Interprofessional competence model and interprofessional building ...
Enhancing Interprofessional Collaborative Practice...
Transcript of Enhancing Interprofessional Collaborative Practice...
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Presenters:
Renee Barnwell, RN, MSN, RN, CHPN
Rebekah Ellsworth, RN, MSN, CHPCA
HRSA-NEPQR IPCP Grant # UD7HP26048
Enhancing Interprofessional
Collaborative Practice in End
of Life Care
Enhancing Interprofessional
Collaborative Practice in
Hospice & Palliative Care
o HRSA NEPQR-IPCP Grant
Awarded July 2013 - June 2016
Four Seasons ~ Compassion for Life
o Institute of Medicine (IOM)Study on
Interprofessional Education
• Education
• Practice Model
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Project Goals
1. Enhance an existing Interdisciplinary
Teams practice model into a robust
interprofessional collaborative practice
(IPCP) model designed specifically for
delivery of care to patients with advanced
and/or life-limiting illness.
2. Implement this IPCP model for Hospice
and Palliative Care in a large service area
that is predominantly rural and
underserved
Project Goals
3. Strengthen the IPCP model through
systematic development of nurse
leadership, team competency, and
dissemination and replication of the
model in order to improve patient and
population outcomes
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Project Objectives
> Increase IPCP competency among an
interdisciplinary team of HPC providers
(nurses, nursing assistants, nurse
practitioners, physicians, physical
therapists, respiratory therapists,
social workers, chaplains, music
therapists, and students of all
disciplines) using existing IDT
structure and process.
> Establish methods through which
nurses and nursing students develop
leadership skills in interprofessional
team-building, problem-solving, and
care coordination, thus creating an
enduring structure for nurse
leadership, and thereby quality, in HPC.
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> Improve patient- and population-
centered health outcomes by
enhancing the existing IDT model for
HPC and expanding it in an IPCP
environment in a larger service area in
which patients are (a) predominantly
rural and underserved, and (b) seen in
diverse care settings.
> Disseminate best practices in IPCP
through Four Seasons’ Center of
Excellence (COE), which offers high-
quality experiential programs for HPC
providers and organizations.
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Model Development
Registered Nurses Spiritual Care Counselor
Nurse Practitioner Licensed Clinical Social Worker
Certified Nurse Assistant Medical Doctor
Volunteer Patient-Family
Advisor
Music Therapist
Actions to Create IPCP Model for EOL Care
The Project Team Includes:
Project Team Organized and
Trained
Literature review
Systems Assessments Systemic Collaboration
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Collaborative, Trans-disciplinary CareProfessional Boundary
Hospice Interdisciplinary Team
*specific to Four Seasons, but not all hospice agencies
Nurse Medical Social Worker
Nurse Practitioner* Spiritual Care Counselor
Hospice Aide Bereavement Counselor
Physician Music Therapist*
Volunteer Patient Family Advisor*
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Palliative Care Team
Physician Medical Social Worker
Nurse Practitioner Nurse
Spiritual Care Counselor
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IPCP Competencies
Teamwork:Apply relationship-building values and the principles of
team dynamics to perform effectively in different
team roles to plan and deliver patient-/population-
centered care that is safe, timely, efficient, effective,
and equitable
Roles & Responsibilities:Use the knowledge of one’s own role and those of
other professions to appropriately assess and
address the healthcare needs of the patients and
populations served
IPCP Competencies
Values & Ethics:Work with individuals of other professions to maintain
a climate of mutual respect and shared values
Communication & Collaboration:Communicate with patients, families, communities, and
other health professionals in a responsive and
responsible manner that supports a team approach
to the maintenance of health and the treatment of
disease.
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Four Seasons’ Values
o Compassion: A companion for the journey
o Balance: Seek harmony of mind, body, and spirit
o Respect: Each person is honored
o Integrity: Be trustworthy in all things
o Teamwork: Together everyone achieves more
o Excellence: Dream more (than others think is
practical) Expect more (than others think is possible)
o Resilience: Recover and Thrive from any
Challenge or Change
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Aromatherapy,
Art, Mental
Health,
Massage, Music,
Pet, Reiki,
Wound, etc…
Medical:
Referring, Attending,
Consulting
.
Pharmacy:
Compounding, PBM, Retail,
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Interprofessional Collaborative
Practice: Defining & Assessing
Interprofessional collaborative practice: “When
multiple health workers from different
professional backgrounds work together with
patients, families, carers [sic], and communities to
deliver the highest quality of care” (WHO, 2010)
Interprofessionality:
beyond multi-disciplinary
Interprofessionality: “the process by which
professionals reflect on and develop ways of
practicing that provide an integrated and cohesive
answer to the needs of the client/family/population…
[I]t involves continuous interaction and knowledge
sharing between professionals, organized to solve or
explore a variety of education and care issues all while
seeking to optimize the patient’s participation…
Interprofessionality requires a paradigm shift, since
interprofessional practice has unique characteristics in
terms of values, codes of conduct, and ways of
working. These characteristics must be elucidated”
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IPCP Professional Development
oAssess•Individual and Team evaluation of Competency
levels• Novice, Proficient, Expert
•Self & Observed Assessments
•Ongoing observation and assessment of
competence
oEducate•IPCP Model
•Competencies, Definitions, and Behaviors
•Provide Reflective Practice Space
IPCP Professional Development
oEducate•3 C’s
(Communication, Consultation and Collaboration)
•SBAR
•TeamSTEPPS
•Preceptor Program
•Grand Rounds
•Patient and Family Advisor (PFA)
Recruitment, Orientation, Training, Feedback
•Facilitator Training
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Structures & Processes
to Enhance IPCP
oIPCP Project Team Specialists
oNursing Leadership
•IPCP Specialists
•Care Experience Coordinator
oPatient and Family Advisor Role
oInterdisciplinary Team (IDT) Meeting
Best Practices
oSustaining IPCP
IPCP Impact Potential
oOutcomes Identified•Patient & Family Outcomes
•Pain, Dyspnea management, CAHPS, Service Recovery, QDACT
•Competency Development
•Self , Team, and Observed Assessments
•Meeting Ratings
oOutcomes Current Reality•Seeing improvements in most areas
•Above national benchmarks on CAHPS
•Competency Assessments more realistic with
increased understanding
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Grant ManagementoInternal &/or External Resources:
•Agency Support
•Searching & Writing grant applications
oGrants.gov•Registration
•Search grant opportunities & Guidance
oSteering & Project Team•Selection
•Functions
•Accountability
Grant ManagementoReporting to Grantor
•Training & Support
•Translate Grantor language
•Financial & Progress Reports
•Audits
Audit & Monitor internally
Work plan
Budget
Outcomes
Federal audit:
https://www.whitehouse.gov/omb/grants_docs/
Agency General Financial Audit
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Discussion & Questions….
References
D’Amour, D. & Oandasan, I. (2005). Interprofessionality as the field
of interprofessional practice and interprofessional education:
An emerging concept. Journal of Interprofessional Care, 19
(Supplement 1), 8-20
HPNA. (2010). Professional competencies for the generalist
hospice and palliative nurse. (2nd Ed.). Dubuque, IA:
Kendall/Hunt Publishing Company.
Interprofessional Education collaborative Expert Panel. (2011).
Core competencies for interprofessional collaborative practice.
Report of an expert panel. Washington, DC. Interprofessional
Education Collaborative.
Institute of Medicine (IOM) Consensus Committee Report. (2015).
Measuring the Impact of IPE on Collaborative Practice and
Patient Outcomes.
https://iom.nationalacademies.org/Reports/2015/Impact-of-
IPE.aspx
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References
National Quality Forum. (2006). A national framework for preferred
practices for palliative and hospice care quality: A consensus
report. Retrieved from
http://www.qualityforum.org/Publications/2006/12/A_National_F
ramework_and_Preferred_Practices_for_Palliative_and_Hospic
e_Care_Quality.aspx
World Health Organization (WHO). (2010). Framework for action on
interprofessional education & collaborative practice. Geneva:
World Health Organization. Retrieved April 19, 2016 from
http://www.who.int/hrh/resources/framework_action/en/
HRSA Grant Project Statement
This project is supported by the Health Resources
and Services Administration (HRSA) of the U.S. Department
of Health and Human Services (HHS) under grant number
UD7HP26048; HRSA-NEPQR Interprofessional
Collaborative Practice Project, Advancing Interprofessional
Collaborative Practice in Hospice and Palliative Care; total
award amount $1,419,046, 100% financed with HRSA
government support and 0% financed with non-
governmental sources.
This information, content and conclusions are those of
the authors, Four Seasons~Compassion for Life IPCP
Project Team, and should not be construed as the official
position or policy of, nor should any endorsements be
inferred by HRSA , HHS, or the U.S. Government.