Nathan Painter, PharmD, CDE; Michael Caruso MD; Joycelyn Mallari, PharmD; Zephon Lister, MA, MS; Anne Berit Petersen, MS,...
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Nathan Painter, PharmD, CDE

Published on: Mar 3, 2016
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Transcripts - Nathan Painter, PharmD, CDE

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Nathan Painter, PharmD, CDE; Michael Caruso MD; Joycelyn Mallari, PharmD; Zephon Lister, MA, MS; Anne Berit Petersen, MS, MPH, RN; Sandy Suarez, MSW; Barbara Hernandez, PhD ; Yasmin Chene, MT(ASCP), PA-C; Donna Smith-Burgess, MA, MS, LMFT; Wayne Dysinger, MD, MPH The Development and Structure of the Loma Linda University Interprofessional Prevention Education in Diabetes for the Underserved at SACHS Clinic Lab Structure <ul><li>Type 2 Diabetes Mellitus has a major impact on the US healthcare system and is associated with high mortality, 1,2 morbidity, 3,4 and costs 5 . </li></ul><ul><li>Research clearly indicates that interdisciplinary approaches to diabetes care aids in the improvement of clinical outcomes (glucose, BP, lipids, A1c, and weight) as well as lifestyle changes (diet and exercise), and reduced costs 6 . </li></ul><ul><li>Identified need for interprofessional learning opportunities on campus. </li></ul><ul><li>Participating faculty represent the schools of Medicine, Pharmacy, Nursing, Social Work, Marriage and Family Therapy, Nutrition, and Physician’s Assistant program. </li></ul><ul><li>Collaboration led to the development of an interprofessional lab at Social Action Community Health System (SACHS) Clinic in San Bernardino, California. </li></ul>Introduction <ul><li>By the end of the lab, students should be able to: </li></ul><ul><li>Recognize and utilize the expertise, background, and knowledge of other health professionals </li></ul><ul><li>Identify the benefits and challenges of using collaborative care approaches in diabetes management </li></ul><ul><li>Discuss the implementation of collaborative care models in different healthcare environments </li></ul>Goals <ul><li>Students report that one of the most beneficial aspects of the lab is being able to interact and learn together with students from other professions. </li></ul><ul><li>Implementing an experiential approach, as opposed to a didactic approach appears to provide a more engaging experience for students who are beginning to develop ideas about collaborative care and their potential participation on interprofessional healthcare teams. </li></ul><ul><li>Discussion with the schools needs to occur to incorporate more students from additional programs in a consistent manner into the lab. </li></ul><ul><li>Identified the need to formalize the curriculum </li></ul><ul><ul><li>Facilitator Manual </li></ul></ul><ul><ul><li>Share with colleagues </li></ul></ul><ul><ul><ul><li>PERC (Prevention Education Resource Center) </li></ul></ul></ul><ul><ul><ul><li>Other resources in our respective fields </li></ul></ul></ul><ul><li>Broader and more formalized integration into academic programs </li></ul><ul><ul><li>Interprofessional Deans Council </li></ul></ul><ul><li>Develop Clinical Practicum for Lab </li></ul><ul><ul><li>Diabetes Clinic </li></ul></ul><ul><ul><li>Student-Run Evening Clinic </li></ul></ul>Results & Future Directions <ul><li>Anderson RN, Smith BL. Deaths: Leading Causes for 2002. National Vital Statistics Reports 2005;53(17):1–92. </li></ul><ul><li>Diabetes in America, 2nd ed . Washington, DC: U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases,1995. NIH Publication No. 95-1468. 293–336. </li></ul><ul><li>Hogan P, Dall T, Nikolov P. American Diabetes Association. Economic Costs of Diabetes Mellitus in the US in 2002. Diabetes Care 2003;26:917–932. </li></ul><ul><li>Centers for Disease Control and Prevention. Team Care: Comprehensive Lifetime Management for Diabetes. Atlanta, Georgia: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 2001. </li></ul>References Lab Format <ul><ul><li>Students are divided into small groups in which as many different professions are represented as possible. </li></ul></ul><ul><ul><li>These groups act as healthcare teams that work together and respond to various concepts and exercises which are introduced from faculty facilitators. </li></ul></ul><ul><ul><li>Through small group interaction, student groups act as collaborative healthcare teams to address patient needs. </li></ul></ul><ul><ul><li>Pre- and post- training evaluations are used to assess the students’ experience of learning the roles, contribution, and work styles of students from other healthcare professions. </li></ul></ul>Results <ul><ul><li>The final lab structure contains five experiential segments, each of which is designed to help students progressively build toward working collaboratively as a healthcare team. The lab segments are: </li></ul></ul><ul><ul><li>Introduction of interprofessional team members </li></ul></ul><ul><ul><ul><li>In the first segment healthcare teams are asked to discuss two questions regarding their profession among themselves and then with the other small groups in the lab. </li></ul></ul></ul><ul><ul><li>Making the case for collaborative care in the treatment of chronic illness </li></ul></ul><ul><ul><ul><li>After this discussion a quiz is given to introduce the concepts, benefits, and importance of interprofessional care in the treatment of patients. </li></ul></ul></ul><ul><ul><li>Connecting with the lived experience of patient’s living with chronic illness - patient interview </li></ul></ul><ul><ul><ul><li>The third segment allows students to interview a patient and family that is living with diabetes. </li></ul></ul></ul><ul><ul><li>Development of an interprofessional collaborative treatment plan </li></ul></ul><ul><ul><ul><li>Based on the information garnered from the interview, the teams develop an interprofessional treatment plan taking into account the strengths and expertise of each discipline represented. </li></ul></ul></ul><ul><ul><li>Implementation of interprofessional care within various healthcare settings </li></ul></ul><ul><ul><ul><li>Students then discuss how to implement their treatment plan within various healthcare environments and discuss the benefits and challenges of working collaboratively in diverse healthcare settings. </li></ul></ul></ul>The current training module was developed over an 18 month period with the purpose of providing students an experiential interprofessional lab on collaborative care. During this 18 month period different lab exercises and components were developed, piloted and then evaluated before becoming part of the current training lab. Pre- and post-training evaluations are used to continually assess and refine components of the lab. Methods <ul><li>Local indigent clinic that serves over 32,000 patients per year and is a major site for training students from Loma Linda University. </li></ul><ul><li>Majority Hispanic population </li></ul><ul><li>Services provided at SACHS: </li></ul><ul><ul><li>Behavioral Health • Primary Care </li></ul></ul><ul><ul><li>Dental • Occupational and Physical </li></ul></ul><ul><ul><li>Obstetrics Therapy </li></ul></ul><ul><ul><li>Pediatrics • Speech </li></ul></ul><ul><li>An estimated 35% of clinic patients have diabetes with many more at risk for developing diabetes. </li></ul>SACHS Clinic <ul><li>The mission of Loma Linda University (LLU) is “To make man whole.” </li></ul><ul><li>The lab advances this mission by focusing on an interdisciplinary approach to improve patients’ overall quality of life with a focus on diabetes management and education. </li></ul>LLU Mission <ul><ul><li>Use of mixed-method approach </li></ul></ul><ul><ul><li>Implement a pre-post/post-pre evaluation design </li></ul></ul><ul><ul><li>Develop and use standardized instruments (Demographic and Quality Improvement Measures, Attitudes Toward Health Care Teams Scale (ATHCTS), Kinetic Medical Team Drawing (KMTD), and Perception of Interprofessional Education and Collaboration Scale (PIECS) </li></ul></ul>Evaluation Tools

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