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2017 SPECIFIC CAA IPE STANDARDS5. Collaborative Practice: Understand how to apply values and principles ofinterprofessional team dynamics Understand how to perform effectively in different IP teamroles to plan and deliver care that is safe, timely, efficient,effective and equitable

WHAT TO TEACH? Team building skills, leadership Knowledge of professions and availability Patient-centered care Impact of culture and environment Communication(Bridges, Davidson, et al.)

EXAMPLES OF IPE OPPORTUNITIES FORCURRICULAR INTEGRATIONNeurogenic, Swallowing Disorders, Aphasia, Dementia, TBINeurologyPharmacyNursingNeurosurgeryPhysical TherapyNutrition/DietaryMedical imagingRehabilitationMusic TherapyRadiologyOccupational TherapyRespiratory therapyNeuropsychologyArt therapySocial work

CURRICULAR INTEGRATIONEducation:TeachersPsychologistsSchool aidesAdministrative SupportAdministratorsReading specialistsSchool nursesSecurityChild Language/Autism/PhonologyPediatric neurologyDevelopmental gy

CURRICULAR INTEGRATIONCleft Palate, Voice, Resonance, Cerebral Palsy:Plastic surgeryGeneticsOrthodonticsAAC l Surgery

CRITICAL RESOURCES FOR A SUCCESSFULIPE PROGRAM Commitment from departments and colleges Diverse calendar agreement Curricular mapping Mentor and faculty training Sense of community Adequate physical space Technology Community relationships

EMERGING APPROACHES FOR IPE Team-based experiences, shared practica or observations,online discussions and activities, health mentoring. Promote “generic outcomes”: Learning of knowledge, skills orattitudes where IPE adds value via collaboration Designed experiences: Deliberate and coordinated planning,organizational home, curricular placement, administrativeresponsibility(Johnson, A., Prelock, P. & Apel, K. 2016)

RECOMMENDATIONS FOR BEST PRACTICESIN IPESummarized from 7 sources: Need for administrative support Interprofessional programmatic infrastructure Committed faculty Recognition of student participation(Bridges, et al.)

SOMETHING TO CONSIDER“There is no single way to provideinterprofessional education (IPE) nor is there asingle way to measure outcome”(DiGiovanni, J. and McCarthy, J., IPE 102)

EVALUATING SLP STUDENT OUTCOMES Learning from other disciplines Value of IPE as clinical skill Create change via experience Realize outcome benefits N 45

KNOWLEDGE GAINED FROM OTHERDISCIPLINES96% yesExamples:PA, OT, PT scope of practiceNutrition can affect outcomesIntricacies of discharge planningCollaboration in hospitals/home careImportance of social workMedication use, side effects, pain management

IMPROVING KNOWLEDGE AND SKILLS ASCLINICIAN100% yesExamples:Self-confidence, comfort levelFlexibilityCollaboration, communicationRole responsibilities, view modification

CHANGE VIEW AS CLINICIAN?91% yesExamples: Feeling of importance, role validation Respect, professionalism More knowledge than aware of Respect for expertise

VALUE OF IPP IN CASE MANAGEMENTPLANNING100% yesExamples:Importance to patient care, collaborationListening, contributing, consensus buildingEssential for maximizing efficiencySee patient as wholeIncreased awareness of details

ARE YOU MORE CONFIDENT?100% yesExamples: Greater self-confidence Able to contribute Role/views/suggestions respected Validation of knowledge

TOURO IPE MODEL AND SUCCESSFULPROGRAMMING Commitment, administrative support Curriculum mapping and placement Calendar agreement Faculty training, coordinated planning Space, community, technology Student recognition

Development andimplementation ofInterprofessional Educationinvolving all programs withinthe Touro College SHS

BEGINNER STEPSA COMMITTEE IS FORMED Informal planning began during thecourse of meetings with the programschairs/directors of the Manhattancampus. Sept 2013 Chairs tasked by the SHS Deanto appoint a representative of his/herhealth science program to thecommittee Objective-to explore ways to integrateIPE into our SHS ECHAIR)PTChairOTFacultySpeechFaculty

IPE COMMITTEE MEETS OCT 2013- first meeting Determined which IPEC competencies to address Examined what types of things were being doneelsewhere Identified topics that would be suitable for IPE/ relevantto all healthcare professionals Idea exchange including simulation, case studies,community based engagement

IPE COMMITTEE CHALLENGES

IPE COMMITTEE CHALLENGESChose students in their final year, by invitation only.10/program

IPE COMMITTEE CHALLENGESChose students in their final year, by invitation only.10/programProfessional space outside of the classroom

IPE COMMITTEE CHALLENGESChose students in their final year, by invitation only.10/programProfessional space outside of the classroomFound a common free time for most programs thefollowing October

IPE COMMITTEE CHALLENGESChose students in their final year, by invitation only.10/programProfessional space outside of the classroomFound a common free time for most programs thefollowing OctoberDean “found” 3000 to support this initiative

IPE COMMITTEE CHALLENGESChose students in their final year, by invitation only.10/programProfessional space outside of the classroomFound a common free time for most programs thefollowing OctoberDean “found” 3000 to support this initiativeSelected Quality improvement (QI) as the overarchingtheme - especially during transitions of care

st1 annual Touro SHSInterprofessional symposium:Healthcare QualityHow Quality Improvement (QI) is utilized byInterprofessional healthcare teams in a variety ofsettings

QUALITY IMPROVEMENT (QI) By examining what is done and how it is done in the healthcaresetting; reviewing the steps, who performs each step, and howefficiently the process works, improvement can be achieved. QI improves outcomes for patients and healthcare workers,reduces errors, improves efficiency and enhancescommunication between patients, providers and third partypayers. It can and should take place in all health care settings - includingemergency medical services; inpatient and outpatient units ofhospitals; nursing facilities; home care; and outpatient facilities

DEVELOPMENT OF THE PATIENT CASE The IPE committee developed the patient case as a team(Enlightening!) Patient case needed to be realistic have relevance to all the professions-OT OTA PT PA RN andSLP allow the patient to move through each of the followinghealthcare settings-acute care, rehab, SNF, and homecare toemphasize the QI aspect of care

DEVELOPMENT OF THE PATIENT CASE 58 yo male s/p MVA with PMH of substance abuse. TBI with frontal lobe abnormalities including Dysphagia;impulse control deficits; aggression; irritability; memory deficits Femoral neck injury requiring THA Pharmaceutical salesman Sole source of income for his family. Primary caretaker of his mother who has late stage Alzheimer’sdisease and is in a SNF

1ST ANNUAL INTERPROFESSIONALEDUCATION SYMPOSIUM Borrowed a small auditorium at Beth IsraelMedical Center (through a favor) with max seatingfor 70 Planned an afternoon program

1ST ANNUAL INTERPROFESSIONALEDUCATION SYMPOSIUMSCHEDULE:1-1:30 check in1:30 – 2:30 Panel2:30 – 3:15 Break out3:15 – 3:30 Refreshments3:30– 4:00 Wrap up4:00 – 4:30 evaluations andcertificates

1ST INTERPROFESSIONAL EDUCATIONSYMPOSIUM1-1:30 CHECK IN19 faculty and 45 students in attendanceAll faculty came 30 minutes early and werebriefed about the case and provided a guidewith questions to facilitate the discussion.

1ST INTERPROFESSIONAL EDUCATIONSYMPOSIUM1:30-2:30 PANELModerated panel of invited healthcare professionals fromeach discipline discussed health care QI in their settings,described their roles, and answered questions from theaudience.

1ST INTERPROFESSIONAL EDUCATIONSYMPOSIUM2:30 – 3:15 BREAK OUT Multidisciplinary break-outgroups followed a hypotheticalpatient through various practicesettings with patient care and QIchallenges. Students familiarizedthemselves with the case, thendiscussion lasted for about 45minutes. One person was scribe.

1ST INTERPROFESSIONAL EDUCATIONSYMPOSIUM2:30 – 3:15 BREAK OUT What are this patients’ current quality concerns? What is each discipline’s role in optimizing safety andoutcomes? How could the compromised care issues of this casehave been avoided? In anticipation of care-transition, what would you do tolimit further complications and optimize qualityoutcomes?

SETTING I- INPATIENT/ACUTE CARE Patient was admitted through the ER, receivedTHA surgery five days ago. D/C scheduled fortomorrow.Current concerns: Infection – Pneumonia Found out-of-bed on the floor

SETTING II- INPATIENT REHABPatient was admitted through the ER, received THA surgery five daysbefore D/C from acute floor, current in-patient rehabilitation stay has beenthree weeks. D/C scheduled for tomorrow. Current concerns: Non-compliant with hip precautions Pain management/control compromised Dysphagia diet Unable to navigate steps safely

SETTING III- SNFPatient was admitted through the ER, received THA surgery fivedays after admission. Spent three weeks on an in-patient rehabunit, has been in this SNF for 19 days, scheduled for D/Ctomorrow. Current concerns: Pressure ulcerOff all pain medsModified dysphagia dietAble to navigate stepsUnsafe in the bathroomSignificant financial management concernsPlanter flexor contractureNoted signs of depression

SETTING IV- HOME CAREPatient was admitted through the ER, received THR surgery five days afteradmission. Spent three weeks on an in-patient rehab unit, has been in a SNFfor 20 days, and has now been home for two weeks.Current concerns: RN coming 3x/wk for wound management (pressure ulcer) OT has not started yet, it was not prescribed PT coming 5x/wk SLP has been requested for evaluation secondary tonoted inappropriate food Patient has lost access-a-ride due to non-compliance with rules Unable to transport to see PA Self-medicating pain and depression

1ST INTERPROFESSIONAL EDUCATIONSYMPOSIUM2:30 – 3:15 BREAK OUT What are this patients’ current quality concerns? What is each discipline’s role in optimizing safety andoutcomes? How could the compromised care issues of this casehave been avoided? In anticipation of care-transition, what would you do tolimit further complications and optimize qualityoutcomes?

1ST INTERPROFESSIONAL EDUCATIONSYMPOSIUM3:15-3:30 REFRESHMENTS

1ST INTERPROFESSIONAL EDUCATIONSYMPOSIUM3:30 – 4:00 GROUP REPORTSGroups reportedtheir finding to thelarger group

OUTCOMESStatement1. The moderator was interactive and knowledgeable.2. The wrap up was relevant to the session.3. The panelists were engaging and knowledgeable.4. The panelists' information was helpful to my learning.4.6666674.3888894.6666674.3333335. The break-out session was helpful to my learning.4.6666676. The break-out session reports were helpful to my learning.4.2222227. The facility was confortable.4.6111118. The topic was relevant to my clincial experiences so far.4.2777789. My impression of the program is favorable.4.588235

OUTCOMES What is one thing you learned from attending thisevent? importance of team approach to quality care delivery; awareness of overlappingteam functions; health professions students are knowledgeable of their discipline;enhanced familiarity with other disciplines; importance of interdisciplinarycommunication to clients/patients.Please write any other comments or recommendations. Very enjoyable; would like collaboration with social workers/nutritionists; smallerbreakout groups; provision of role/responsibility list for healthcare team.

BUDGET 3,000 (food & gifts for panelists)

PROS AND CONS OF 1ST IPE SYMPOSIUMPROS Got the conversation started Students did explain their role on theinterprofessional team (but not as well asthey could have due to lack of advancedpreparation or exposure to the case) Students did learn about the roles andresponsibilities of other team membersbut not as well as they could have ( asabove) Lots of conversation and opportunities forcollaboration with faculty from otherprogramsCONS

PROS AND CONS OF 1ST IPE SYMPOSIUMPROS Got the conversation started Students did explain their role on theinterprofessional team (but not as well asthey could have due to lack of advancedpreparation or exposure to the case) Students did learn about the roles andresponsibilities of other team membersbut not as well as they could have ( asabove) Lots of conversation and opportunities forcollaboration with faculty from otherprogramsCONS Limitation of space so only 10 studentsper program benefitted Poor faculty prep Poor student prep Panel, though interesting, was long Break out sessions were too short Group reporting at the end lostpeople’s attention and wasn’t verybeneficial Survey did not assess IPECcompetencies well

OUTCOMESStatement1. The moderator was interactive and knowledgeable.2. The wrap up was relevant to the session.3. The panelists were engaging and knowledgeable.4. The panelists' information was helpful to my learning.4.6666674.3888894.6666674.3333335. The break-out session was helpful to my learning.4.6666676. The break-out session reports were helpful to my learning.4.2222227. The facility was confortable.4.6111118. The topic was relevant to my clincial experiences so far.4.2777789. My impression of the program is favorable.4.588235

PLANNING FOR THE FUTUREWishlist Include as many students aspossible More time for collaboration Better student preparation Add curricular integration piece Better faculty facilitator prep andfaculty buy-in Consider including moreprofessionsNeeds Bigger Space Longer program Bigger budget for spaceand for food More formal curricularintegration and facultytraining

IPE COMMITTEE CHALLENGES

IPE COMMITTEE CHALLENGESNew IPE symposium would include all students in theirfinal year of study ( 350 students)

IPE COMMITTEE CHALLENGESNew IPE symposium would include all students in theirfinal year of study ( 350 students)Professional space outside of the classroom big enoughto hold 350 students and 40 faculty

IPE COMMITTEE CHALLENGESNew IPE symposium would include all students in theirfinal year of study ( 350 students)Professional space outside of the classroom big enoughto hold 350 students and 40 facultyFound a common free time in March where all studentscould attend. Also identified a course in everyone'sprogram to integrate the patient case

IPE COMMITTEE CHALLENGESNew IPE symposium would include all students in theirfinal year of study ( 350 students)Professional space outside of the classroom big enoughto hold 350 students and 40 facultyFound a common free time in March where all studentscould attend. Also identified a course in everyone'sprogram to integrate the patient case 10.000 to support this initiative

IPE COMMITTEE CHALLENGESNew IPE symposium would include all students in theirfinal year of study ( 350 students)Professional space outside of the classroom big enoughto hold 350 students and 40 facultyFound a common free time in March where all studentscould attend. Also identified a course in everyone'sprogram to integrate the patient case 10.000 to support this initiativeSee next slide

nd2 annual Touro SHSInterprofessional symposium:Destination: HOMEFocus on Interprofessional collaboration to achieve safeand stable transitions for patients into their communitiesfrom healthcare settings

BACK TO THE DRAWING BOARD IPE Committee developed a case requiring carefrom all the professions in our SHS again.

MEET ROBERTO ALVAREZ51-year-old male admitted to rehabilitation hospital s/p left CVAwith right hemiparesis which occurred four weeks ago. Chiefcomplaint is inability to control right side and inability to speakunderstandably. Unstable angina since 2000. Patient underwentCABG x 4, 6 months agoLives alone in a 3rd floor walk up. Has a girlfriend who has beenwith him intermittently for the last 10 years.Worked intermittently as a construction worker. Has not workeddue to cardiac symptoms for the last 2 ½ years.

MEET ROBERTO ALVAREZRequires moderate assist for all transfers. Ambulates with a quadcane and close contact guard. Requires moderate assistance tocomplete all other bed mobility activities, grooming and dressingactivities.Can feed himself with mod assist and frequent coughing noted.Patient has a right homonymous hemianopsia and impairedvisual perceptionLong list of medications etc

PLANNING FOR THE FUTUREWishlistNeeds Bigger Space Scouted locations with -a main ballroom and breakout rooms Include as many students aspossible -35 round Tables that can seat 12 -central location near public transportation forall 3 campuses (NYC, Long Island, Brooklyn) Hotels were very expensive. Hotel cateringwas very expensive Found a Temple in Long Island, near the train,with a main ballroom, breakout rooms, an onsite caterer and not too many events midweek

PLANNING FOR THE FUTUREWishlist Better student preparation Add curricular integrationNeeds Each program identified onecourse where this patient casecould be integrated. Students would concentrateon the care of this patientfrom their profession'sperspective. Prepared a powerpoint withvoiceover for the facultyteaching those courses

2nd Annual Interprofessional Education SymposiumDestination: HOMEPre-Symposium Curricular Integration Guide forFaculty in preparation for March 19th eventSons of Israel Conference CenterWoodmere, NY

CURRICULAR INTEGRATION BLUEPRINTStudents were instructed to complete the following items as they prepared to “treat” thepati

Pharmacy, Medicine, Osteopathic medicine, Dentistry, and Public Health Interprofessional Education Collaborative Expert Panel. 2011. Core Competencies for Interprofessional Collaborative Practice: Report of an Expert Panel. Washington, DC: IPEC