12th All-Ohio Institute on Community Psychiatry MARCH 27, 2015 Using an Interprofessional Consultation Team to Enhance Workforce and Learner Experiences in the Integration of Mental Health and Primary Care Janice Spalding, M.D., FAAFP; Douglas Smith, M.D., DFAPA; Lon C. Herman, M.A.; Jody M. Bell, APP, CPS; Ron Rett, B.S.; and Nichole E. Ammon, M.S.Ed., PCC-S INTEGRATED CARE TECHNICAL ASSISTANCE and CONSULTATION TEAM Background and History Who is the TACT Team? Nichole E. Ammon, MSEd, PCC-S Jody M. Bell, APP, CPS Sara E. Dugan, PharmD, BCPP Lon C. Herman, MA Ron Rett, BA Douglas Smith, MD, DFAPA Janice Spalding, MD John M. Ellis, LISW-S, LICDC, ICCS Vicki Montesano, PhD Not pictured: Laura Riley, CNP Mark R. Munetz, MD MEDTAPP Healthcare Access Initiative • This program is partially funded by the MEDTAPP Healthcare Access (HCA) Initiative* and utilizes federal financial participation funds through the Ohio Department of Medicaid • The MEDTAPP HCA Initiative partners with Ohio’s colleges and universities to support the development and retention of additional healthcare providers to better serve the Ohio Medicaid population using emerging, interdisciplinary, and evidence-based care models • Views stated in this presentation are those of the researchers only and are not attributed to the study sponsors, the Ohio Department of Medicaid or to the Federal Medicaid Program *MEDTAPP HCA Initiative funding supports teaching and training activities associated with this program, and does not support the delivery of Medicaid eligible services. TACT TEAM GOAL – Prepare health professions trainees to become effective members of interprofessional, integrated health care teams – Specific focus on ensuring trainees receive advanced interprofessional education with an interdisciplinary, team integrated care settings in Ohio Microsoft Clip Art 2014 TACT’s APPROACH to CONSULTATION and TRAINING CASE STUDY • Organizations that are working towards integration of health care services and plan to utilize integrated care teams – Community Mental Health Center (CMHC) and – Federally Qualified Health Center (FQHC) • Both host students/trainees during field placement experiences ASSESSMENT • Utilization of a web-based survey to explore organizational familiarity and exposure to topics commonly found in both interprofessional practice/education and integrated health care COMPETENCY FOCUS AREAS • Values and Ethics for Interprofessional Practice • Interprofessional Communication • Person-Centered Care • Teams and Teamwork • Roles and Responsibilities • Population Management ENHANCE COMPETENCIES • Identify strengths and areas for improvement based on assessment • Provide focused consultation and live, customized training to bolster areas identified by the organizational assessment – Including emphasis on teaching/modeling to end-of-pipeline learners ONGOING EVALUATION and CONSULTATION • Collaboration and Satisfaction About Care Decisions (CSACD) scale (©J. Baggs, 1992) – Adapted by TACT, with permission, to evaluate integrated care planning among teams – Web-based implementation of test/re-test over time LESSONS LEARNED TRENDS • Communication – – – – Individuals Teams Systems Terminology • Interprofessional Education – Understanding your impact on learners • Population Management – Understanding the shared population – Understanding your partner in integration – Understanding how regulations may or may not impact daily tasks NEEDS: WORKFORCE PREPARATION • There is no one best view or model of integrated health care • Engagement occurs around something that is evolving and malleable • COMMUNICATION and COLLABORATION skills NEEDS: QUALITY FIELD PLACEMENTS • Knowledge about what students and trainees actually experience during field placements – Interprofessional, team-based care – Integration of health care services • Environment that models collaborative care at it’s best (regardless of how the organization(s) are managing integration) TEAM-BASED PRACTICE and EDUCATION is POSSIBLE • Effective leadership is essential! • Each team is different – Establish team expectations early – Develop clear roles and responsibilities • Productive discussions may involve divergent opinions – A common vocabulary is critical – However, it will not be the starting point • Debriefing and feedback sessions are worth the time CHALLENGES Organizations Integrating Health Care TACT • Access to learners – Impacting classroom and/or curriculum – Approach begins at the organizational (field placement) level • Time – Productivity = Billable v. Productive • Time is critical and not enough is set aside for: – – – meetings / huddles general communication teaching and training NEXT STEPS • Ongoing use of assessment / evaluation tools – Organizational survey – CSACD • Focused Consultation • e-Learning Modules • Regional (live) Training • Better Engagement of Students / Trainees In development – Learner Evaluation tool Identify what areas of interprofessional, integrated health care the learners are (and are not) gaining exposure to