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Welcome to the first Q&A feature in an ongoing series with ASU’s IPE champions. Today we’re talking about implementing IPE in clinical practice from three different practitioner vantage points: behavioral health, community health nursing, and physician assistant.
Meet today’s IPE panelists:
Colleen Clemency Cordes, PhD
Interim Director and Clinical Associate Professor
Doctor of Behavioral Health Program
Arizona State University
Kay Jarrell, MS, RN, CNE
Clinical Associate Professor
College of Nursing & Health Innovation
Arizona State University
Kristin Will, MHPE, PA-C
Mayo Clinic in Arizona
Director, Postgraduate Physician Assistant Fellowship in Hospital Internal Medicine
Assistant Professor, Mayo Clinic College of Medicine
Physician Assistant, Division of Hospital Internal Medicine
Implementing IPE in clinical practice:
Q1: Describe an interprofessional experience in a clinical setting that involved you and your students. What were the advantages to the practitioners and the patients?
(CC): Our pharmacist referred a patient to me during a routine visit for her diabetes management. While the pharmacist had been working with the patient to improve her long-term blood sugar scores, she had demonstrated limited adherence to her plan. Through a behavioral health assessment, we determined that the patient’s depression was poorly controlled, which limited her motivation to engage in her diabetes plan. Working with the pharmacist and the patient’s physician, we were able to increase her anti-depressant to a therapeutic dose, while having the patient follow up with us for additional counseling. Her next pharmacy appointment showed that her long-term blood sugars had dropped and she was making positive strides towards better diabetes management.
(KJ): Last year senior nursing students in community health visited Matthew Henson Senior Housing. Our goal was to provide health education, screening, and disease management to the residents. Graduate students in the social work program were doing their internships at the facility during the same time and came to work with the nursing students each week. Together the students developed a more comprehensive plan of care than either could have accomplished separately. They appreciated being able to collaborate with one another and learn how each profession approached patient care.
(KW): Our interprofessional education modules train new allied health employees utilizing the simulation laboratory as part of their onboarding process. These modules augment the trainees’ orientation experience while learning from other allied health professionals in the hospital setting. In caring for hospitalized patients, health care professionals do not care for patients in silos. Therefore, we sought to develop a tool to train new employees that mirrors how they will actually work. The advantages of offering these interprofessional modules has led to better understanding of other allied health professionals roles and responsibilities, improved communication and improved patient care.
Q2: Thinking ahead, name a profession or discipline not currently involved in your interprofessional clinical experience whose involvement would be beneficial. Why?
(CC): In my current clinic system, we lack access to registered dietitians (RD) due to budgetary reasons. Having an RD on our team could significantly assist in the comprehensive treatment of many patients with chronic diseases, but would especially complement our interprofessional approach to diabetes management.
(KJ): I have been unable to schedule nutrition students with nursing students in community settings. The majority of our clients have chronic illnesses that require dietary management. They are on limited budgets and don’t always make good choices. Raman noodles are cheap and easy. Telling clients to eat fresh fruits and vegetables is unrealistic. It would be beneficial to our clients if nursing students and nutrition students could work together to address how to eat healthy on a limited income.
(KW): Our interprofessional education intervention up until this point has only involved allied health professionals. We have not yet had the involvement of physicians. In the future, we hope to include physician trainees such as Internal Medicine Residents (post-graduate year-1) to provide an even more comprehensive interprofessional experience for our participants. Physicians are an integral component within care of the hospitalized patient. We recognize this is a limitation of our current module design, but we hope to include physician participants in the near future.
Q3: How do you predict that interprofessional clinical practice will impact health care moving forward, especially in light of the ACA, an aging population, and increasing degenerative diseases?
(CC): The Affordable Care Act has really galvanized the field of integrated primary care by providing increased incentives and reimbursement for collaborative healthcare. When interprofessional teams can effectively work together, we are able to move from a sick care system to a well-care system, resulting in better patient outcomes, improved quality of life, and reduced health care costs.
(KJ): The Affordable Care Act expands access to preventive health care for millions of Americans. Health care can be directed toward preventing chronic disease rather than treating illness. Currently 75% of our nation’s health spending is for the treatment of chronic disease, most of which is preventable. It will take a team of professionals to re-design the delivery of health services as we shift from treating illness to promoting health. A holistic, interprofessional approach will be necessary to engage the public and health professionals in changing this paradigm. Students who have had an IPE experience will be practice ready for this challenge.
(KW): The future of health care involves not only providing cost-efficient, high quality, health care for patients, but studying and implementing ways of improving the delivery of health care itself. Interprofessional education and translation into interprofessional clinical practice is at the heart of the study of health care delivery. Through working together in a flattened hierarchal approach, health care providers can provide better care for patients through teamwork and new innovative strategies. Integrating IPE into the study of health care delivery is a key fundamental component and will need even further research to identify all the favorable outcomes IPE brings to quality of healthcare.