Interprofessional education is critical to advanced care coordination

Organizations do not spend adequate time on coordination of care, said Tracy Christopherson, director of interprofessional practice, Elsevier, clinical solutions / CPM, during a Sept. 23 National eHealth Collaborative webinar.

Well-functioning coordinated teams mean better patient and family outcomes, more efficient healthcare services, and higher levels of satisfaction among providers. As healthcare reform drives greater accountability in the delivery of care, a culture and professional practice framework must be implemented.

According to Christopherson, such a framework should stem from a collective commitment to transform healthcare processes that is guided by core beliefs. The framework should model how to achieve behaviors essential to culture and practice transformation, apply evidence-based practice and encompass health and healing care, partnership culture, interdisciplinary integration, and health informatics.

“It requires new skills and ways to relate to each other,” she said.

Designated by the Health Resources and Services Administration, the National Center for Interprofessional Practice and Education is on the front lines advancing interprofessional education and practice as a viable and efficient healthcare delivery model, she said. Its goals include:

• Provide sustainable national leadership in transitioning from a focus on care delivery to a focus on health
• Focus on large-scale systems change at the interface of practice and education
• Accommodate the unknown through developmental evaluation using multiple methodologies, allowing for real-time adjustments
• Promote collaboration, avoid duplication and create definitions and standards to advance interprofessional practice and education

Interprofessional education helps providers avoid fragmentation in the system by building intentionally designed health IT systems. Providers must manage an interdependent relationship between practice and technology and care planning and clinical documentation. Components necessary to promote care coordination include: practice and culture change spread across the continuum, evidence-based content, integrated interprofessional care and intentional workflow design.

“Issues in healthcare are chronic dilemmas and polarities that need to be managed. You need to understand and know when we have problems that need to be solved. It helps to have the team look at whole picture,” she said.

Further, an integrated, collaborative team of providers ensure that patients and their families receive consistent care regardless of who the physician is.

At Gundersen Health Systems in Lacrosse, Wisc., Karen C. Arndt, BSBA, BSN, RN, CEN, Nursing Systems Specialist said its three areas of focus on improving care coordination included collaboration, improved communication, and a patient- and family-centered hospital experience.

Its interprofessional education effort entailed an inpatient council that includes team members from all aspects of care. This group addresses patient care issues through different viewpoints and develops solutions and action plans. For example, the group deals with workflow design issues and pain management strategies.

“We try to solve the issues as a team,” she said.

Interdisciplinary bedside rounding also is part of this more collaborative approach, said Shannon Hulett, RN, MSN, CNL, medical surgical clinical nurse leader at the Gundersen Health System. Hulett said the team focuses on an individualized plan of care, so patients and families can identify what is important to them.

“Everyone meets to discuss the plans for the day and plans for the stay,” she said.