & prevention activities•Conduct surveys, collect community and health related data•Contribute information on community needs and •needed resources.
CHOWs: Community Health Outreach Workers
Communication
• Communicate respectfully and appropriately in all situations
• Listen actively• Encourage ideas and opinions
of all team members • Recognize differences in
experience, expertise, culture, and status that may affect communication
• Facilitate conflict resolution to enhance interprofessional working relationships
Collaborative Leadership
• Value contributions of all health team and family/community members
• Facilitate contributions of all team members
• Build support for working together
• Apply leadership practices that support collaborative and effective team practice
Teams & Teamwork
• Collaborate to deliver patient-centered, community-based care
• Develop shared principles of care
• Integrate knowledge and experience of other professions to inform care decisions
• Respect patients’ perspectives and community values that inform care preferences
TeamSTEPPS Skills
SHARED VISION & PHILOSOPHY• SHARED MENTAL MODELCOMMUNICATION• SBAR• TEAM SKILLS: BRIEF, HUDDLE, DEBRIEF• CUS• TEACHBACK (HEALTH LITERACY TOOL)• CHECKBACK
Shared Mental ModelThe perception of, understanding of, or
knowledge about a situation or process that is shared among team members through
communication."Teams that perform well hold shared mental models."
(Rouse, Cannon-Bowers, and Salas 1992)
SBAR
Introduce Situation Background Assessment Recommendation
Brief
Who is on the team?Agree on Goals
Roles & Responsibilities
Understood
Plan of CareAvailability
Access Resources
Huddle
Problem-solvingReview situation Discuss new &
emerging events
Anticipate outcomes & possibilities
Assign resourcesExpress Concerns
DebriefCommunicate clearly
about eventGo over detailsWere roles &
responsibilities understood?
What went wellWhat should change
Can we improve?
Continuous Communication
CUS• I am Concerned• I am Uncomfortable• There is a Safety issue
Teachback• Confirmation of
understanding• Opportunity to correct
miscommunication• Comprehensive:“Tell me in
your own words…”
CASE EXAMPLE
What are the risks in this scenario?• What communication was missed?• How would an interpreter or community
health worker improve safety, quality and outcome?
• Describe an alternative scenario.
Interprofessional Collaborative Practice
“Health care delivered by well-functioning coordinated teams leads to better patient and family outcomes, more efficient health care services, and higher levels of satisfaction among health care providers. We all share the vision of a U.S. health care system that engages patients, families, and communities in collaborative, team-based care.”
Dr. Mary K. Wakefield, HRSA
WHY IT MATTERS