draft nexus principles - amazon web services...principle 4 – it is not clear how the bullet point...
TRANSCRIPT
Generalcomment:
“Overall,thestatementsaddresskeyprinciplesandimportantlyaregroundedinthecontextofnationalqualitygoals.Ithinkthereareanumberofthingsthatwouldimproveitsclarityandroleinestablishingfoundationalprinciples.IwouldincludeabriefexplanationofNexusandincludethedefinitionofInterprofessionalPracticealongwiththedefinitionofIPE.Iwouldalsoincludeastatementofobjectiveandscope-whyaretheseprinciplesneeded?What’sthefocus,whatispurposelyoutsideofscope?Iwouldsuggestaformatthatmakesiteasytoidentifycoreprinciplesandattributes,suchas:(1)Background,Nationalqualitygoals,Nexus,Definitions(2)Coreprinciplesforpracticeandeducation,Commitmenttosharedgoals,Mutualrespectandtrust,Supportandrespectfortheneedforcollaborativeaswellasindependentpractice(3)PrinciplesforImplementationandplanning:Choose1-2wordstolabelprinciplefollowedbydescription,e.g.authentic,balanced,highvalue,integrated…(4)PrinciplesofDeveloping,MeasuringandImprovingInterprofessionalCompetence.”SuggestionforAdditionalReferences
• MacyFoundationreportsonAlignment,PatientandFamilyCenteredCare,Technology• Mitchell,P,etal(2012)Coreprinciplesandvaluesofeffectiveteam-basedhealthcare.DiscussionPaper,
InstituteofMedicine,Washington,DC.Thispaperseemsfoundationaltothecurrentwork.
1.)TheNexusPrincipleswillhelpcreateasharedunderstandingofinterprofessionalpracticeandeducation.YES–10NO–0Comments:
• “Theseprincipleswillhelpguideinstitutionsandcoalitionsastheyplantheirworktogether.”–CarlaDieter• “Ilikethem.Theyareclearandstraightforward.”–BetsyClark• “Ultimatelyyes-IthinkitwouldhelptoincludeabriefexplanationoftheconceptofNexusaswellasthe
definitionofinterprofessionalpracticealongwiththedefinitionofIPE.Moredetailandexplanationwillbeneededtoachievethisaim.”–GerriLamb
2.)TheNexusPrinciplesrepresentcurrentthinkingaboutIPE.YES–10NO–0
The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067. The National Center is also funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation and the University of Minnesota. © 2015 Regents of the University of Minnesota, All Rights Reserved
@nexusipe
Nexus Principles Feedback Summary
Comments:• “Ithinkitisconfusingtousetheacronym"IPE"twodifferentways.Thefirstastheacronymmostcommonly
usedintheliterature-IPE=interprofessionaleducation.Thesecondasyouhavereferencedinyourprinciples-IPE=interprofessionalpracticeandeducation.”
• “Ibelievetheycapturewhereweare.”
• “Ithoughtconcepts/attributeslikeauthenticity,patientengagementetc.wereagoodstartbutneedstogofurtherinidentifyingthemorecomprehensivedomain-agoodanalogyformeisthesixaimsofthehealthcaresysteminCrossingtheQualityChasm-thesesixaimscapturedtheessenceofwhatwasimportanttoenvisionwhereweweregoing.”
3.)TheNexusPrincipleswillhelpguidethefuturedevelopmentIPE.YES–10NO–0Comments:
• “These,aswritten,remainfocusedmoreonacademiaandthestudentlearner.Theylessreflectthepracticingclinicianlearnerinthepracticesetting.Theyarebothimportant.”
• “I'mnotascertainaboutguidingthefuturedevelopment.Theyareagoodbaseline,however.”
• “Yes-assumingtheycapturethemostimportantelements.Iwonderedwhythefocuswaslimitedtoplanning,implementation,andmeasurement-whataboutimprovement,evolution,andsustainability?”
Critiques/RecommendationsforSpecificPrinciples:
Generalcommentonthissection:“Thepointabouttheimportanceofindependentaswellascollaborativeworkisimportant.Ithinkmoreneedstobesaidaboutthis–andthefactorsthatmightcomeintodeterminingtheappropriatebalance.”
• Principle1:Interprofessionaleducation“occurswhenstudentsfromtwoormoreprofessionslearnwith,about,andfromeachothertoenableeffectivecollaborationandimprovehealthoutcomes”(adaptedfromWorldHealthOrganizations,2010).
o “True.Wouldadddefinitionorprincipletoincorporatepracticinghealthcareproviderlearnerasreferencedabove.”
o “BecausesomanyofusseehealthprofessionseducationthroughthelensofUME/GME/CMEand
The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067. The National Center is also funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation and the University of Minnesota. © 2015 Regents of the University of Minnesota, All Rights Reserved
[email protected] @nexusipe
• Principle2:InterprofessionalPracticeandEducation(IPE):1.Supportsallstakeholderstodevelopmutualrespect,understandingandtrust–thefoundationofsuccessfulinterprofessionalcollaborativepractice—withinandacrossprofessionalandorganizationalboundaries2.Aimstoinspirehealthprofessionalstoastrongcommitmenttoimprovehealthandcarethroughcollaborative,aswellasindependent,work3.Fostersanenvironmentinwhichallstakeholders(patientsandclients,familiesandcommunities,students,teachers,)learnandteacheachother.
o “Seeaboveregardingacronymusedtwodifferentways.Principlesthemselvesarefine.”
o “3rdbulletpoint:includehealthcareprofessionals.”
o “Suggestadd'from'to"learnfromandteacheachother".”
o “Perhapsabetterphrasingwouldbeteach,andlearnfrom,eachother.”PrinciplesofIPEPlanningandImplementation
Generalcommentonthissection:
“Iwouldtranslateeachoftheprinciplesintooneortwowordphrases(similartohowtheIOMReportframedthesixaimsforthehealthcaresysteminCrossingtheQualityChasm)e.g.Authenticity,patientengagement,balance–wouldaddaprincipleofintegrationacrosseducationandpractice.Ithinkthiswouldmaketheprinciplesclearerandeasiertoremember.Principle3seemstobeaboutbeingflexible,adaptive-wouldemphasizethisandframepositivelyastherestoftheprinciples(ratherthanstartingwith“noonepurpose.Principle4–itIsnotclearhowthebulletpointunderthisprincipleisrelevanttoengagingpatientsandtheirfamilies.”
• Principle3:NoonepurposeunderliesallIPEplanning,butallIPEplanningisbasedononeormorefoundationaltheoriesorconceptsappliedoradaptedtothespecificsituation,suchasaccesstocare,patientsafety,qualityorcommunityengagement.
o “Agree.”
o “Iassumequalityreferstoqualityofcare.”
The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067. The National Center is also funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation and the University of Minnesota. © 2015 Regents of the University of Minnesota, All Rights Reserved
[email protected] @nexusipeo “Thisprinciplemayassumelineardevelopmentofformalinstructionstrategies.Workplacelearningactivitiesmustbedesignedtoincludereflectionandadjustmentofteamperformanceinthecourseoftheirrealwork.Sowhilethisiscertainlyplanned,theresolutionandconsensusprocessispartoftheeducationalprocess,nottheplanningprocess,andiscontinuouslyrevisited.”
o “Thisisanimportantaspectthatneedstobeincorporatedinallplanning.”
o “Isconsensustheaccurateterm?Whathappensifconsensusisnotreached?Doesitactuallymeanreachtreatmentdecisionsratherthanconsensus?”
o “Notclearhowthebulletpointisrelevanttoengagingpatientsandtheirfamilies”
• Principle5:Planningandimplementationprovideforauthenticcollaborativeworkexperiencesthatbringtogetherprofessionslikelytoworkcollaborativelytogetherincurrentandfuturepractice.
o “Wouldprobablytakeout"work"fromcollaborativeworkexperiencesandjustleavecollaborativeexperiences.”
o “RhetoricalobservationthatpriorPrinciplesincludedsubjectofinterprofessionaleducationandcollaborativepracticebutPrinciples5,6omitthat.”
o “Smallpoint,butthesecond"together"seemsunnecessary.Doesn'tcollaborativemeanworktogether?”
• Principle6:Planningandimplementationrequirebalancebetweentheneedsandstandardsofhealthandeducationsystemsandstudentacademicrequirements.
o “Academiafocusedonly.Howabout"andlearnerrequirements"”
o “PlanningandimplementationofIPErequirebalancebetweentheneedsofthepatientsandhealthcaresystems,healthcareprofessionals,andstudents.”
The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067. The National Center is also funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation and the University of Minnesota. © 2015 Regents of the University of Minnesota, All Rights Reserved
o “Idon'tthinkthatthisshouldbeanaspiration.Iwouldpreferthatfoundationaleducationincorporateinterprofessionalprinciples.Forexample,casestudiescanbevettedtoassurethattheyproperlyillustraterolesofotherprofessionsinvolvedinthecareofapatient.ProfessionalidentityformationbeginsonthefirstdayofprogramentryandIPEobjectivesshouldnotbedeferred.”
PrinciplesofDevelopingandMeasuringInterprofessionalCompetence
Generalcommentonthissection:
“TheseprinciplesseemtoaddressmostlytheacademicsideoftheNexus-needtomakesurethepracticesideisaddressedandinbalancewiththeacademicside.Iwouldexpandtheseprinciplestoinclude“improving”IPcompetence–highlightingthegoaltodevelopcollaborationreadystudentsandpractitioners.Mightwanttoaddaprinciplerelatedtotheneedforsoundstructuralandprocessmeasures;whilethepriorityremainsonimpact(Principle14).ConsiderincludingtheroleoftechnologyinsupportingIPEandevaluation(seelatestMacyreportonTechnologyinHealthProfessionsEducation).”
• Principle8:Ongoingevaluationoftheimpactofinterprofessionaleducationandcollaborativepracticeonlearningandhealth-relatedoutcomesiscritical.Evaluationinvolvestheuseofavarietyofmethodsandmetricsselectedandtailoredforthespecificsituation.
o (N/A)
• Principle9:IPElearninggoalsaredescribedascompetenciesorcapabilities.Theyguideeducationalplanning.
o “IPElearninggoalsaredescribedascompetenciesorcapabilities'ofthehealthcareteam'.”
o “Unsurewhythisisstated?Ultimately,behavioriswhatmattersofcourse.Soistheideathatthingslikeknowledgeandattitudesororganizationalculturedon'tmatter?”
@nexusipe
The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067. The National Center is also funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation and the University of Minnesota. © 2015 Regents of the University of Minnesota, All Rights Reserved
[email protected] @nexusipe
The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067. The National Center is also funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation and the University of Minnesota. © 2015 Regents of the University of Minnesota, All Rights Reserved
@nexusipe
• Principle11:Interprofessionalcurriculahelplearnersrecognizeandunderstandpoliciesandotherenvironmentalfactorsthatmaysupportorhindercollaborativepractice.
o “Agree,butmightadd"policies,practices,andotherenvironmentalfactors."”
o “Termcurriculaimpliesundergraduatelevel.Isthereawaytoencompass'undergraduate,graduateandpracticeinterprofessionaleducation'…maybestateitthisway?”
o “Thepointofthisprincipleisn'tclear.Isthegoaltoincorporateleadershipandimplementationskills
inIPEcurricula?Ifso,thisobjectivewillhavevaryingobjectivesacrossthespectrumofacademiclevels.”
• Principle12:IPElearnersarecontinuouslyassessedandprovidefeedbackontheirattainmentofinterprofessionalcompetencies.Self-reflectionisintegratedintoassessmentmethodologies.
o (N/A)
• Principle13:Interprofessionalcurriculaandlearningactivitiesaredesignedtodeveloppracticebehaviorsthatsetthestageforlifelonglearningandcontinuousprofessionaleducation.
o “I'mnotwildaboutphraseof'curriculaandlearningactivities'.Thisgetsintosemanticsthatmightbetoofussy.But...Ithinkofacurriculumconsistingofthedevelopmentoflearningobjectives,theinstruction,andassessmentoftheextenttowhichtheinstructionaccomplishedtheobjectives.Therefore,it'sredundanttodiscuss'curriculaandlearningactivities'.Thenthesemanticsof'teaching'vs'learning'reappear.Thisisanimportantissueinworkplacelearning,astheenvironmentthatcausespeopletolearnthingsthatwedon'tmeantobeteaching(e.g."hiddencurriculum").”
• Principle14:Interprofessionalpracticeandeducationoutcomesaremeasuredagainsttheimpacton:individualhealth,population/publichealth,organizationalchange,systemefficiencies,andcosteffectiveness.
o “Iwouldarguethattheyarealsomeasuredagainsttheimpactofhealthcarepractitionerperformance.Note:D.Moorecommentsre:ownmodelofevaluation.”
o “Mycommentisan"and"regardingPrincipal14.Weshouldrecognizeoutcomesonlearners,asindividualsandteams,inmorespecificwaysthanarementionedinPrincipals11,12,and13.IPEshouldchangelearnerknowledge,attitudes,andbehaviorsasindividualsaswellasinteams.”