lynne nemeth, phd, rn, faan - the medical...
TRANSCRIPT
Lynne Nemeth, PhD, RN, FAAN
Define the concepts of a virtual learning
collaborative and community of practice
Review previous PPRNet experience with
Alcohol-TRIP projects
Discuss current NIAAA proposal /opportunity
Develop a relevant set of recommendations
to embed in proposal based upon YOUR input
Meets the needs of its members through facilitation of peer-to-peer learning
Use social networking and computer-mediated communication to achieve a shared learning objective
Members share knowledge through text discussions, audio, video, blogs, etc. and propose goals and learning objectives
“Groups of people who share a concern, a set of problems, or a passion about a topic, and who deepen their knowledge and expertise by interacting on an ongoing basis”(Wenger, 2002)
COP differs from work groups or teams Voluntary membership
Goals are less specific/more adaptable
Community exists as long as members participate
Deep PPRNet experience
Operationalized through site
visits, network meetings and
performance reports
PPRNet must continue to
evolve to meet ongoing
advances in evidence, and
practice development to
sustain excellence
USPSTF (2013) recommends that clinicians
screen adults aged 18 and older for alcohol
misuse and provide persons engaged in risky
or hazardous behavior with behavioral
counseling to reduce misuse. (B)
Primary care is ideal for the early detection
and secondary prevention of alcohol-related
problems, due to its high contact-exposure
to the population
14.6% of people with AUD receive treatment (NIAAA, 2011)
Engaging people in primary care where
treatment and coordination of other medical
conditions occurs is an opportunity to
improve
Medications approved by FDA include:
Disulfaram
Oral naltrexone
Extended release naltrexone
Acamprosate
Use note templates
Nursing staff screening first 2 questions
Clinician f/u BI with identified HRD patients
Prescribe medications for patients receptive
to brief intervention
Use “Rethinking Drinking” materials to
educate patients (website, handouts)
(Ornstein et al, 2013)
Practices self-organized to adopt specific
approaches to incorporating alcohol screening,
intervention and medical management into
practice
Screening was readily adopted by nursing staff
with a consistent, practice-based approach
Clinicians embraced a willingness to address
alcohol use in the context of primary care,
gaining experience with some medication use
Most patients were receptive to SBI discussion
Ornstein et al, 2013; Wessell et al, 2014
Proposal: virtual learning collaborative (VLC)
in PPRNet submitted to NIAAA in Sept
Open to all practices (even if you have
participated in a previous study)
Random assignment to VLC or control
All practice clinical staff /providers eligible
CME and nursing CE would be provided for
participation
Develop and implement ALC-TRIP, a multi-component virtual learning community for primary care staff and providers.
Compare the effectiveness of participation in ALC-TRIP on alcohol screening, brief intervention and use of alcohol medications to practices that have not participated in this learning community, in a nationwide sample of 15 practices in each group.
Conduct a process evaluation of this learning community to examine the strengths, weaknesses, opportunities and threats related to this approach from the perspective of the stakeholders.
This R25 requires the input of stakeholders in
planning this intervention and an Advisory
Board to guide the process and evaluation
Need: Letters of support
Need: Practices in AA-TRIP and AM-TRIP
studies as advisors--clinicians and staff
Need: your wisdom and experience in
expanding practice team roles
What are the qualities of site visits and
network meetings that are important to
replicate in an on-line community?
Initial site visits seemed like a huge request
and time burden for some practices—what
concerns arise for this request for
participation?
Monthly webinars?
Checking discussions weekly and contributing
your ideas, experiences?
12-18 months for program duration?
