Building a Better Tomorrow Together:

Taking Collaborative Team

Building from Concept to Practice

2012 National Health Leadership Conference

Presentation Outline

• Interdisciplinary team collaboration

• BBTT program development

• BBTT program implementation

• Lessons learned

Collaborative Care Teams Collaborative care is organizing and working as a team

while effectively utilizing the separate and shared knowledge and skills of care providers and patients to deliver continuous and comprehensive care to best meet the needs of the practice population in a cost-efficient manner.

Team members explore, manage, and/or solve patient health concerns, with the best possible participation of the patient, to improve health outcomes. Collaboration recognizes, utilizes, and respects the strengths and integrity of each team member’s approach and contribution to care.

Interdisciplinary Team Collaboration

• Better for patients

• Better for providers

• Better for the system

Interprofessional Education

Collaborative Practice

What’s the connection?

Building a Better Tomorrow Together • A series of workshops designed for people

working within Nova Scotia’s health care system.

• Purpose: – To help health care providers learn new skills, gain

new insights and increase their confidence to organize and work as a team

– To help health care providers recognize, utilize, and respect the strengths and integrity of each team member’s approach and contribution to care

Building a Better

Tomorrow

(2004 - 2006)

Redesign and Nova

Scotia Branding

(2009)

Facilitator Training

and Support

(2010 – ongoing)

Building a Better Tomorrow Together (BBTT)

The Journey…

Needs Assessment (2004)

Understanding and

respecting team

members roles

Recognizing

that teamwork requires

work

Understanding

Primary Health

Care

Having the

practical know how

for sharing patient care

Communication

BBTT Evaluation (2006)

• Modules increased knowledge, skills, and confidence

• Individual professional practice impacts fostered collaborative team care

• Capacity building was important; in particular the preparation of and support for “in-house” facilitators

• Management and institutional support was important for

– Leadership,

– Building momentum,

– Program implementation, and

– Making and sustaining changes in collaborative team work.

Needs Assessment Revisited (2009)

• Capacity

• Readiness

• What We Heard

Building a Better Tomorrow Together Team Development for Collaboration in Health Care

Program Framework

Enhancing

Collaboration

(1 module)

Assessing your current knowledge and skills regarding interprofessional collaboration

Reflecting on your current collaborative efforts

Interpersonal and Communication Skills

(1 module)

Understanding different communication styles and applying communication techniques in your practice

Team Functioning

(1 module)

Building your team: vision, mission, operating guidelines

Conducting effective team meetings

Roles and Responsibilities

(1 module)

Enhancing confidence in and knowledge of team member roles

Labeling and professional stereotyping

Decision Making and Leadership

(1 module)

Decision making strategies

Leadership roles within teams

The sources and challenges of power in teams

Conflict Resolution

(1 module)

Understanding/respecting different conflict resolution styles

Exploring interest based conflict resolution strategies

Program Planning and Evaluation

(3 modules)

Program planning(steps 1-6)

Program evaluation

Building Community Partnerships

(1 module)

Exploring partnerships based on the social determinants of health

Generations and Learning Styles at Work

(1module)

Appreciating learning styles and generational differences within teams

Understanding Primary

Health Care

(2 modules)

The history and language of primary health care

Population health and health promotion

Chronic Disease Self-Management Support

(1 modules)

Exploring awareness of general chronic disease self-management support principles

An Intro to Cultural Competence in Health Care

(2 modules)

Exploring the meaning of culture and its implications for health and care

GREEN: reflects competencies for

interprofessional collaborative practice and

needs assessment/evaluation results.

BLUE: reflects needs assessment priorities

for quality health care service delivery.

February 2012

Participant Materials • Agenda

• Learning Objectives

• Content/Tools/Activities

• References

• Evaluation Questionnaire

Facilitator’s Guide (Module Plan)

Process Topic Objectives Facilitator’s Highlights Activity Menu

UNIT 1: INTRODUCTION

1A Welcome and Introductions 15 minutes

Introduce yourself and participants. Review workshop objectives. Discuss ground rules and logistics.

Presentation. Large group

discussion.

UNIT 2: : FOUNDATIONS OF PRIMARY HEALTH CARE

2A The History of PHC 10 minutes

Understand the historical nature of primary health care.

Help participants understand that primary health care and the related terminology have evolved over several years.

Presentation. Large group

discussion.

2B The Language of PHC 20 minutes

Define the language behind primary health care.

It is important to de-emphasize debates over definitions given their evolving nature. Although people define words differently, the workshop will focus on generally accepted definitions.

Presentation. Dyad activity.

UNIT 3: : DEFINING PRIMARY HEALTH CARE

Facilitator Requirements

• BBTT modules will be co-facilitated by two individuals; preferably representing two different health care provider groups

• At least one facilitator will have:

– Taken the 3 day BBTT facilitation skills training workshop OR been an active, original BBT facilitator and attended the first day of the BBTT Facilitation Skills workshop

• The second facilitator will have:

– Documented completion of a facilitation skills training program AND demonstrated facilitation skills, based on the IAF definition

– In this scenario, it is assumed that the facilitator who has completed the BBTT Facilitation Skills workshop will mentor the second facilitator regarding the foundational concepts discussed during Day 1 of the workshop.

Facilitator Training Program

• To enhance “in-house” capacity to support interprofessional collaboration within teams.

• The workshop design included two components: – Day 1: orientation to the renewed Building a Better

Tomorrow Together (2009) team development modules and concepts.

– Days 2 and 3: knowledge and skill development around facilitating adult learning and collaborative patient- centred teamwork.

Facilitator Training Program Delivery (2009) • Collaborative primary health care and acute care

initiative

• 4 – 3 day training workshops

• 79 participants

• Recruitment (FAQ)

• Debrief with managers & directors – Facilitator support strategies – Telehealth

– DVD

Support Strategies

• BBTT Facilitators – Modules (manuals, decks, tools)

– Orientation sessions – module content

– Networking sessions – facilitation skills

– Consultant mentorship

– New Community of Practice – Sharepoint; Telehealth

• BBTT Leads – Telehealth meetings q 6-8 weeks

– Information/promotion slide deck

• District Leadership – Consultant meetings with district leadership including BBTT leads

– Priority setting matrix

Challenges

• Facilitator availability

• Funding

• Reaching primary care providers

• Leadership support – getting traction & maintaining momentum

• Series of workshops vs process for team development

• Creating/clarifying expectations

• Capacity/Funding

Successes

• Facilitators

• BBTT Leads

• Participants

• Health leadership

However….

• “You know teams just don’t work, you have to work at it.” – Sargent, J., Loney, E. & Murphy, G. (2010)

Effective interprofessional teams: Contact is not enough.

Lessons Learned

• Setting and managing expectations – Communication

– Leadership support

– Workload balance

• Capacity

• New program – learn and flex as we go.

Where we are now/Next steps

• Implementation Guide

• CME accreditation

• Facilitator CoP

• Funding

• New module roll out: self management support

• Program evaluation

• Atlantic connection – potential partnerships