Following last Month’s event, Building Best Practices with Teamwork, we wanted to compile some of the interesting findings regarding interprofessional collaboration from our Q & A session with our panel of teamwork experts (pictured above). So whether you weren’t able to attend, didn’t have your question answered, or are simply interested in learning more about this group’s experience with interprofessional collaborative practice, we hope that you find the questions and answers (below) valuable. Please feel free to contact Ana Walker at [email protected] with any further questions. In addition, you may download the event’s agenda and annotated bibliography here.
When creating/introducing a new integrated and collaborative model in health care, what have been the challenges and solutions to bridging the gap between the multi-generational work force? (i.e. millennials, gen-x-ers and baby boomers)
Ingemar: We have not really seen or felt such a generational gap. We’re trying to stay on top of technology, flexible work hours, and such.
Stacey: I think it boils down to understanding the culture as a whole and identifying individuals’ preferences and skill sets so that barriers can be identified and addressed.
Ruth: I find that, other than millennials and gen-x-ers generally being more comfortable with technology more quickly, embracing change is more related to the mindset around change. I have seen more mature physicians and practice staff jump in quickly on change and some not. Likewise, some younger physicians and practice staff may embrace the change or not. Our practice teams were focused on patient care. This shared focus, I believe, is the most important factor.
What have you done to help sustain effective teamwork within your organization or coalition?
Ingemar: Consistent communication (mostly emails) to provide meeting agendas, minutes, new information, vision/mission statement pursuits, interesting guests at our monthly meetings, and project discussions. Also, media releases to highlight steps on who is joining, new events, etc. I believe this gives the leadership a sense of accountability and ownership. It also gives the staff a sense of transparency in what is done and why.
Stacey: I like to revisit needs, workflow, processes, etc. and make revisions as needed. The process has to be fluid and adaptable to changes.
Ruth: Integrated Health Partners (IHP) uses a practice coaching model. Every practice is assigned a practice coach who reviews data with the practice, identifies areas of opportunity, works on PCMH capabilities, and assists in goal-setting related to the practice’s improvement plans. The coach shares best practices across practice settings. They lead physician group meetings and work with practice care managers related to clinical and utilization data. All practice coaches are health care Lean certified, allowing them to assist practices in becoming more efficient with change. I view them as the bedrock of sustainability of change.
How is the provision of behavioral health services changing from the old model to the new model?
Ingemar:
We are moving from a behavioral health system that sees its consumers with “blinders” in silos and have little regard or awareness of other health issues to a system where physical health actually matters in the recovery of the consumer. Physical health is becoming paramount for successful recovery.
Other new processes are:
Behavioral health staff provides services on primary care locations to be more accessible.
Behavioral health staff receives notification of admissions, discharges, and transfers from ER at hospitals and is able to intervene or prepare services more timely.
Behavioral health staff is given new data and become better aware of the whole person needs.
Behavioral health systems are beginning to utilize Care Managers for its clientele.
Stacey: We are moving from almost an exclusive specialty mental health model to collaboration and integration among multiple disciplines. Slowly, the silos are being taken down to allow for more comprehensive and effective treatment of the whole person.
Ruth: We have included behavioral health providers in two or three of our Learning Collaboratives. The most recent one focused on collaboration between the behavioral health providers and primary care physicians. We are beginning some additional work with a behavioral health initiative that hopefully will expand on the work begun in the collaborative.
What role does/did the patient play in the design of the practice model using interprofessional team approach? How was the concept introduced to patients and what was their response?
Stacey: We did not include patients in the planning process directly, but did develop it in response to patient’s reported needs in the community. We have fliers posted and everyone on the patient care team can explain integration. Very few declined to have behavioral health be involved in their healthcare, especially when it was suggested by their PCP as being important.
Ruth: When we started the work with the collaboratives, we engaged consultants to conduct focus groups regarding the patients’ current experiences in the practices (focus was on those with a chronic condition). Two years after beginning the collaboratives, another set of focus groups was held to determine impact with noticeable changes in practice style identified by patients (specifically around self-management support). We have included patients early on in the Pathways to Health initiative and have had patients speak at various collaborative sessions. The Pathways to Health (PTH) initiative includes a “virtual” Community Advisory Council (VCAC). This method strives to obtain the patient voice through use of Advisory Council members from community agencies at which patients receive services. Opinions and input are sought on specific topics and provide back to the VCAC that reports results to PTH.
How can we best prepare health professionals for collaborative practice during the course of their education?
Stacey: In addition to the basic curricula, hands-on training (e.g., internship, fellowship) and experience working with medical teams is essential. Many medical residency programs have a strong behavioral health component where residents are exposed to behavioral health and practice collaboratively in the same setting.
Ingemar: Ensure that students are versed in the language of several disciplines. Train effective communication with healthcare providers in several disciplines. Provide knowledge and awareness of a “whole” community including social services, mental health, primary care, dental, etc. Promote internships in a variety of disciplines.
Ruth: I believe good communication skills – oral and written – are vital to a high functioning professional in any setting. Critical thinking skills are increasingly important as data becomes a large part of practice and development of interventions. Health care professionals must have an understanding of why and how things related to each other.
To learn more about interprofessional education and collaborative practice, please visit Education to Practice. Education to Practice is a service of the Michigan Health Council.