Interprofessional Education & Collaborative Practice

Issues for Allied Health

Virtual day of Allied Health & RehabilitationDecember 03 2015

John H.V. Gilbert, C.M., Ph.D., FCAHSPrincipal & Professor Emeritus, College of Health Disciplines,

University of British Columbia.Adjunct Professor, The National University of Malaysia

Adjunct Professor, Dalhousie UniversityCo-Chair, Canadian Interprofessional Health Collaborative

Overview of Presentation

The WHO (2010) Study Group Report Interprofessional Education

Collaborative Practice Health & Education Systems

Improved Health

Outcomes

Health & Education Systems

Local Context

Present & Future

Health Workforc

e

OptimalHealth

ServicesCollaborative

PracticeCollaborative

Practice-Ready

Interprofessional Education

Local Health Needs

Strengthened Health System

FragmentedHealth System

HealthWorkforce

Present & Future Health

Workforce

Collaborative Practice-Ready

Health Workforce

Interprofessional Education

High Level IPE Strategy 1“Interprofessional”

Use the right word - Use the word rightIPE

A three-part definition

“Learning With, From and About,For the purposes of collaboration,To improve the quality of care”*

Quality: Structure, Process, Outcome**

*WHO (2010) Framework for Action on Interprofessional Education & Collaborative Practice – following the CAIPE definition (2002)

**Donabedian A. Evaluating the quality of medical care. Milbank Memorial Fund Quarterly, 1966, 44: 166–206.

Present & Future Health

Workforce

Collaborative Practice-Ready Health

Workforce

Staff trainingChampions

Institutionalsupport

Assessment

Learningoutcomes

Logistics &scheduling

Programmecontent Compulsory

attendanceContextual

learning

Adult learningprinciples

Sharedobjectives

Interprofessional Education

Managerialcommitment

EDUCATOR (TEACHER) MECHANISMS

CURRICULAR (LEARNER) MECHANISMS

Learningmethods

High Level IPE Strategies 2Framing IPECP for Teaching & Learning

High Level IPE Strategies 3

• Design and implement system-wide;• Build knowledge about what works

in specific situations and contexts;• Develop adult learning competency

based approaches to IPE e.g.: PBL, CBL, Simulation

Curricular Reform A Lesson Learned

“Changing a college curriculum is like moving a graveyard - you never know how many friends the dead have until you try to move them.”

(Variously attributed to either Calvin Coolidge or Woodrow Wilson)

Collaborative Practice-

Ready Health Workforce

Optimal Health

Services

CollaborativePractice

Collaborative Practice-Ready

Health Workforce

Optimal Health

Services

Governancemodels

Structuredprotocols

Shared operatingresources

Shared decision-making processes

Supportivemanagement

practices

Facilities

Spacedesign

Personnelpolicies

Collaborative Practice

Communicationsstrategies Built

environment

Conflictresolutionpolicies

ENVIRONMENTAL MECHANISMS

INSTITUTIONAL SUPPORT MECHANISMS

WORKING CULTURE MECHANISMS

COLLABORATIVE PRACTICE

Collaborative Practice

Strategies 1

The PatientNot Just

Another Hockey Puck

• People• Process• Technology• Information

Patient Care Quality Improvement B.C. 2013-2014

IPECP Collaborative Strategies 2Understand the Patient’s Concerns

IPECP Collaborative Practice Strategies 3

• Design and implement system-wide.• Build as a key health workforce

strategy.• Develop coordinated collaborative

connections between all educational & practice partners.

IPECP Collaborative Practice Strategies 4

• Design appropriate space, and complete administrative support.• Build a clear work plan. • Develop equitable funding, and

accountability.

IECP Collaborative Practice Strategies 5Set teaching, learning and practice

in an appropriate framework.•Evaluate and measure.•Monitor outputs, outcomes, and impacts.

•Assign responsibility appropriately and effectively.

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IPECP Collaborative Strategies 6Practice Education (PE)

An Old Idea - A Central Tenet?

“For the things we have to learn before we can do them, we learn by doing them.”

(Aristotle, Nicomachean Ethics (350 B.C.E))

IPECP Collaborative Strategies 7Engage, encourage, and reward

The Practice Educator

Facilitator

Assessor EvaluatorCommunicator

FragmentedHealth System

Strengthened Health System

Health & EducationSystems

FragmentedHealth System

Strengthened Health System

Remunerationmodels

Riskmanagement

Accreditation Regulation

Professionalregistration

Capitalplanning

Financing Commissioning

Fundingstreams

Health & EducationSystems

HEALTH SERVICES DELIVERY MECHANISMS: Structure & Process

PATIENT SAFETY MECHANISMS: Outcomes

Interprofessional Collaborative PracticeSome Real Problems

• interpersonal differences e.g. age, gender, culture• fear of change e.g. place, time, persons• stereotypic rivalry e.g. me, him/her, them• power, income and status e.g. salary vs. fee-for-service• language e.g. gender, profession, social class, jargon• models of practice e.g. medicine, nursing, social work• management structures e.g. acute care, community• management priorities e.g. money, space, people

IPECP: The Global Network• The American Interprofessional Health Collaborative (AIHC),• The Australasian Interprofessional Practice and Education

Network (AIPEN),• The Centre for the Advancement of Interprofessional Education

(CAIPE), • The Canadian Interprofessional Health Collaborative (CIHC),• The European Interprofessional Education Network (EIPEN) • The Japan Association for Interprofessional Education, (JAIPE)

and • The Nordic Interprofessional Education Network (NIPNET).

What we have learned