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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
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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
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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
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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.
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MGH Institute of Health Professions (IHP)
School of Nursing School of Health and Rehabilitation Sciences
BSN (post-baccalaureate)
MS (NP)
Doctor of Nursing Practice
Communication Sciences and Disorders
RN to MS
Occupational Therapy
Physical Therapy
Physician Assistant
PhD in Rehabilitation Sciences
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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
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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
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Building a Collaborative Relationship
Shared commitment to exemplary professional practice and student success Established discipline-specific academic-clinical partnerships over many years Established leadership relationships through various initiatives at all levels Relationships ≠ placements
Shared incentives and resources
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Common Interests Common Values Common Goals
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Interprofessional Education at IHP
School of Nursing School of Health and Rehabilitation Sciences
BSN (post-baccalaureate)
MS (NP)
Doctor of Nursing Practice
Communication Sciences and Disorders
RN to MS
Occupational Therapy
Physical Therapy
Physician Assistant
PhD in Rehabilitation Sciences
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History of Dedicated Education Units
Nursing model Addressing nursing faculty shortages Involving nursing staff as clinical instructors Increasing capacity for clinical education Focus on nursing knowledge and skills
First DEU, 1990 Exclusive academic-practice partnership
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Evolution of the IPDEU
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www.mghihp.edu/overview/interprofessional-education
For video:
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THE IPDEU JOURNEY
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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
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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
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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
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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
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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
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Low Impact High Impact
High Resource
Low Resource
Old Model
New Model
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Low Impact High Impact
High Resource
Low Resource
•Over staffing •Decreased productivity
•No additional staffing •Maintain productivity
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Low Impact High Impact
High Resource
Low Resource
•CIs not skilled in IPE
•IPI training
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Low Impact High Impact
High Resource
Low Resource
•24 students/ semester
•~200 students/ semester
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Low Impact High Impact
High Resource
Low Resource
•IPE and discipline objectives
•IPE objectives
only
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Low Impact High Impact
High Resource
Low Resource
•CFC and IPI Effort
•Active observation
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Low Impact High Impact
High Resource
Low Resource
•1 hour debriefing
•½ hour debriefing
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IPDEU STRUCTURE
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IPDEU Structure
IHP
Academic Deans SHRS /SON
IPIs Nursing and Rehabilitation
Director of IMPACT Practice
Student Dyads Patients
Clinical Faculty Coordinators (CFCs)
Provost Senior VP for Patient Care
Nursing Unit Directors
Rehab Directors
Executive Director Institute for Patient Care
Mass General
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IHP
Academic Deans SHRS /SON
Executive Director Institute for Patient Care
IPIs Nursing and Rehabilitation
Director of IMPACT Practice
Clinical Faculty Coordinators
(CFCs)
Provost Senior VP for Patient Care
Nursing Unit Directors
Rehab Directors
Student Dyads Patients
Mass General
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IHP
Academic Deans SHRS /SON
Executive Director Institute for Patient Care
IPIs Nursing and Rehabilitation
Director of IMPACT Practice
Clinical Faculty Coordinators
(CFCs)
Provost Senior VP for Patient Care
Nursing Unit Directors
Rehab Directors
Student Dyads Patients
Mass General
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IHP
Academic Deans SHRS /SON
Executive Director Institute for Patient Care
IPIs Nursing and Rehabilitation
Director of IMPACT Practice
Clinical Faculty Coordinators
(CFCs)
Provost Senior VP for Patient Care
Nursing Unit Directors
Rehab Directors
Student Dyads Patients
Mass General
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IHP
Academic Deans SHRS /SON
Executive Director Institute for Patient Care
IPIs Nursing and Rehabilitation
Director of IMPACT Practice
Clinical Faculty Coordinators
(CFCs)
Provost Senior VP for Patient Care
Nursing Unit Directors
Rehab Directors
Student Dyads Patients
Mass General
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IHP Mass General
Academic Deans SHRS /SON
Executive Director Institute for Patient Care
IPIs Nursing and Rehabilitation
Director of IMPACT Practice
Clinical Faculty Coordinators
(CFCs)
Provost Senior VP for Patient Care
Nursing Unit Directors
Rehab Directors
Student Dyads Patients
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Overcoming Challenges Together
Costs and productivity Scalability Scheduling and Logistics Training interprofessional practice instructors Making IPP visible and valued Curriculum considerations Sustainability
C
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Future Directions Exploring outcomes for different stakeholders Expand visibility of health professions across the institutions
Additional grant funding Identify future opportunities for collaboration
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What are your goals for IPE/IPP partnerships?
What are your opportunities? What are your potential barriers?
What are potential strategies?
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Low Impact High Impact
High Resource
Low Resource