Using an Interprofessional Consultation Team to Enhance

12th All-Ohio Institute on Community Psychiatry
MARCH 27, 2015
Using an Interprofessional
Consultation Team to Enhance
Workforce and Learner
Experiences in the Integration of
Mental Health and Primary Care
Janice Spalding, M.D., FAAFP; Douglas Smith, M.D., DFAPA; Lon C. Herman, M.A.;
Jody M. Bell, APP, CPS; Ron Rett, B.S.; and Nichole E. Ammon, M.S.Ed., PCC-S
INTEGRATED CARE TECHNICAL
ASSISTANCE and CONSULTATION TEAM
Background and History
Who is the TACT Team?
Nichole E. Ammon, MSEd, PCC-S
Jody M. Bell, APP, CPS
Sara E. Dugan, PharmD, BCPP
Lon C. Herman, MA
Ron Rett, BA
Douglas Smith, MD, DFAPA
Janice Spalding, MD
John M. Ellis, LISW-S, LICDC, ICCS
Vicki Montesano, PhD
Not pictured:
Laura Riley, CNP
Mark R. Munetz, MD
MEDTAPP Healthcare Access Initiative
• This program is partially funded by the MEDTAPP
Healthcare Access (HCA) Initiative* and utilizes federal
financial participation funds through the Ohio Department
of Medicaid
• The MEDTAPP HCA Initiative partners with Ohio’s colleges
and universities to support the development and retention
of additional healthcare providers to better serve the Ohio
Medicaid population using emerging, interdisciplinary, and
evidence-based care models
• Views stated in this presentation are those of the
researchers only and are not attributed to the study
sponsors, the Ohio Department of Medicaid or to the
Federal Medicaid Program
*MEDTAPP HCA Initiative funding supports teaching and training activities associated with this
program, and does not support the delivery of Medicaid eligible services.
TACT TEAM
GOAL
– Prepare health professions
trainees to become effective
members of interprofessional,
integrated health care teams
– Specific focus on ensuring
trainees receive advanced
interprofessional education with
an interdisciplinary, team
integrated care settings in Ohio
Microsoft Clip Art 2014
TACT’s APPROACH to
CONSULTATION and
TRAINING
CASE STUDY
• Organizations that are working towards
integration of health care services and plan to
utilize integrated care teams
– Community Mental Health Center (CMHC)
and
– Federally Qualified Health Center (FQHC)
• Both host students/trainees during field
placement experiences
ASSESSMENT
• Utilization of a web-based survey to explore
organizational familiarity and exposure to
topics commonly found in both
interprofessional practice/education and
integrated health care
COMPETENCY FOCUS AREAS
• Values and Ethics for Interprofessional
Practice
• Interprofessional Communication
• Person-Centered Care
• Teams and Teamwork
• Roles and Responsibilities
• Population Management
ENHANCE COMPETENCIES
• Identify strengths and areas for improvement
based on assessment
• Provide focused consultation and live,
customized training to bolster areas identified
by the organizational assessment
– Including emphasis on teaching/modeling to
end-of-pipeline learners
ONGOING
EVALUATION and CONSULTATION
• Collaboration and Satisfaction About Care
Decisions (CSACD) scale (©J. Baggs, 1992)
– Adapted by TACT, with permission, to evaluate
integrated care planning among teams
– Web-based implementation of test/re-test over time
LESSONS LEARNED
TRENDS
• Communication
–
–
–
–
Individuals
Teams
Systems
Terminology
• Interprofessional
Education
– Understanding your
impact on learners
• Population
Management
– Understanding the
shared population
– Understanding your
partner in integration
– Understanding how
regulations may or may
not impact daily tasks
NEEDS:
WORKFORCE PREPARATION
• There is no one best view or model of integrated
health care
• Engagement occurs around something that is
evolving and malleable
• COMMUNICATION and COLLABORATION skills
NEEDS:
QUALITY FIELD PLACEMENTS
• Knowledge about what students and trainees
actually experience during field placements
– Interprofessional, team-based care
– Integration of health care services
• Environment that models collaborative care at
it’s best
(regardless of how the organization(s) are managing integration)
TEAM-BASED PRACTICE and
EDUCATION is POSSIBLE
• Effective leadership
is essential!
• Each team is
different
– Establish team
expectations early
– Develop clear roles
and responsibilities
• Productive discussions
may involve divergent
opinions
– A common vocabulary is
critical
– However, it will not be
the starting point
• Debriefing and
feedback sessions are
worth the time
CHALLENGES
Organizations Integrating
Health Care
TACT
• Access to learners
– Impacting classroom
and/or curriculum
– Approach begins at the
organizational (field
placement) level
• Time –
Productivity = Billable v. Productive
•
Time is critical and not enough
is set aside for:
–
–
–
meetings / huddles
general communication
teaching and training
NEXT STEPS
• Ongoing use of
assessment / evaluation
tools
– Organizational survey
– CSACD
• Focused Consultation
• e-Learning Modules
• Regional (live) Training
• Better Engagement of
Students / Trainees
In development –
Learner Evaluation tool
Identify what areas of
interprofessional,
integrated health care the
learners are (and are not)
gaining exposure to