On Thursday, May 19th, 103 students from the Doctor of Pharmacy, Doctor of Nursing Practice, MEDEX Northwest Physician Assistant and Master of Social Work programs discussed a real patient case in which a family had been excluded from care planning and decision-making process. The case came from Drs. Yanling Yu and Rex Johnson, who have been working with UW health sciences students and faculty for the last four years to promote interprofessional collaboration and shared decision-making practices. Students were eager for the opportunity to learn about, with and from each other while discussing how they would work together on this case.
Drs. Yu and Johnson shared their personal story of how Yanling's father, 'Baba," died as the result of receiving a contraindicated medication during hospitalization in 2008 and how they were excluded from the care team and care decision-making process. A lack of transparency and communication about the care plan was a major factor in Mr. Yu’s premature death. Dr. Yu shared that they had not been informed about the possible side effects, risks or options. They were told that it was not the responsibility of a pharmacist to inform the patient, but the responsibility of the prescribing physician. Drs. Yu and Johnson knew their father was having an adverse reaction to the medication he was receiving and they could see his physical changes. They figured out on their own that Baba's kidneys were failing based on reported lab values and shared their concerns with the healthcare team. Unfortunately, they were right but their concerns were not taken seriously.
After Dr. Yu and Dr. Johnson shared their story, students worked together in interprofessional groups to determine where they saw areas of concern in the case. They discussed how someone in their profession would have worked with the family to improve Baba’s outcome and how team communication could have been improved.
During the second half of the session, an interprofessional panel of faculty consisting of Dr. Nanci Murphy (School of Pharmacy), Dr. Charlotte Sanders (School of Social Work), Ms. Lois Thetford (MEDEX Northwest Physician Assistant Program), and Dr. Phyllis Christiansen (School of Nursing) joined Dr. Yu and Dr. Johnson to share their perspectives on how their professions could have worked together to improve Baba's outcome. Dr. Brenda Zierler (School of Nursing) facilitated the discussion. Panelists also shared where they currently practice and how they promote shared decision-making and coordinated care for their patients/clients. Then, Dr. Yu and Dr. Johnson shared how they believe the healthcare team could have involved them more in their father’s care decision-making process and students had the opportunity to ask further questions.
Students were excited to share their experiences:
"One of the best IPE sessions, I've participated in."
"I learned that everyone has the potential and responsibility to be the patient's advocate."
"The immense value of effective communication and collaboration"
"It's very important to actively participate in shared decision-making and to speak up when there's concerns or questions."
"To understand the patient and family goals of care, unique characteristics that are important to the patient and family, and let that be the foundation on which your care and shared-decision making is based on."
Drs. Yu and Johnson co-founded Washington Advocates for Patient Safety and have been working to promote patient safety practices. In 2011, after three years of campaigning, they helped to pass state law SHB1493 to increase the transparency of state medical boards’ disciplinary proceedings, guaranteeing patients and their families the right to explanations of boards’ decisions and to provide a statement on how the medical errors and harm they experienced have affected their lives.
Each year the Josiah Macy Jr. Foundation selects five faculty leaders from institutions across the U.S. to lead educational change in each Scholar’s institution. Mayumi Willgerodt, PhD, MPH, RN (University of Washington School of Nursing) joined the Macy Faculty Scholar program in 2013. With support from the Foundation, she developed an interprofessional education (IPE) curriculum for pediatric dental residents, advanced practice nursing students and social work students to care for underserved children. On May 25th, the Foundation published an interview with Dr. Willgerodt.
To read Dr. Willgerodt's interview about her experiences with the Macy Faculty Scholar program, click here.
For more information about Dr. Willgerodt's research, click here.
For more information about the Macy Faculty Scholar program, click here.
On August 4, 2015 over 30 clinicians, faculty and administration staff from the University of Washington (UW) Regional Heart Center, UW ISIS TeamCORE, and the Center for Health Sciences Interprofessional Education, Research, and Practice gathered at the UW Magnuson Health Sciences Building to take part in a Leadership Workshop, “Building High Performing Teams”.
Beth Speck, Senior Organization Development Consultant from UW’s Organizational Development and Training, facilitated two, 90-minute sessions during which participants problem-solved team performance issues using Liberating Structures. Liberating Structures are simple tools that make it possible for people and organizations to create, do new things, and be innovative. Participants were taken through six exercises using Liberating Structures, including "Celebrity Interview" —a 40-minute interview of a team from floor 6NE of the UW Medical Center that successfully implemented interprofessional rounding over the last two years. Celebrity panel members included Sherri Del Bene, RN; Mike Krug, MD; Christy Vogt, RN; Gaby Berger, MD; and Eric Higashi, 6NE unit manager. Panel members answered questions about their approach to change, barriers to implementing a new process, and strategies for overcoming roadblocks and improving process.
This workshop was part of a quarterly Leadership Series funded by a training grant from the U.S. Health Resources and Services Administration. The next workshop in the series is planned for early November 2015.
From July 27–29, the University of Washington’s Center for Health Sciences Interprofessional Education, Research and Practice hosted a two-and-half-day professional development workshop on “coaching”. Held in the UW South Campus center, 30 clinicians, faculty, and administration staff attended from over five UW departments and 2 visiting universities including UWMC Regional Heart Center, UW ISIS TeamCORE, Organization Development and Training (OD&T), UWMC Medical Staff Administration, University of Missouri and University of Kansas.
Dr. Marjorie M. Godfrey and Dr. Nan Cochran, consultants from the Dartmouth Institute Microsystem Academy, developed and implemented the workshop designed specifically for this group. An expert in the Dartmouth Coaching Model, Dr. Godfrey opened the workshop with a comprehensive overview of the theoretical framework involved in developing their Coaching Model. Theory bursts like this were followed by interactive group exercises during which participants practiced facilitating team building and mitigating conflict by using tools like motivational interviewing and shared decision making. Many exercises involved having participants reflect on their personal leadership styles and personality traits learned through self-assessments such as the Thomas-Kilmann Instrument (TKI) and the Myers-Briggs Type Indicator (MBTI).
When asked to describe a moment in the workshop that stood out as particularly meaningful or useful, participants said:
“The Troika consultation exercise really stuck out for me. It made me realize how often I use it informally in my personal life and need to use it more professionally.”
“The coaching workshop today helped me to begin to understand my story and consider others' stories that are brought to any difficult situation.”
Following this in-person workshop Drs. Godfrey and Cochran will host follow-up webinars with participants over the next few months to reinforce their learning and development.
This workshop was partially funded by a training grant from the U.S. Health Resources and Services Administration.
Congratulations to Dr. Mayumi Willgerodt, Professor in the School of Nursing and Health Studies on becoming the first Graduate Studies Director at UW Bothell. Beginning this Autumn quarter, she will support faculty in developing new graduate programs, partnering with other universities and creating alternative types of graduate programs such as certificates. She will provide leadership for increasing the visibility of UW Bothell’s graduate programs and work to enhance the experiences for graduate students of all professions. Dr. Willgerodt has long been a champion of IPE at the University of Washington where she recently developed an innovative IPE approach to oral health education partnering the UW Doctor of Nursing Practice Pediatric Nurse Practitioner program with the Dental Residency program at the Center for Pediatric Dentistry. In addition to her new role as Graduate Studies Director at UW Bothell, Dr. Willgerodt will continue her work with the UW School of Nursing developing Interprofessional Education and Collaborative Practice training for faculty, students and healthcare providers.
To read the UW Bothell announcement, click here.
Frustration, defensiveness, taking comments personally – these are responses many people have to difficult interactions with colleagues and team members. So, how do healthcare professionals communicate with each other without getting “hooked negatively” when there is an issue that needs to be addressed? How do they deal with conflict to be able to take care of their patients safely and effectively?
Through a series of presentations on Wednesday, March 25, Sara Kim, PhD, Sarah Shannon, PhD, RN and special guest, Chuck Pratt, discussed how conflicts originate, how they escalate and what practical approaches can be used to effectively address conflict in the workplace. More than 70 UW Medical Center providers, UW Health Sciences faculty, students and administrators attended the presentations and many of the attendees had the opportunity to practice these skills in small groups after the presentations. The presentations and small group sessions were sponsored in part by the UW Institute for Simulation and Interprofessional Studies and the UW Center for Health Sciences Interprofessional Education, Research and Practice.
Dr. Sarah Shannon, Associate Professor in the UW Department of Biobehavioral Nursing and Health Systems and Ethics Consultant at UWMC, and Dr. Sara Kim, the Director of Educational Innovations and Strategic Programs at the UW Institute for Simulation and Interprofessional Studies (ISIS) and Associate Director of the Center for Medical Education presented, “From Conflict to Common Goals: A Blueprint for Planning Difficult Conversations.”
Dr. Kim began with an eye-opening look at what workplace conflict is, where it comes from and what it means for healthcare – how it affects the flow of work and, ultimately, the quality and safety of care provided to patients. Dr. Shannon followed with an outline of different types of conflict and how to address each of them in the workplace using different tools. Dr. Shannon explained how task-based conflicts, which usually begin with issues such as resource constraints or simple miscommunications can be addressed by “finding your voice”. Tools such as CUS (I’m Concerned, I’m Uncomfortable, it’s a patient Safety issue), the Two Challenge Rule or checklists are helpful.
Relationship-based conflicts, which stem from the “fundamental attributional error” need to be addressed differently. If not addressed, these can escalate into disruptive behavior, the third type of conflict. Dr. Shannon explained that the fundamental attributional error occurs when we ascribe contextual reasons for our own behavior while attributing others’ behavior to negative personality traits. She elaborates, “If I tripped right now, it’s because the carpet wasn’t laid down well. If you trip, it’s because you’re clumsy.” Overcoming this fundamental attributional error is key to addressing relationship-based conflict.
Dr. Shannon shared a four step strategy she and colleagues have been developing over the last ten years to build “Entrenched Conflict Skills”: 1) Get ready, 2) Create Space, 3) Do the Work, 4) Close and Affirm. Click here to view the teaching model. To get ready, she recommends that rather than rehearsing a negative response we instead adopt a respectful, curious attitude. “I wonder what I don’t know about this situation.” Create space with a neutral start and a mutual goal. Ask the other person if s/he has time to talk about the issue and arrange a time and place to discuss it. Once you’ve agreed to discuss the issue, begin doing the work by listening and asking questions to find out from the other person’s perspective what was going on. Keep asking questions until you’ve heard the other person’s story. This doesn’t take long and it releases a lot of the tension when we allow people to express what they believe to be the problem. Then, it’s important to share your story. Be clear about what happened from your perspective and what you believe to be the problem. Dr. Shannon makes it clear that “your story is not ‘you’re wrong’.” She cautions that using statements of moral superiority are a threat to making progress. Statements like “as the patient’s advocate” or “it’s my name that’ll be on that order” can be polarizing. If the other person makes a statement like this, Dr. Shannon urges, “Let it lay. Let it be. Do not react in kind.” To close and affirm, first negotiate the next step. This could be agreeing to talk again. Then, it’s important to affirm your professional relationship. “You don’t have to like someone to work with them, but you have to communicate with them in our complex organizational structures,” Dr. Shannon states. Thank the other person for taking the time to have the conversation and affirm that you are working towards a mutual goal.
Special guest speaker, Chuck Pratt, presented “Promoting Dialogue: Compassionate Listening Skills for Building Professional Relationships.
Mr. Pratt is a member of the University Consulting Alliance, a pool of more than 50 independent consultants with a variety of specialties and experience who serve as resources for the UW. He specializes in leadership development, teambuilding, conflict management, coaching, interpersonal skills training, group facilitation, emotional intelligence, and dialogue.
“Human beings are psychological and emotional creatures and the neuroscience research is very compelling that we make our decisions emotionally and then use logic to sell them,” says Mr. Pratt. Using Marshall Rosenberg’s model for Nonviolent Communication, he explains that as humans, we all share the same basic needs and the actions we take are to meet our needs. Our feelings indicate if our needs are being met and negative emotion is the expression of an unmet need. Rosenberg’s Model has four parts: 1) what we are observing, 2) what we are feeling, 3) what we are needing, and 4) requesting what we need. Focusing on the other person’s unmet need(s) prevents taking it personally or getting hooked negatively. It’s not an easy thing to do, he says.
Explaining that the body reacts the same way to psychological threats as to physical threats, triggering the fight or flight response, Mr. Pratt suggests using the SCARF Model to understand why. Developed by David Rock as a framework for understanding psychological threats, the SCARF is an acronym for Status, Certainty, Autonomy, Relatedness, and Fairness. Mr. Pratt sums up David Rock’s suggestions for preventing the perception of a psychological threat like this,“If you tell people what to do, you’re doomed to fail. You have to ask questions to train their brain to think the way they need to think so they can solve the problem for themselves. Then, you’re going to be much more successful at getting people to do the things you think they need to do.”
After the presentations, 38 attendees participated in one of three small group sessions where they had the opportunity to practice the skills. Facilitators included Dr. Kim and Dr. Shannon, along with Susan Marshall, MD, Professor of Pediatrics and Director of Medical Education at Seattle Children’s Hospital; Janet Powell, PhD, OTR/L, FAOTA, Associate Professor and Head of the Division of Occupational Therapy in the UW Department of Rehabilitation Medicine; and Mayumi Willgerodt, PhD, MPH, Professor of Nursing and Health Studies at UW Bothell. Participants sat in a semicircle facing two seats. In one seat sat a trained actor and in the other, the “hot seat”, participants could practice face-to-face interactions with the actor. In the scenario, the actor portrayed a healthcare employee who did not take one last blood pressure for a patient prior to discharge. The supervisor, played in turns by the participants, needed to address this with the employee. When a participant in the “hot seat” struggled with what to say to the actor or asked for advice, the other participants could offer suggestions.
Participants were asked to evaluate the presentations and the small group sessions and their responses were overwhelmingly positive.
- “The framing and format was great! Very participatory.”
- “I am thankful we were given concrete things to say and adapt.”
- “I enjoyed the role playing practice. Practice takes the mechanical response away and increases the more natural response.”
Drs. Shannon and Kim have previously led workshops utilizing their teaching model and simulated face-to-face interactions with actors and will continue to lead more for faculty, staff, care providers and educators. Dr. Kim commented that, “At every workshop I learn something new about my own communication style and the importance of communication training around conflict for individuals and for our organization.” Dr. Shannon shared, “These workshops are a wonderful opportunity to provide intensive, interactive and fun communication training around a topic that usually is quite stressful for people.”
The IHI West Coast Region Conference has recently opened for registration. This is the first ever IHI conference on the west coast! The conference will take place on Friday, April 17 - Saturday, April 18 in Portland, OR. Tickets are a refundable $35 and scholarships are available to help cover the cost of travel and lodging.
Please see this link (http://www.psuohsuihi.org/general-information/) for speaker information and the registration portal.
Several members of the UW IHI Exec team will be attendance and we hope to see you there!
Ira Kantrowitz-Gordon, PhD, CNM, assistant professor in Family and Child Nursing specializing in Midwifery and Women’s Health, and colleagues recently received funding for an Interprofessional Oral-Systemic Health Curricular Innovation Development project from the New York University College of Nursing’s Oral Health Nursing Education and Practice (OHNEP) initiative. Dr. Kantrowitz-Gordon will lead the project along with colleagues Amy Kim, DDS, and Donald Chi, DDS, PhD from the School of Dentistry, and Mayumi Willgerodt, PhD, MPH from the School of Nursing at the Bothell campus. All four have been involved in a variety of interprofessional education initiatives at the University of Washington aimed at building collaborative skills and meeting the Core Competencies for Interprofessional Collaborative Practice (Interprofessional Education Collaborative, 2011).
Early childhood caries is the most common disease among children ages 1–3, occurring in approximately 1 out of 4 children, disproportionately impacting socioeconomically disadvantaged and minority populations. Working together, nurse-midwifery and dental students will gain competency in content from Smiles for Life modules on pregnant and child oral health, interprofessional practice, and presentation of health information to public audiences through an interprofessional practice experience for the benefit of patients and their own health care practices. Utilizing CenteringPregnancy (Centering Healthcare Institute, Silver Spring, MD), an evidence-based model for group prenatal care, pairs of nurse-midwifery and dental students will present a structured and interactive presentation to families at a CenteringPregnancy session. Students will present content regarding self-care during pregnancy and postpartum as well as important oral health information for the care of the future infant.
After participation in this activity, pregnant women and their families will have increased knowledge of strategies to maintain oral health during pregnancy and early childhood and an increased likelihood of identifying a dental home for the family and initiating dental care by 12 months of age. These outcomes are important first steps towards achieving improved oral health during pregnancy and early childhood.
On November 1, 2014, the Zoobiquity 2014 conference was held at the University of Washington and the Woodland Park Zoo. The conference theme was “Human and animal health in a changing global environment.” Human and animal health professionals participated in lecture-style case presentations and interactive discussions as well as in “Walking Rounds” at the Woodland Park Zoo on topics ranging from diagnosis and treatment of obesity in humans and their pets to Ebola to management of arthritis pain in humans and gorillas. Much of the dialogue focused on the concept of “One Health” which was recently described in an IPE Faculty Feature on Dr. Peter Rabinowitz, MD, MPH, the founder of the newly launched Center for One Health Research in the UW School of Public Health Department of Environmental and Occupational Health Sciences. The next U.S. Zoobiquity conference will be held in Boston, MA in April 2015.
- Registering for winter quarter?
- Do you need a one-credit elective?
- Are you interested in community organizing and health equity?
- Do you care about farmworker justice and health?
This winter, there will be two courses offered to all health sciences students that focus on health equity, social justice, and community based learning and action: the common book course, UCONJ 532, and health equity and community organizing, UCONJ 624. Please see attached fliers and read below:
UCONJ 523: Making Science Public: Improving Farmworker Health through Community-Engaged Research and Storytelling
This year’s common book Fresh Fruit, Broken Bodies by Seth Holmes, opens up important discussions on topics like structural violence, farmworker justice, and how we can participate in proactive responses that improve farmworker health. Through this course, health science students will engage in collaborative community-based projects that will reduce the harm of groundwater toxins, which is an ongoing issue facing communities in the Yakima Valley. This course meets six Monday evenings over the course of the quarter (5:30-7:20) and will include a day-trip to Yakima (TBD). This visit to Yakima will include a tour of a Confined Animal Feeding Operation (a major source of groundwater contamination) and an opportunity to meet local community activists who are working on this issue. Email Kelsen Caldwell email@example.com for more information or to request an add code.
UCONJ 624: Health Equity and Community Organizing
The second course, health equity and community organizing (UCONJ 624) will be taught in collaboration with Sound Alliance and will help students to learn the skills to develop effective, winnable community organizing campaigns that produce greater health equity. The goal of this course is for students to be able to work upstream to address the social determinants of health—so we don’t have to keep doing direct service and charity forever without ever addressing the reason why needs exist in the first place. The course meets Thursdays (from 5:30-7:20) and the bulk of the coursework is oriented toward actually getting involved in a Health Equity Circle campaign so you can apply your new skills and frameworks. If you’re interested, you can email David Fernando firstname.lastname@example.org for more information or to request an add code.
On Thursday, October 9th, students from the UW Chapter of the Institute for Healthcare Improvement (IHI) Open School gathered for the 2014 Fall Symposium event. There was a diverse attendance from the schools of pharmacy, health administration, medicine, and business. The evening began with a brief presentation from all the members of the IHI leadership team who spoke about the mission and vision of IHI, ways to get involved, opportunities for learning, and some information regarding prior events.
Then, participants transitioned to the specific "teddy bear surgery" learning activity where interprofessional student teams worked on a hypothetical patient case called, "Teddy". Teams went through a set of challenging and mistake ridden surgery instructions that demonstrated the importance of clear communication and interprofessional collaboration. Important takeaways included the ease of making a mistake in a surgical environment, the importance of double checking patient information, and the clear definition of roles and responsibilities. At the conclusion of the activity, IHI leadership hosted a Q&A session to discuss specific learnings and the importance of quality improvement in healthcare.
A couple of participants shared personal experiences. One student shared a story about speaking up in the OR when she was just observing and it played a role in preventing a wrong site surgery from moving forward. Another student shared a story about how she assisted in completing a post-surgery instrument count and how her willingness to speak up about noticing an obscured instrument likely prevented the patient from having to go through an X-ray to find it.
Participants said the event actually forced them to think about and appreciate the importance of surgical time outs and constant double checks due to human error. They also appreciated the notion of how easy it was to make mistake even down to making sure the right patient is on the table, among many others.
Contributed by Sergio Vincenti, IHI Open School-UW Chapter, VP of Marketing and Communications
Congratulations to UW IPE Faculty Scholar Brenda Zierler, PhD, RN, FAAN on receiving the 2014 Leadership Award from the Betty Irene Moore School of Nursing at UC Davis on Tuesday, September 22! UC Davis School of Nursing Dean Heather Young shared that "Dr. Zierler has worked with both the School of Nursing and the School of Medicine to help us identify how we can improve our curriculum so that students are exposed to more interprofessional opportunities throughout their education." To read the full article from the Betty Irene Moore School of Nursing news webpage, click here.
Opportunities for students to increase knowledge about reducing medical errors and improving patient care in interprofessional settings, especially in cases when cultures clash. The kick-off meeting is at Rotunda (Magnuson Health Sciences Center) from 5:30pm to 8:00pm on Wednesday, October 3, 2012. Please come join us for the keynote addressed by Dr. Noel Chrisman, Professor of Psychosocial & Pommunity Health in the School of Nursing. Dinner will be provided!
Upcoming Discussion Sessions:
- 2012/10/16 5:00-7:00PM
School of Social Work Building, Room 305 AB (Hosted by School of Social Work & School of Nursing)
- 2012/10/22 11:00AM-1:00PM
Health Sciences Building, Room H105 (Hosted by School of Medex & School of Pharmacy)
- 2012/11/15 5:00-7:00PM
Health Sciences Building, Room T661 (Hosted by School of Dentistry & School of Rehab Medicine)
- 2012/11/27 5:00-7:00PM
Health Sciences Building, Room T553 (Hosted by School of Medicine & School of Public Health)
UW Oral health PhD candidate Wenjie Li has formed a UW School of Dentistry team to participate in the annual 26-mile Rock and Roll Marathon on June 22 to raise funds to support a community outreach program that promotes oral health for women and children in need. Anyone interested in participating in either the marathon or the half-marathon is cordially invited to join the team.
The marathon begins at 7:00am at the Seattle Center. Participants of this team will not only be supporting oral heath, but they will also be experiencing beautiful scenery, live local bands, spirited cheer squads and other benefits along the way.
For more information about joining the UW School of Dentistry in this cause, please contact either Wenjii Li (email@example.com) or Heidi Sarff (firstname.lastname@example.org).
Donations for the event are also welcome. Please visit this site to make a donation.
On May 4th and June 8th, a free “Nursing Simulation Instructor Course” will be hosted by The Community Health Education and Simulation Center, Northwest Hospital and Medical Center, and UW Medicine. This opportunity allows participants to spend a full day gaining beneficial learning experience from simulation experts. The objectives of this course are to:
1. 1. Discuss integrating simulation into curriculum
2. 2. Demonstrate debriefing methods
3. 3. Discuss steps to scenario development
4. 4. Identify equipment needs for scenario
5. 5. Develop and debrief a simulation scenario
Not only will participating students receive valuable training and a free lunch, but they will also earn 7 contact hours for continuing education credit. Registration is on a first-serve basis so be sure to sign up as soon as possible.
Congratulations to Erin Abu-Rish Blakeney, RN, PhD-C for being announced the 2012 Baldwin Award Winner for being lead author on the manuscript titled “Current trends in interprofessional education of health sciences students: a literature review.”
According to the Journal of Interprofessional Care Editor-In-Chief Scott Reeves, her IPE literature review is recognized as “research that will have the most influential impact on interprofessional education, research, or practice.” This paper was carefully selected by a panel of judges at the Journal of Interprofessional Care because it ‘not only makes a significant contribution to IPE literature but will also provoke questions and critiques, and will have a lasting value.’”
Special thanks to everyone who collaborated on this project: Sara Kim, Lapio Choe, Lara Varpio, Andrew White, Karen Craddick, Katherine Blondon, Lynne Robins, Pamela Nagasawa, Elisabeth Malik, Lee-Ling Chen, Allison Thigpen, Joanne Rich, and Brenda Zierler.
IPE Initiative Emphasizes Health Care Collaboration
by A. Jion Kim
Reprinted from The Daily
Early last month, nearly 600 students in the UW’s six health sciences schools — dentistry, medicine, nursing, pharmacy, public health, and social work — formed teams and discussed the fictitious case of patient “Gregory,” a 31-year-old male seen in the UW Dental Urgent Care Clinic for tooth pain. Each team generated ideas for the best methods of treatment, as well as ways to increase patient compliance and address possible barriers to Gregory’s health care.
The activity, “Providing Care Across Settings,” is the second in the seven-session series of the new Foundations of Interprofessional Practice (FIP)- — a year-long pilot curriculum emphasizing solving real health challenges in collaborative teams. FIP was established through the new Interprofessional Education (IPE) Initiative: Vision for a Collaborative Future, a team-based approach to teaching and delivering health care, which was launched last year.
While the IPE Initiative is new, interprofessional education has been a part of the UW for decades. Dr. Brenda Zierler, the Inaugural UW Health Sciences IPE Faculty Scholar and professor of biobehavioral nursing and health systems, said interprofessional education in the health-related fields has been ongoing since 1997. It was formally funded in 2000 from a University Initiatives Fund grant from the provost, with the establishment of the Center for Health Science Interprofessional Education under founding director Dr. Pamela Mitchell.
“The new initiative is based on a vision of the current health science deans, new accreditation standards and health care reform,” Zierler said. She is the principal investigator on the grants from the U.S. Health Resources and Services Administration and Josiah Macy Jr. Foundation, which were instrumental in funding the early IPE activities and faculty development for IPE.
The deans of the pharmacy, public health, and nursing schools are relatively new, and Dr. Joel Berg was selected as the dean of the School of Dentistry in 2012. Despite the turnover in positions, all six health sciences deans quickly united in throwing their support behind the initiative.
“The fact that we have six deans working together because they believe in this concept shows great leadership,” Zierler said. “We couldn’t do this without them. They’re modeling the behavior we’re trying to teach.”
Zierler said a key goal of the initiative is to address the Institute for Healthcare Improvement’s (IHI) Triple Aim. The IHI is an independent, not-for-profit organization that advocates health care improvement worldwide through the “triple aim”: improving the patient experience of care, improving the health of populations, and reducing the cost of health care.
Another purpose of the IPE Initiative is to keep up with the changes in the health care field. As a member of the IPE envisioning committee the past year, Zierler examined trends in health care both nationally and internationally and worked with fellow committee members to create a vision for the initiative.
“[The IPE Initiative] is a reflection of the way the delivery of health care is changing, in going from a much more siloed, compartmentalized mode of health care to one which is really based on the provision of team participation, essentially,” School of Pharmacy Dean Dr. Thomas Baillie said. “The interprofessional education initiative is a way … to make students more familiar with the concerns and activities of colleagues in other health sciences schools to promote more of a team approach.”
The health sciences students will be obtaining part of their interprofessional training through the seven sessions of the FIP curriculum. An interdisciplinary team of health sciences faculty designed each session to focus on at least one of four core competencies: values and ethics for interprofessional practice, roles and responsibilities, interprofessional communication, and teams and teamwork.
“As health practices become increasingly interdisciplinary, the IPE curriculum is giving students a framework and the skills to actually use in practice,” said assistant professor of social work Megan Moore, who was involved in the IPE curriculum planning. “The IPE goal is really to teach students from different professions how to work together to achieve excellent patient outcomes and deliver high quality care.”
The seven sessions are spread out over the course of the academic year.
The IPE Initiative will extend beyond the FIP curriculum. The bigger goal, Baillie said, is to gradually introduce interprofessional courses to students in all six health sciences schools over a period of time.
“All health care professionals are involved in working with other health care professionals,” said Dr. Paul Ramsey, the dean of the School of Medicine. “Even, for example, a doctor or family physician in a very small town … will still be interacting with nurses and physician assistants and pharmacists and dentists … so regardless of the nature of the practice — whether it is in private practice or an academic setting of a teaching hospital like Harborview — all health professionals work in teams now.”
Reach Special Sections Editor A. Jion Kim at email@example.com. Twitter: @AJionKim
The IHI Open School- UW Chapter kicked off Spring quarter on Thursday, April 3rd, with an interprofessional “Speed Networking” event. Students gathered at Mod Pizza on University Avenue for an opportunity to get to know their peers in the different health science professions. Similar to “speed dating”, students were split into pairs to “speed network.” In order to help elicit conversation between the pairs, students were provided a list of questions to refer to. Sample questions included:
1. How long is your program and what does it entail? Are there internship, fellowship, residency, etc. opportunities?
2. How did you choose your program and what do you want to do in the future? What about this career appeals to you?
3. What are some pros and cons for careers in your field?
4. Why did you join IHI and what do you hope to gain as a member of the IHI chapter?
5. In what ways do professionals in your field interact with other healthcare professionals?
After getting to know each other, the pairs were split again and each person was matched up with someone new. Over the course of the evening, all of the participants got the opportunity to chat and network with everyone who attended. During the event, students commented on how the setup was an excellent way to learn more about their peers and other disciplines. A special thanks to the IHI Open School regional organization for providing funding for pizza and beverages.
For the fifth year in a row, the University of Washington hosted healthcare professional students for a week of immersive team-training simulation in the areas of Adult, Pediatric and OB/GYN Acute Care. The innovative Team-Based Interprofessional Training Simulations (TeamBITS) program allows students who typically train in specialty-specific environments to practice their skills together as they would in a real-world setting. Over four days, from May 19–22, 352 students came together from the Schools of Medicine (180 students), Nursing (123 BSN students), and Pharmacy (49 students) to participate in a total of 13 four-hour team training sessions at ISIS Simulation Centers at Harborview Medical Center and the University of Washington Medical Center.
During the course of a team-training session, students have opportunities to discuss care options with simulated patients and their families (played by actors) and other health professionals participating in the simulation, voice concerns and make decisions in “real time”. Then, students and faculty debrief at the conclusion of the session. Faculty ask for feedback, “What went well? What could have gone better? How realistic was the scenario? How could we have provided a better/more relevant/more realistic experience?” Students overwhelmingly gave positive responses to their experiences.
“Very useful skills! I didn't realize the deficits in my knowledge of each person’s roles until we started working as a team—this will help me so much in future,” said a medical student.
“This type of IPE was the most useful of all and this should be done multiple times,” shared a pharmacy student.
Said another medical student, “I feel that I haven't had much exposure [up] to this point and feel it's an important piece of medical education. It would be wonderful to do this earlier in our curriculum and several times, as opposed to just this one time.”
A nursing student shared, “Excellent prep for interprofessional settings. I think this is so important for us about to graduate.”
In response to the need for effective communication training for health professions students, the University of Washington received funding in 2008 from the Josiah Macy Jr. Foundation and Hearst Foundation (over $1 million) to develop an interprofessional curriculum for healthcare professional students based on the Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) model of effective communication (Project Co-PIs: Dr. Brenda Zierler, PhD, RN, FAAN and Dr. Brian Ross, PhD, MD). Since this time, faculty and other representatives from the UW Schools of Medicine, Nursing, Pharmacy and MEDEX (Physician’s Assistant) program have developed a truly interprofessional training curriculum for these students. Led by the efforts of Dr. Brian Ross, PhD, MD, Karen McDonough, MD, and Dr. Brenda Zierler, PhD, RN, FAAN, and additionally supported by faculty and staff from Harborview Medical Center, University of Washington Medical Center and Health Sciences Schools, and Seattle Children’s Hospital, the resulting experience combines both clinical practice and team skills in a simulated training environment. The goal of this training program is to promote high-quality, patient-centered healthcare by training healthcare professionals to communicate more effectively with each other and with patients during challenging clinical situations. This format of interprofessional education is quickly becoming a model for healthcare professional training across the country.
University of Washington IPE faculty member Brenda Zierler from the School of Nursing and Leslie Hall from the University of Missouri School of Medicine published an introductory guide to IPE faculty development for facilitation of IPE and collaborative care training in the August issue of the Journal of Interprofessional Care. The need for IPE and collaborative care training experiences for health professions students is increasing as more health professions schools are required to incorporate IPE training into curriculum to meet national accreditation standards. In turn, the need for faculty training in IPE and collaborative care facilitation is increasing.
Hall and Zierler’s guide focuses on strategies for developing faculty to effectively facilitate IPE using a series of didactic presentations, small group activities, and immersion experiences with direct involvement in IPE facilitation to build interprofessional leadership skills. Click here to read their full article.