humanizing access to care: an interprofessional approach ... … · humanizing access to care: an...

Humanizing Access to Care: An Interprofessional Approach to Enhance

Interpersonal Communication for Improving Patient Quality and Safety

Margaret Brommelsiek, PhD

Carol Schmer, PhD, RN

University of Missouri-Kansas City School of Nursing & Health Studies

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, The John A. Hartford Foundation and the University of Minnesota. © 2015

Regents of the University of Minnesota, All Rights Reserved.

This activity has been planned and implemented by the National Center for Interprofessional Practice and Education.

In support of improving patient care, the National Center for Interprofessional Practice and Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for

Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physicians: The National Center for Interprofessional Practice and Education designates this live activity for a maximum of 1.5AMA PRA Category 1 Credits™.

Physician Assistants: The American Academy of Physician Assistants (AAPA) accepts credit from organizations accredited by the ACCME.

Nurses: Participants will be awarded up to 1.5 contact hours of credit for attendance at this workshop.

Nurse Practitioners: The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts credit from organizations accredited by the ACCME and ANCC.

Pharmacists: This activity is approved for 1.5 contact hours (.15 CEU) UAN: 0593-0000-17-032-H04-P




Disclosures

The National Center for Interprofessional Practice and Education has a

conflict of interest policy that requires disclosure of financial interests

or affiliations of organizations with a direct interest in the subject

matter of the presentation.

Margaret Brommelsiek and Carol Schmer

do not have a vested interest in or affiliation with any corporate

organization offering financial support or grant monies for this

interprofessional continuing education activity, or any affiliation with

an organization whose philosophy could potentially bias his/her

presentation.




Interprofessional continuing education credit will be awarded to participants

that paid the continuing education credit fee while registering for the Summit.

All workshop participants are asked to scan their barcode (from nametag)

upon entrance to session and complete the evaluation distributed at the end

of the workshop. Those who registered to receive continuing education credit

will also receive a certificate of completion following the Summit.

Learning Objectives:

Demonstrate an understanding of how IPE and IPC impact

patient quality and safety.

Articulate best practices in IPC team and provider-patient communication.

Correlate culturally sensitive care, patient access, and improved health outcome.

Brief Mindful Meditation:Mindfulness is focusing our attention and awareness on something or someone – to be present in the moment in a non-judgmental way.

BreatheSit in a relaxed position and close your eyes. Take a deep breath through your nose

and then exhale. Focus on your breathing. If a thought comes into your mind,

acknowledge it, let it go, and return your focus to the breath.

TasteNotice how the chocolate feels in your hand. Observe the shape and color. Unwrap

it and listen to the crinkle of the foil paper. Smell the chocolate and note your

thoughts. Inhale deeply. Slowly eat your chocolate savoring the flavor and texture.

Share

What did you discover through mindfulness?

Mindfulness

Awareness

Acceptance Presence

Interprofessional Teamwork:

Teamwork requires coordination, open communication, and

cultural awareness of other members of the team and the individuals

being served.

Coordination is a willingness to openly share information with others and to

cross professional boundaries as needed to ensure patient quality and

safety.

Communication promotes collaboration and the prevention of error by

encouraging the formation and maintenance of relationships, shared knowledge,

and team-based problem solving. (Dent and Harden. 2001. Eds. P.238; O’Daniel and Rosenstein, 2008)

Cultural Awareness influences our experience of health and illness, healthcare delivery, and the meanings attached to health status. (Dayer-Berenson, 2011; Kosoko-Lasaki et al, 2009)

Coordination:One-Minute Lesson: An ‘elevator speech’ is a very brief explanation and

consists of a one-two sentence statement. An example would be: “I am a

pharmacist who is a member of a collaborative healthcare team. I am responsible

for medication-related recommendations to prescribers and for counseling and

educating patients about their medications and wellness plan.”

1. Please write an ‘elevator speech’ that explains your chosen

health profession, its role, and how it functions (responsibility)

as part of a healthcare team (what it does/provides)

2. Please write a one sentence statement about how your chosen profession

complements the other professions on a healthcare team

Share with the group.

Five-Minute Assignment:

Communication:


As a healthcare professional

Have you ever experienced communication as a barrier?

What did you do to help remedy the situation?

DavidKanigan.com

Share with the group.

As a patient

Have you ever experienced communication as a barrier?

What was that like for you?

One-Minute Lesson: As senders and receivers, we are responsible for

clear, understandable messages and to actively listen to what we receive.

Cultural Awareness:One-Minute Lesson: Culture affects how patients express, experience, cope with feelings, describe and explain symptoms. In healthcare, there are three cultures to

negotiate: ones’ own, one’s professional subculture, the patient’s. (Dayer-Berenson, 2011)


As a healthcare professional

Have you ever experienced barriers due to cultural differences?

What did you do to help remedy the situation?

As a patient

Have you ever experienced barriers to care due to cultural differences?

What was that like for you?

Share with group.

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Lived Experience of Health and Illness:

Narrative: A patient’s story about the lived experience of health and illness.

Through capturing the lived experience of a patient, a provider

can better understand the impact that health and illness

reveal about an individual’s well-being.

Nuance: The subtle cues expressed by a patient through

non-verbal gestures or silence and lead to meaning.

Nuance is located through presence – deep engagement

with an other evokes a reciprocity of caring.

Ears

Eyes

Focused Attention

Heart

Social Determinants of Health:

An individual’s lived experience of health can be informed by a number of

factors including: Poverty, Education, and Access to Care.

Understanding the culture in which these factors exist is a first step to

humanistic care delivery.

If we can view culture as an interconnected story, with each person’s self-

identity situated within that story (Quevedo, 2008), then we will be better able to

envision a larger cultural narrative that impacts and informs health and well-

being .

Meaningful Patient Relationships:The ways in which we interact with others defines the quality of our

relationships.

Relationship-centered care is a perspective that both provider and patient

are unique individuals with their own emotions and values.

When a moral relationship develops, one serves out of genuine concern.

In healthcare, developing reciprocal relationships grounded in trust,

empathy, and care with patients begins by changing the conversation.

www.pinterest.comStarduststartupfacotory.org www.monkeybuddha.com

Communicating with another is an essential part of being human.

Humanism in communication is referred to as Dialogic.

Dialogic Communication:

Dialogic communication is also called presence, existential communication,

and dialogue.

This type of communication places essential faith in human interaction –it is an

attitude/orientation toward another.

Dialogic communication is a reciprocal process that is grounded in trust, openness, spontaneity, caring, sincerity, and empathy.

Changing the Conversation:

Martin Bub by artist

Andy Warhol

Ten-Minute Assignment: Working in groups of 2 or 3:

One-Minute Lesson: All of us have a communication style that we

use in their professional lives. Using a dialogic style of

communication can elicit trust between provider-patient and

provider-provider and also help to improve our relationships in care

delivery.

1. A sender shares a piece of information that is important for another

provider to do his/her job and the receiver responds to that message.

How was the message articulated? As a conversation between colleagues

or as a directive?

2. A sender provides information about a treatment plan to a patient and the patient

responds. How was the message articulated? As a conversation between provider

and patient or as a directive by a healthcare provider?

3. Discuss the similarities and differences between these conversations.

4. Share with the group.

A Word About Self-Care:

Self-care is the fourth strategy in the quadruple aim for improving healthcare

delivery, quality, and safety.

Through practicing self-care, we are better prepared for negotiating the challenges

and stress of caring for others in today’s complex healthcare environment.

Self-Care = Life Balance

Safe Housing

Eat Healthily

Exercising

“Me” Time

Self-Awareness

Reflective

Social Network

Creative Activity

Self-Love

Forgiveness

Laugh/Cry

Self-Compassion

Self-Reflective

Nature

Faith

Meditation

Relaxation

Personal Vision

Socialize

Journaling

Setting Boundaries

Vacations

Taking a Class

Time for Lunch

Getting Creative through Self-Care:1. Take one of the small books on your tables.

2. Go through the assorted pictures on the table and select images that resonate with you

and visually build a narrative of a self-care strategy.

3. As you work on your books, reflect about your life as healthcare professionals. Focus on

your own life’s journey and how this insight can be transferred in the delivery of

empathic care.

4. The first page of your book is a Title Page – Write in the title of your self-care strategy

5. The next two pages begin to tell your story; the following four pages is a progression of

your self-care strategy.

6. On the back page, write a brief narrative (50-word mini-saga) that reflects your visual

interpretation.

7. Share with the group.

Last Thoughts:

1. What did you hear?

2. What did you see?

3. What did you feel?

4. What did you learn?

You

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