Center for Interprofessional Practice and Education
at Washington University Medical Campus

Fall 2019 Newsletter

News from the Center for Interprofessional Practice and Education & its Community Partners

Select a story below to expand each section.

Phase I- The Monumental Lift

Phase I- The Monumental Lift

Dennis Chang, MD

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One of 70 interprofessional teams of learners practicing collaborative communication techniques during Session 2 of Phase I.

Phase I has successfully launched!

  • 650 learners across 6 health professions
  • Three 3-hour sessions
    • Session 1: 7 waves of Poverty Simulations
      • 4 session leaders
      • 98 volunteers to serve as community members
      • 2 Stories of Promise client/patients
    • Sessions 2&3: 7 concurrent sessions across campus
      • 8 session leaders
      • 7 clients/patients
      • 7 improv experts
      • 10 logistics experts
      • 72 faculty/clinician facilitators
      • 3 student interns
      • 1 student worker

A big thank you to all from our growing interprofessional community as it truly took a village to pull this off! We’re sifting through mountains of data and still conducting focus groups but early reports show both learners and facilitators learned more about social determinants of health and from, with and about each other’s professions.

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The CIPE Curriculum and Assessment Committee will spend the spring digesting the feedback and making improvements toward next year’s Phase I in Fall 2020. More to come!

 

Dennis Chang, MD

Chair, CIPE Curriculum & Assessment Committee

Breathe Easy: Interprofessional Education Enhances Asthma-Related Knowledge

Breathe Easy: Interprofessional Education Enhances Asthma-Related Knowledge

Justinne Guyton, PharmD, BCACP and Sara Richter, PharmD, BCPS

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This fall, second-year pharmacy and medicine students from St. Louis College of Pharmacy and Washington University School of Medicine in St. Louis participated in an interprofessional session related to the management of asthma. The idea began with a research project initiated by Christina Angel, MD, who was looking for a way to unite medical and pharmacy students to share their knowledge and expertise. Patricia Kao, MD, Megan Wren, MD, Justinne Guyton, PharmD, and Sara Richter, PharmD, provided mentorship throughout the project.  Together, faculty at each institution developed an activity and questionnaire. What started out as a pilot in 2017 with 20 student volunteers has expanded to an annual activity in both curricula, with more than 600 students participating in the past two years!

The session began with an individual quiz to assess baseline knowledge of asthma management and inhaler devices. Next, students in interprofessional groups discussed their respective curricula in general and then, more specifically, their asthma coursework. Groups proceeded through asthma-related cases and prompts to highlight the different expertise among professions. Medical students demonstrated the steps in a pulmonary physical exam and described lung sounds. Pharmacy students demonstrated inhaler device technique on placebo inhalers and described barriers to their use. Collaboratively, the students created a patient-specific, evidence-based plan to optimize the asthma management for a patient case, while facilitators from both professions were available for guidance throughout the session. The last activity was an individual post-quiz to reassess students’ asthma and inhaler device knowledge. 

Data from fall 2018 showed an increase in quiz scores for both professions. The medical students’ average quiz score rose from 65% (pre) to 85% (post) with an increase of 27% on questions specifically related to inhaler devices. Pharmacy students’ average quiz scores rose from 82% (pre) to 91% (post) with an increase of 17% on questions related to asthma assessment and management.1 The increase in scores in questions related to the other profession’s expertise demonstrates the importance of interprofessional education and practice.

Equally as important, students in both professions noted better understanding of the other profession’s roles and responsibilities following the activity, as measured by the SPICE R2 Instrument.2 Additionally, over 80% of students agreed or strongly agreed that the activity was useful in their learning.  One pharmacy student commented, “It was nice to confer with the medical students and learn more about assessing the patient. We were asked questions we had not really thought about before so that was a good way to get us thinking outside the box.” A medical student commented, “It showed me how differently we may approach problems, and how these multiple perspectives can result in better care for patients.”

Following the success seen in 2018, the activity returned in fall 2019, and we look forward to analyzing the results and feedback. Based on the level of engagement noted by session facilitators, we expect to discover that students, yet again, found this activity to be a breath of fresh air.

Written by:

Justinne Guyton, PharmD, BCACP Associate Professor of Pharmacy Practice

St. Louis College of Pharmacy

 

Sara Richter, PharmD, BCPS Assistant Professor of Pharmacy Practice

St. Louis College of Pharmacy

 

 

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References:

  1. Richter SK, Guyton J, Angel CG, Wren M. A Case-Based, Interprofessional Activity to Enhance Student Understanding of Professional Roles and Clinical Knowledge. (Abstract) American Journal of Pharmaceutical Education 2019;83(5):966.
  2. Zorek JA, Fike DS, Eickhoff JC, et al. Refinement and Validation of the Student Perceptions of Physician-Pharmacist Interprofessional Clinical Education Instrument. Am J Pharm Educ. 2016; 80(3): Article 47.
Co-location of Physical Therapy in Women's Health Center: Steps Toward Improving Interprofessional and Personalized Medicine

Co-location of Physical Therapy in Women’s Health Center: Steps Toward Improving Interprofessional and Personalized Medicine

Taylor D Chapman PT, DPT, WCS, CLT

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Dr. Taylor Chapman, Pelvic Health Clinical Associate and Dr. Jerry Lowder from Female Pelvic and Reconstructive Medicine (Urogynecology)

A patient walks into your clinic with urinary urgency, frequency, and dysuria. After seeing an array of clinicians, waiting months and driving three hours to Washington University, she is convinced that today’s visit with you, the physician, will be the end of her frustrating journey.  She has repeatedly tested negative for a bladder infection, not responded to simple behavioral modifications, had urodynamics (bladder testing) that demonstrated non-significant findings, and tried pharmaceuticals without symptom relief. She has not tried pelvic health physical therapy (PT) and, unfortunately, PT is not available near her home. What do you do?

Clinicians face scenarios such as this daily. If conservative treatment options, such as PT, are not conveniently available for patients, are not well coordinated with a physician’s practice, or not well understood by the clinician, PT may be underutilized. The patient may choose not to attend PT because of long waitlists and/or travel necessary to be seen by a qualified therapist, resulting in significant risk of the patient losing interest in this poorly understood service, allowing mild conditions to progress to severe ones over time.

Washington University has taken initial steps to overcome these obstacles and change the untimely and unpredictable care pathway previously described. The division of Female Pelvic Medicine & Reconstructive Surgery and the Pelvic PT teams have come together to provide care in the same location, changing the paradigm in which we practice to increase patient convenience and access to appointments, increase important collaborations and interprofessional interactions, and more effectively use patient time. For example, a patient arrives at PT and reports new-onset symptoms of a bladder infection. The PT and urogynecology team immediately communicate about the patient and a urine specimen is collected onsite providing convenient services all while building an improved understanding of patient responsibilities between clinicians. This close collaboration with quick feedback loops among clinicians allows each to work at the height of their license, minimizing waste and resulting in more satisfied patients. Our ongoing quality assurance survey supports this, demonstrating patient preference of co-location of clinicians versus separate clinic locations. Since the initiation of the co-located pilot program, we have grown and now provide all physicians in the Women’s Health Center direct access to six pelvic PTs through EPIC scheduling, with a therapist on-site two days per week. We are currently collecting data to assess clinical outcomes, patient satisfaction, and cost to demonstrate the value and need for growth of this interprofessional service line.

In addition, co-located care aligns with the shift in health care reimbursement toward quality-oriented, outcome-driven alternative payment models and pathways. Merit-based incentive payment systems have already been put in place for patients with Medicare. Historical precedent shows that reimbursement across all third-party payers tend to follow Medicare trends, meaning over time, these parameters may more broadly impact practice. Health systems with low-cost, conservative care services readily available will be most prepared for this impending shift. Co-located, interprofessional models represent an initial, yet crucial, strategic step that Washington University can make to meet the needs of patients and payers in the coming years as the industry moves into the era of personalized medicine.

Taylor D Chapman PT, DPT, WCS, CLT

taylordchapman@wustl.edu

Thank you to the Washington University Obstetrics and Gynecology Department, The Female Pelvic Medicine and Reconstructive Pelvic Surgery Specialists, and The Physical Therapy Program for your passion for continued improvements in healthcare services and willingness to integrate professions to enhance the quality of care provided.  

Prison Hospice: An Interprofessional Effort

Prison Hospice: An Interprofessional Effort

 Christa Burke, MSW, LCSW, ACHP-SW, APHSW-C 

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An interprofessional team is teaching prisoners how to care for fellow inmates who are dying. Physicians, Nurses, Chaplains and Social Workers are working together to support the Missouri Department of Correction’s Prison Hospice Program.

Since 2015 the Missouri Hospice and Palliative Care Association has coordinated a grant funded effort to support hospice programs within all Missouri correctional facilities. The interprofessional team brings hospice and palliative care experts from around the state for an in-depth seven-hour training covering the physical, spiritual, psycho-social and emotional aspects of dying with a goal to provide a select group of offenders the tools to provide compassionate, comforting care to those at end of life in Missouri prisons. Several BJC employees have been actively involved in the effort to provide this interprofessional education to offenders. Chaplain Hamish Seegers and social worker, Christa Burke, both on the Palliative Care Team at Barnes-Jewish Hospital, have participated in trainings at several correctional facilities during 2019. This program has had a profound effect on many offenders with many reflecting on their ability to find meaning in their lives while in prison and as an opportunity to give back to others.

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Christa Burke, MSW, LCSW, ACHP-SW, APHSW-C

Social Worker, Palliative Medicine Service

Barnes-Jewish Hospital

Recent CIPE Scholarship

Recent CIPE Scholarship:

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Yoon Lee, PharmD student presenting at the Collaborating Across Borders Conference in Indianapolis, IN.

 Conference Presentations:

Crist, S.M., & Hantack, K. (2019) Merging Ethical Principles in Pediatric Case Discussions with Both Nursing and Pharmacy Students. Poster session presented at the biennial Collaborating Across Borders VII Conference, Indianapolis, IN.

Grice, G., Graber M., Aebersold, M. (2019) Diagnosis: A Team Sport. Oral presentation at biennial Collaborating Across Borders VII Conference, Indianapolis, IN.

Hageman, H. (2019). Building Experiential Learning Activities Linked to IPEC’s Core Competencies with Academic Practice Partnerships. Oral presentation at Annual IPEC Institute Conference, Portland, OR.

Lee, Y., Xu, Z., Obiofuma, C., Landon, M., Qi, A., Katz, B., Evans, S., Ross, W.R., Chen, S., & Kerwin, L. (2019). Integration of Pharmacy Students into the Washington University Saturday Neighborhood Health Clinic. Poster session presented at the biennial Collaborating Across Borders VII Conference, Indianapolis, IN.

Stevens, A., Bland, M., Yau, T., Chen, J., Nellis, P. & Mueggenburg, K. (2019). Student Perceived Value of Preparedness for Practice after Completing a Transitions of Care Interprofessional Education Experience.  Poster session presented at the annual BJH Multidisciplinary Conference, St. Louis, MO.

Tyminski, Q., Hageman, H., & Fliesher, S. (2019) An Interprofessional Poverty Simulation to Explore the Lived Experience of Poverty and the Role of the Health Care Team Within This Population. Oral presentation at the biennial Collaborating Across Borders VII Conference, Indianapolis, IN.

Grant Funding:

Training in Interprofessional Education for Palliative Care in Oncology

Local interprofessional team was accepted into the InterProfessional Education eXchange (ipex), a national training program for educators in developing interprofessional education for supportive care in oncology.

Department of Health and Human Services, National Institutes of Health
The team in alphabetical order: Christa Burke, MSW, LCSW, ACHP-SW, APHSW-C, Brian Carpenter, PhD, Maria Dans*, MD, Heather Hageman, MBA, and Amy Jacobs, MSN, RN AGCNS, ACHPN.

*PI

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The interprofessional palliative care in oncology team at the Interprofessional Education Exchange Training in Chicago, IL. (From left to right: Heather Hageman, MBA Christa Burke, MSW, LCSW, ACHP-SW, APHSW-C, Amy Jacobs, MSN, RN AGCNS, ACHPN, Maria Dans, MD, and Brian Carpenter, PhD.)

CIPE Professional Development Events
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