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A Virtual Learning Collaborative for PPRNet Clinicians and Staff: ALC-TRIP (reprise). Lynne Nemeth, PhD, RN, FAAN. Objectives. Define the concepts of a virtual learning collaborative and community of practice Review previous PPRNet experience with Alcohol-TRIP projects - PowerPoint PPT Presentation
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A VIRTUAL LEARNING COLLABORATIVE FOR PPRNET CLINICIANS
AND STAFF: ALC-TRIP (REPRISE)
Lynne Nemeth, PhD, RN, FAAN
OBJECTIVES Define the concepts of a virtual learning
collaborative and community of practice Review previous PPRNet experience with
Alcohol-TRIP projects Discuss current NIAAA proposal
/opportunity Develop a relevant set of
recommendations to embed in proposal based upon YOUR input
VIRTUAL LEARNING CONCEPTS
VIRTUAL LEARNING COLLABORATIVE Meets the needs of its
members through facilitation of peer-to-peer learning
Use social networking and computer-mediated communication to achieve a shared learning objective
Members share knowledge through text discussions, audio, video, blogs, etc. and propose goals and learning objectives
COMMUNITY OF PRACTICE (COP)“Groups of people who share a concern, a set of problems, or a passion about a topic, and who deepen their knowledge and expertise by interacting on an ongoing basis”(Wenger, 2002)
COP differs from work groups or teams Voluntary membership Goals are less specific/more
adaptable Community exists as long
as members participate
PPRNET EXPERIENCE
TRANSLATING RESEARCH INTO PRACTICE-TRIP
Deep PPRNet experience Operationalized through
site visits, network meetings and performance reports
PPRNet must continue to evolve to meet ongoing advances in evidence, and practice development to sustain excellence
ALCOHOL SCREENING & BRIEF INTERVENTION (SBI) USPSTF (2013) recommends that
clinicians screen adults aged 18 and older for alcohol misuse and provide persons engaged in risky or hazardous behavior with behavioral counseling to reduce misuse. (B)
Primary care is ideal for the early detection and secondary prevention of alcohol-related problems, due to its high contact-exposure to the population
TREATMENT FOR ALCOHOL USE DISORDERS (AUD) 14.6% of people with AUD receive
treatment (NIAAA, 2011)
Engaging people in primary care where treatment and coordination of other medical conditions occurs is an opportunity to improve
Medications approved by FDA include:Disulfaram Oral naltrexoneExtended release naltrexoneAcamprosate
HOW PRACTICES IMPLEMENTED ALCOHOL SBI AND TREATMENT IN AM-TRIP Use note templates Nursing staff screening first 2 questions Clinician f/u BI with identified HRD
patients Prescribe medications for patients
receptive to brief intervention Use “Rethinking Drinking” materials to
educate patients (website, handouts)
(Ornstein et al, 2013)
QUALITATIVE CONCLUSIONS OF AM-TRIP Practices self-organized to adopt specific
approaches to incorporating alcohol screening, intervention and medical management into practice
Screening was readily adopted by nursing staff with a consistent, practice-based approach
Clinicians embraced a willingness to address alcohol use in the context of primary care, gaining experience with some medication use
Most patients were receptive to SBI discussion
Ornstein et al, 2013; Wessell et al, 2014
CURRENT PROPOSAL
DISSEMINATION AND IMPLEMENTATION IS NEEDED Proposal: virtual learning collaborative
(VLC) in PPRNet submitted to NIAAA in Sept
Open to all practices (even if you have participated in a previous study)
Random assignment to VLC or control All practice clinical staff /providers
eligible CME and nursing CE would be provided
for participation
AIMS Develop and implement ALC-TRIP, a multi-
component virtual learning community for primary care staff and providers.
Compare the effectiveness of participation in ALC-TRIP on alcohol screening, brief intervention and use of alcohol medications to practices that have not participated in this learning community, in a nationwide sample of 15 practices in each group.
Conduct a process evaluation of this learning community to examine the strengths, weaknesses, opportunities and threats related to this approach from the perspective of the stakeholders.
RECOMMENDATIONS
INPUT This R25 requires the input of
stakeholders in planning this intervention and an Advisory Board to guide the process and evaluation
Need: Letters of support Need: Practices in AA-TRIP and AM-TRIP
studies as advisors--clinicians and staff Need: your wisdom and experience in
expanding practice team roles
SITE VISITS VS. ONLINE COMMUNITY What are the qualities of site visits and
network meetings that are important to replicate in an on-line community?
Initial site visits seemed like a huge request and time burden for some practices—what concerns arise for this request for participation?
DOSE Monthly webinars? Checking discussions weekly and
contributing your ideas, experiences? 12-18 months for program duration?
YOUR INPUT IS APPRECIATEDAny questions? Letters of support to [email protected]