Interprofessional Education for Collaborative Patient-Centred Practice: The Manitoba Initiative

1. Interprofessional Education for Collaborative Patient-Centred Practice: The Manitoba Initiative Judy Anderson, Christine Ateah, Colleen Metge, Moni Fricke, Laura MacDonald, Penny Davis, Sora Ludwig Representing the Faculties of Medicine, Nursing, Pharmacy, Dentistry and School of Medical Rehabilitation, University of Manitoba Research Measures Goals & Objectives Integration of IECPCP Goals and Learning Objectives • Our research measures at this point in our project are focused on the student experience (orientation, awareness & demonstration). We propose to use action research methodology to investigate and develop new skills and approaches to interprofessional patient-centred care. • Action research methods bridge the divide between research and practice (e.g., “what to do in a collaborative practice”). (Somekh, 1995) As well, use of action research methods may address the perceived failure of social sciences research to make a difference in outcome, i.e., bringing about actual improvements in patient care or practice (e.g., “establishing collaborative patient-centred practices”). • For a project of this nature, action research means to: find a starting point (establish interprofessional patient-centred care), clarify the situation (try to define the essential components of care with a ‘learner community’ of health professional students and willing practice partners), develop action strategies (what are the respective roles of individuals and the team in care), put them into practice and make the findings known (scholarly communication or knowledge-translation activities). (Altrichter H et al., 1993) • During this learning experience, students and the ‘champions’ will: • A. Define Health • Define ‘health’ from the context of your professional culture and, after discussion, from the perspective of the other health-professional cultures. [As the ‘champions’, we have done this: e.g. for Pharmacy] • Five Faculties/Schools [Medicine, Nursing, Pharmacy, Dentistry & School of Medical Rehabilitation], two (2) partners [Winnipeg Regional Health Authority & the Northern Medical Unit] and three (3) practice platforms have a 5-phase initiative to: • Develop the awareness of the critical nature of patient problems with the quality of health care and develop interest in improving the practice of health care and patient safety through a patient-centred approach to collaborative interprofessional education, practice and research. • Demonstrate the effectiveness of collaborative, patient-centred practice by immersing small interprofessional groups of pre-licensure students in one of four collaborative practice settings in urban, rural and remote locations in Winnipeg, Manitoba and Nunavut. • Evaluate and communicate behavioural changes, which is the direct outcome required, to improve practice and result from, new knowledge, attitudes, skills and values including respect and valuation of input from other professionals. After Research Ethics Board approval, research methodologies will compare behaviours between participating and control subjects. Research findings will be communicated broadly in presentations, and written and online reports. • Implement a broader program of interprofessional education in core curricula. Results of the demonstration and evaluation phases will be used to design strategies to target courses and programs that involve collaborative learning and practice. • Sustain the collaborative learning and practice by faculty and students through the research platform of the Initiative. Research activities will engage, develop and lead future interprofessional collaborations, such as projects on quality improvement in patient care; collaborative practice rounds; and effective collaborations with patients. KNOWLEDGE & PRACTICE Inter-Professional Patient-centred Care in Primary Care Practice Different health professions INFORMATION Components of patient-centred & quality care Collaboration Engage in and demonstrate collaborative practice Patient-centred care Summarize the components of patient-centred quality of care DATA Health Defined Define health at the individual, family, practitioner & community level INFO NEEDS = feedback loops indicate that consideration of all material in the care of a patient is a continuous process and is useful for improving patient care decisions in an interprofessional environment • Define ‘health’ from the perspectives of a patient and a community health provider. • Based on Objectives #1 and #2, describe a holistic model of healthcare Project Phases • B. Develop an Approach to Patient-Centred Quality Care • Review the relevant literature on patient care and health-care provider perspectives to arrive at key features of care: • Define and characterize high-quality patient care • Develop an approach to care that builds the synergy between features of quality care and patient-centred care. The Manitoba Initiative Our Premise: • C. Engage in Collaborative Learning about Patient-Centred Practice • Define collaborative practice as related to primary healthcare in Canada today. • Identify a list of the roles that various professionals contribute or could contribute to a collaborative practice • Identify the patient’s role in a collaborative practice model • Evaluate how expectations of practice, care and impact of care differ when care is provided by a group vs. care provided by a team Interprofessional education, collaboration and patient-centred practice (IECPCP) are essential for improving the quality of patient care and patient safety but are not standards in current education programs. The Manitoba Initiative involves three diverse practice platforms, education, practice and research to develop and sustain IECPCP. November 2006 We are HERE • D. Define and Evaluate Interprofessionalism in Primary Health Care • Define interprofessionalism in practice and contrast it to the collaborative model of practice • Obtain perspectives of interprofessionalism from administrators, regulatory bodies, professional, patients to understand advantages and challenges • Progress to date: we have • identified our 5 Faculty/School “Champions” • agreed on pre-licensure students for IPE at practice sites • developed learning objectives for the students’ experience • hired Office Assistant and Research Associate • enrolled 3 faculty champions in designing and completing a new PhD- • level course (Education) on interprofessional education and learning Somekh B. The contribution of action research to development in social endeavours: a position paper on action research methodology. Br Ed Res J 1995;21(3):339-355. Altrichter H, Posch P, Somekh B. Teachers investigate their work : an introduction to the methods of action research. London ; New York: Routledge; 1993. Acknowledgements The Manitoba Initiative is supported by Contribution Agreement from Health Canada: 6804-14-2005/6880031; we are very grateful for the ongoing support of the Deans/Director of the units involved in this initiative.