Start Date

10-29-2016 3:15 PM

End Date

10-29-2016 4:15 PM

Description

Purpose: To provide hospital professional staff with the opportunity for interprofessional standardized patient conferencing, through simulated bedside grand rounds.

Background: There is a need for conferencing techniques, regarding matters of patient concern, that are capable of providing a particular level of collaboration between providers at hospital interprofessional (IP) rounds1. This is due to the mortality attributed to preventable medical errors2 along with an estimated 3.4 trillion dollars in wasteful healthcare costs/year owing to fragmented oversight.3 The AAMC’s Aligning and Educating for Quality Initiative recognizes the medical conference as a quality improvement endeavor within graduate medical education.4

Description: To help address these issues, conferencing techniques employing interprofessional competencies5 will be practiced with in-situ team-based simulated grand rounds, informed by a modified didactic TeamSTEPPS® program.6 Following an hour of didactic training that contains an introduction to the structure and function of grand rounds plus TeamSTEPPS® resources, participants will engage in simulated bedside IP team grand rounds. These rounds will be attended by a reference team of providers familiarized with the case. This bedside simulation occurs within the reference unit that includes a standardized patient acting as a part of the reference team. The format of the rounds begin with a brief case presentation followed by communal questioning, consideration of alternatives plus conjoint development of a working diagnosis and treatment plan.7

Results: A model of clinical case conferencing between the reference team and patient, in an IP grand rounds format, may measurably impact patient outcomes and improve provider interprofessional competencies.5

Conclusion: Specific competencies related to IP collaboration should be practiced at regularly scheduled hospital meetings utilizing conferencing techniques provided in advance by combining didactic lessons with simulated events.

Relevance: The grand round conference is a patient-centered collaborative signature pedagogy7 that affords providers with the opportunity to exercise interprofessional conferencing skills and competencies.

Measurable learning objectives relevant to the simulated conference goals: A theoretically grounded8 re-structured simulated clinical grand round conference with the effectiveness determined by IP team competencies in:

1) a pre- and post-intervention survey of team process and performance9

2) an observation of the qualified variables along with

3) a patient safety culture survey.10 It is hoped that this intervention may additionally provide a nexus between IP education and practice by training professionals and exposing students to functional well working interprofessional practice teams.11

References

  1. World Health Organization. Framework for Action on Interprofessional Education and Collaborative Care. Geneva, Switzerland: World Health Organization; 2010.
  2. Makary, MA, Daniel, M. Medical error the third leading cause of death in the US. Br J Med. 2016;353(i2139):1-5.
  3. Berwick DM, Hackbarth, AD. Eliminating waste in US health care. JAMA. 2012;307(14):1513-1516.
  4. Davis DA, Rayburn WF. Integrating Continuing Professional Development with Health System Reform: Building Pillars of Support. Acad Med. 2016;91(1):26-9.
  5. Agency for Healthcare Research and Quality. Team STEPPS®. Agency for Healthcare Research and Quality, Rockville, MD. 2015.
  6. Interprofessional Education Collaborative. Core competencies for interprofessional collaborative practice: report of an expert panel. Washington, DC: Interprofessional Education Collaborative; 2011.
  7. Shulman, L. S. (2005). Pedagogies. Liberal Education, 91(2):18-25.
  8. Barr H. Toward a theoretical framework for interprofessional education. J Interprofessional Care. 2013;27(1):4-9.
  9. Temkin-Greener H, Gross D, Kunitz SJ, Mukamel D. Measuring interdisciplinary team performance in a long-term care setting. Med Care. 2004;42(5):472-81.
  10. Moskowitz E, Veloski JJ, Fields SK, Nash DB. Development and evaluation of a 1-day interclerkship program for medical students on medical errors and patient safety. Am J Med Qual. 2007;22(1):13-7
  11. Seneviratne CC, Stone JA, King KM. Achieving interprofessional practice in cardiac rehabilitation. J Cardiop Rehabil Prev. 2009;29(6):380-4.

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Oct 29th, 3:15 PM Oct 29th, 4:15 PM

Utilizing TeamSTEPPS resources combined with a simulated grand rounds workshop: Signature pedagogy for interprofessional practice and education

Purpose: To provide hospital professional staff with the opportunity for interprofessional standardized patient conferencing, through simulated bedside grand rounds.

Background: There is a need for conferencing techniques, regarding matters of patient concern, that are capable of providing a particular level of collaboration between providers at hospital interprofessional (IP) rounds1. This is due to the mortality attributed to preventable medical errors2 along with an estimated 3.4 trillion dollars in wasteful healthcare costs/year owing to fragmented oversight.3 The AAMC’s Aligning and Educating for Quality Initiative recognizes the medical conference as a quality improvement endeavor within graduate medical education.4

Description: To help address these issues, conferencing techniques employing interprofessional competencies5 will be practiced with in-situ team-based simulated grand rounds, informed by a modified didactic TeamSTEPPS® program.6 Following an hour of didactic training that contains an introduction to the structure and function of grand rounds plus TeamSTEPPS® resources, participants will engage in simulated bedside IP team grand rounds. These rounds will be attended by a reference team of providers familiarized with the case. This bedside simulation occurs within the reference unit that includes a standardized patient acting as a part of the reference team. The format of the rounds begin with a brief case presentation followed by communal questioning, consideration of alternatives plus conjoint development of a working diagnosis and treatment plan.7

Results: A model of clinical case conferencing between the reference team and patient, in an IP grand rounds format, may measurably impact patient outcomes and improve provider interprofessional competencies.5

Conclusion: Specific competencies related to IP collaboration should be practiced at regularly scheduled hospital meetings utilizing conferencing techniques provided in advance by combining didactic lessons with simulated events.

Relevance: The grand round conference is a patient-centered collaborative signature pedagogy7 that affords providers with the opportunity to exercise interprofessional conferencing skills and competencies.

Measurable learning objectives relevant to the simulated conference goals: A theoretically grounded8 re-structured simulated clinical grand round conference with the effectiveness determined by IP team competencies in:

1) a pre- and post-intervention survey of team process and performance9

2) an observation of the qualified variables along with

3) a patient safety culture survey.10 It is hoped that this intervention may additionally provide a nexus between IP education and practice by training professionals and exposing students to functional well working interprofessional practice teams.11

References

  1. World Health Organization. Framework for Action on Interprofessional Education and Collaborative Care. Geneva, Switzerland: World Health Organization; 2010.
  2. Makary, MA, Daniel, M. Medical error the third leading cause of death in the US. Br J Med. 2016;353(i2139):1-5.
  3. Berwick DM, Hackbarth, AD. Eliminating waste in US health care. JAMA. 2012;307(14):1513-1516.
  4. Davis DA, Rayburn WF. Integrating Continuing Professional Development with Health System Reform: Building Pillars of Support. Acad Med. 2016;91(1):26-9.
  5. Agency for Healthcare Research and Quality. Team STEPPS®. Agency for Healthcare Research and Quality, Rockville, MD. 2015.
  6. Interprofessional Education Collaborative. Core competencies for interprofessional collaborative practice: report of an expert panel. Washington, DC: Interprofessional Education Collaborative; 2011.
  7. Shulman, L. S. (2005). Pedagogies. Liberal Education, 91(2):18-25.
  8. Barr H. Toward a theoretical framework for interprofessional education. J Interprofessional Care. 2013;27(1):4-9.
  9. Temkin-Greener H, Gross D, Kunitz SJ, Mukamel D. Measuring interdisciplinary team performance in a long-term care setting. Med Care. 2004;42(5):472-81.
  10. Moskowitz E, Veloski JJ, Fields SK, Nash DB. Development and evaluation of a 1-day interclerkship program for medical students on medical errors and patient safety. Am J Med Qual. 2007;22(1):13-7
  11. Seneviratne CC, Stone JA, King KM. Achieving interprofessional practice in cardiac rehabilitation. J Cardiop Rehabil Prev. 2009;29(6):380-4.