Improving Fragmentation in Healthcare Delivery through Strengthening Interprofessional Communication

a. To train advanced health professions students on methods for modifying patient behavior for persons with multiple chronic conditions by enhancing interpersonal communication skills during patient assessment.

b. Narrative as a diagnostic tool provides a nuanced view focused on patients’ stories that are context bound. Thus attention to narrative informs care decisions. Through an Advanced Education Program grant the advanced nursing curriculum is being expanded through improving interpersonal communication and ethical decision making in caring for persons with multiple chronic conditions (MCC) for a medically underserved patient population. Project participants include graduate nursing, dentistry, pharmacy, and social work students who learn and work together as interprofessional clinical (IPC) teams for assessing, evaluating, and developing patient-centered care plans.

c. Taking an innovative approach to IPE, methods grounded in the humanities and behavioral health are being utilized and implemented in a clinical setting which include narrative and reflective practice, interpersonal and interprofessional communication, and motivational interviewing strategies. This training allows the IPC teams to be more fully present through intentionality and non-judgmental response and for their patients to fully tell their story. Two goals inform the project: improved patient and team communication; reduced fragmentation in healthcare delivery.

d. Student and patient experiences were analyzed using a series of pre- and post-surveys along with focus groups that were analyzed qualitatively for key themes. Preliminary results suggest that students begin with high levels of readiness for IPCP and that following a semester-long experience, the students reported high levels of IP collaboration along with increased skills for teamwork.

e. Cohorts of graduate students in nursing, dentistry, pharmacy, and social work are trained together and work as IP clinical teams in an urban clinic.

f. Focused-immersion sessions followed by clinical practicum experiences as IP clinical teams can serve to improve communication and patient-provider interactions.

g. Apply interpersonal communication and motivational interviewing strategies in developing IP clinical teams; Identify methods for using narrative and reflective practice in Advanced Nursing curricula; Value the importance of the patient’s story as part of health assessment.