Interprofessional Education for NonCommunicable Diseases 17 th NHSRS

Interprofessional Education for Non-Communicable Diseases 17 th NHSRS RW Zuberi February 27, 2014 Zuberi. RW@2014 1

Disclosure I have no financial interest, arrangement or affiliation that would constitute a conflict of interest Zuberi. RW@2014 2

By the end of the session, we expect to have a little clearer understanding of What are Non-communicable Diseases (NCDs) What is Interprofessional Education (IPE) Does IPE “work”? IPE for NCDs in Pakistan Zuberi. RW@2014 3

What are NCDs Zuberi. RW@2014 Cancers Cardiovascular diseases Diabetes Stroke Chronic respiratory diseases Tobacco and substance abuse Mental health Malnutrition Osteoporosis Trauma and injuries 4

NCDs KILL > 40 M people every year. Share 4 risk 4 groups of diseases about 80% of all NCD deaths factors CV diseases account for most NCD deaths (17. 3 million) / yr Cancers (7. 6 million / year) Respiratory diseases (4. 2 million / year) Diabetes (1. 3 million / year) Zuberi. RW@2014 5

What is IPE Zuberi. RW@2014 6

What is IPE? WHO 2010: IPE is an experience that occurs when students from two or more prof. learn about from & with each other Collaborative (2011 a): IPE happens when multiple health workers from diff. professional BG work together with pts, families & communities to deliver highest quality care Each health profession possesses its own identity and pride in what it does that is special. Cannot replace the specific education of 7 professions Zuberi. RW@2014 National Academy of

3 types of Professional Competencies (Barr, 1998) 1. Individual Professional Competencies: Complementary 2. Common Competencies 3. Collaborative Competencies Values and ethics for interprofessional practice Roles and responsibilities for collaborative practice 8 Zuberi. RW@2014 Interprofessional communication Interprofessional Education Collaborative, 2011 a

Why IPE? For the sake of IPE – buzz word For Innovation Publications For Cost Savings To respect b/w contributing prof. , Team-Work Lends itself to learning across the spectrum of care from PHC rehab It is a disservice to our patients if we do not teach / train teams together to provide optimal care Zuberi. RW@2014 9

IPE has not delivered on its high expectations … Many studies patients are provided better care when two or more health professions work together but no robust evidence that IPE impacts health Educators / Care providers often say they educate or work interprofessionally, but when evaluated, evidence of collaboration is weak or nonexistent The problem lies in “Walking the Talk” Zuberi. RW@2014 10

Active ingredients of IPE effectiveness are difficult to define Systematic Reviews: summarize current knowledge, existing gaps, identify directions 1999 – 0 2010 – 6 studies that assessed effectiveness of IPE interventions compared to control groups none Interprofessional exchange + Education + RCT, CBA or ITS Outcomes reported Zuberi. RW@2014 11

IPE is Complex: apples ~ oranges Varied Participants: Pre-licensure, post licensure GPs and Practice nurses All who work in a Department HCPs: psychiatrists mental hlth W & admin Varied Curricula: NCD is not one area Varied Formats Zuberi. RW@2014 Inclusion of formal & informal, or just one 12

IPE is Complex: Apples ~ oranges Varied Outcomes Evaluated and Reported Changes in learners’ attitudes towards other prof. knowledge about collaboration Collaboration improved Patient Care Satisfaction studies Varied Abilities of Facilitators Variable Organizational Context Zuberi. RW@2014 13

IPE is Complex … Zuberi. RW@2014 14

Where to start? Educational Ethos Curricular Outcomes: Why and What: IPE for all aspects of all NCDs? Targeted to diff. health problems / specific indicators Teaching/Learning ~ congruent with future practice Assessment ~ congruent with future practice Evaluation achievement of outcome Zuberi. RW@2014 15

The Concept of Validity of Learning Learner level UG PG HCP Where? Classroom Field site Lab Clinic Zuberi. RW@2014 How? Exposure Experiential L Team based L Task based L Multimod al T-b Tb. L Miller’s Pyramid of 16

Explore IPE for NCDs in Pakistan Holistic, comprehensive pt. -centered integrated care Lack of history, culture & tradition of IPE in Pak Multi-scale Multi-modal Multi-level Systems Approaches Primary Health Care: 4 risk factors: tobacco, diet, inactivity, alcohol Primary Care: High impact essential NCD interventions for early detection & treatment (NCD 17 Zuberi. RW@2014

IPE for NCDs in Pakistan Specialty-based Inter-professional Care: Together, Separate or a Combination NCD Clinics Diabetes clinics with initiated (South. Hypertension & CV Clinics Asia) in PHC, DHQ Respiratory Clinics & Talukka Hosp. , Mental Health Clinics Academic medical Stroke Clinics college hospitals Trauma – run by nurses Cancer 18 Zuberi. RW@2014

Plan & Implement IPE initiatives Rigorous studies, where education meets research to improve health care outcomes Please be very clear. IPE for which Level of learner Outcome Curriculum Delivery method Evaluation method Then Compare and Contrast, Analyze Zuberi. RW@2014 19

Points to ponder “High-income countries 4 x more likely to have hlth insurance coverage for NCDs than -income ones” “Low-income countries generally have a lower capacity for prevention and control of NCDs” “Countries with inadeq. health insurance unlikely to provide universal access to essential NCD services” WHO updated March 2013 Zuberi. RW@201 4 20

References WHO 2010 WHO update 2013 http: //www. aacn. nche. edu/Education/pdf/IPECReport. pdf Interprofessional Education Collaborative (2011 a). Core Competencies for Interprofessional Collaborative Practice. Report of an Expert Panel. May 2011, Washington, DC. Interprofessional Education Collaborative (2011 b). Team based Competencies. Building a Shared Foundation for Education and Clinical Practice. Proceedings of a Conference. Feb. 16 -17, 2011, Washington, DC. Effectiveness of interprofessional education: Key finding from a new systematic review Journal of Interprofessional Care, May 2010; 24(3); 230 -241 Ten principles of good interdisciplinary team work Nancarrow et al. Human Resources for Health 2013, 11: 19 http: //www. human-resources-health. com/content/11/1/19 Systems medicine & integrated care to combat chronic noncommunicable diseases 21 http: //link. springer. com/article/10. 1186/gm 259 Zuberi. RW@2014

Any Questions? Attribute sheet for each Q MUST completed Zuberi. RW@2014 22

Thank You Zuberi. RW@2014 23