Interprofessional Collaborative Practice Model Research Articles

Nurse-Led Care Coordination in a Transitional Clinic for Uninsured Patients With Diabetes.

The purpose of this article is to inform the reader of the practice of the registered nurse care coordinator (RNCC) within an interprofessional, nurse-led clinic serving uninsured diabetic patients in a large urban city. This clinic serves as a transitional care clinic, providing integrated diabetes management and assisting patients to establish with other primary care doctors in the community once appropriate. The clinic uses an interprofessional collaborative practice (IPCP) model with the RNCC at the center of patient onboarding, integrated responsive care, and clinic transitioning. Interprofessional, nurse-led clinic for uninsured patients with diabetes. Interprofessional models of care are strengthened using a specialized care coordinator. Care coordination is a key component in case management of a population with chronic disease. The RNCC, having specialized clinical expertise, is an essential member of the interdisciplinary team, contributing a wide range of resources to assist patients in achieving successful outcomes managing diabetes. Transitional care coordination, moving from unmanaged to managed diabetes care, is part of a bundled health care process fundamental to this clinic's IPCP model. In a transitional clinic setting, frequent interaction with patients through onboarding, routine check-ins, and warm handoff helps support and empower the patient to be engaged in their personal health care journey.

Patients' experiences of and roles in interprofessional collaborative practice in primary care: a constructivist grounded theory study.

This constructivist grounded theory study aimed to (1) explore patients' experiences of and roles in interprofessional collaborative practice for chronic conditions in primary care and (2) consider the relevance and alignment of an existing theoretical framework on patients' roles and based on the experiences of patient advocates. High-quality management of chronic conditions requires an interprofessional collaborative practice model of care considering an individual's mental, physical, and social health situation. Patients' experiences of this model in the primary care setting are relatively unknown. A constructivist grounded theory approach was taken. Interview data were collected from primary care patients with chronic conditions across Australia in August 2020 - February 2022. Interviews were recorded, transcribed verbatim, and thematically analysed by (1) initial line-by-line coding, (2) focused coding, (3) memo writing, (4) categorisation, and (5) theme and sub-theme development. Themes and sub-themes were mapped against an existing theoretical framework to expand and confirm the results from a previous study with a similar research aim. Twenty adults with chronic conditions spanning physical disability, diabetes, heart disease, cancer, autoimmune, and mental health conditions participated. Two themes were developed: (1) Adapting to Change with two sub-themes describing how patients adapt to interprofessional team care and (2) Shifting across the spectrum of roles, with five sub-themes outlining the roles patients enact while receiving care. The findings suggest that patients' roles are highly variable and fluid in interprofessional collaborative practice, and further work is recommended to develop a resource to support greater patient engagement in interprofessional collaborative practice.

Teaching Person-Centered Care and Interprofessional Collaboration through a Virtual Mental Health World Café: A Mixed Methods IPE Pilot Project

The purpose of this convergent mixed methods interprofessional education (IPE) pilot project was to help health profession students gain valuable insight about the experiences of people living with mental illness, to help them have a better understanding of person-centered care and have greater knowledge about the importance of interprofessional collaboration. A developmental workgroup which consisted of mental health consumers, four interdisciplinary students, and our team developed and implemented a virtual Mental Health World Café IPE event. Twelve other students attended the World Café event. A paired sample t-test was used to examine group differences between pre- and post-test scores for the Interprofessional Socialization and Valuing Scale and the Texas AHEC Survey measures among the four student leaders and the 12 student participants of the virtual Mental Health World Cafe. We conducted individual interviews with the four student leaders and collected reflective journals from the 12 students who attended the World Café event. We examined to what extent the statistically significant quantitative results supported the qualitative results separately for the student leaders and for the student participants of the virtual World Café. We also examined how both the quantitative and qualitative findings aligned with the key components of the Patient-Centered Care in Interprofessional Collaborative Practice Model. While the project allowed the students to reflect upon how they may apply the principles of person-centered care and interprofessional collaboration, the impact of the consumers on the student’s experiences was profound and resulted in widespread engagement of the students who attended the event.

Interprofessional Collaborative Practice: Management of Chronic Disease and Mental Health Issues in Primary Care.

This case study describes the process of implementing and evaluating an interprofessional collaborative practice (IPCP) program for primary care and behavioral health integration focused on chronic disease management. The result was a strong IPCP program in a nurse-led federally qualified health center serving medically underserved populations. The IPCP program at the Larry Combest Community Health and Wellness Center at the Texas Tech University Health Sciences Center spanned >10 years of planning, development, and implementation, supported by demonstration, grants, and cooperative grants from the Health Resources and Services Administration. The program launched 3 projects: a patient navigation program, an IPCP program for chronic disease management, and a program for primary care and behavioral health integration. We established 3 evaluation domains to track the outcomes of the program: TeamSTEPPS education outcomes (Team Strategies and Tools to Enhance Performance and Patient Safety), process/service measures, and patient clinical and behavioral measures. TeamSTEPPS outcomes were evaluated before and after training on a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree). Mean (SD) scores increased significantly in team structure (4.2 [0.9] vs 4.7 [0.5]; P < .001), situation monitoring (4.2 [0.8] vs 4.6 [0.5]; P = .002), and communication (4.1 [0.8] vs 4.5 [0.5]; P = .001). From 2014 to 2020, the rate of depression screening and follow-up improved from 16% to 91%, and the hypertension control rate improved from 50% to 62%. Lessons learned include recognizing partner contributions and the worth of each team member. Our program evolved with the help of networks, champions, and collaborative partners. Program outcomes show the positive impact of a team-based IPCP model on health outcomes among medically underserved populations.

Leading Multisector Partnerships to Address Social Determinants of Health and Advance Health Equity for an Underresourced Heart Failure Patient Population.

Addressing the social determinants of health (SDoH) to advance health equity for persons with heart failure is a complex endeavor. Best results are achieved in partnership with multiple sectors beyond just the health care industry. We describe the evolution of an academic-practice-community partnership addressing the SDoH to advance health equity for a population of underresourced heart failure patients. Using a bundled approach to care delivery within a nurse-led interprofessional collaborative practice model and cultivating multisector partnerships, we initiated a systematic approach to addressing the SDoH within a heart failure clinic in the southeastern United States. Through our SDoH program, our clinic has improved access to care, medications, and food for our patients, thus advancing health equity and reducing hospital readmissions. Our multisector partnerships to address SDoH and advance health equity provide a foundation to improve population health outcomes for underresourced persons with heart failure. An SDoH program such as ours would not have been possible without strong leadership and collaboration of colleagues from multiple disciplines and sectors. In keeping with the Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity report, we showcase our actions consistent with the report's recommendations.

Taking an interprofessional collaborative practice to the next level: Strategies to promote high performing teams

Interprofessional collaborative practice is an effective model to deliver care to vulnerable populations. Nurse-led interprofessional clinics have shown improvements in patient outcomes including patients with heart failure. Yet, few studies report the sustainability of high performing interprofessional teams. The purpose of this paper is to describe the interventions and strategies implemented by the Heart Failure Transitional Care Services for Adults Clinic team over a 4-year time period to hardwire and promote high team performance and interprofessional collaboration as well as the ongoing evaluation of team function. This prospective study used an implementation science design so that important information learned could be easily translated into practice in a timely way. All domains of the SOAP-C questionnaire improved over time. Four of 7 domains in the CPAT questionnaire also improved over time. Team assessment revealed the team is in the performing stage of Tuckman's stages of team development. Working to build a high performing nurse-led interprofessional team that cares for underserved patients with heart failure is challenging, yet achievable. Our findings extend our previous work and support others who utilize the interprofessional collaborative practice model to improve health outcomes. • Successful integration of interprofessional collaborative practice competencies is achievable. • Consistent and focused attention on the entire team is essential for high performing teams. • Integration of interprofessional collaborative practice competencies can assist teams to become high performing teams.

The Association of COVID-19 on Organizational Attitudes in Primary Care Among Interprofessional Practice Clinics.

This article describes the association of COVID-19 on organizational attributes in primary care among 2 academic-practice partnership interprofessional collaborative practice (IPCP) clinics. Our team used a concurrent, triangulation repeated-measures study design to examine responses to the Survey of Organizational Attitudes of Primary Care (SOAP-C) instrument between January and December 2020. Analysis revealed statistically nonsignificant change over 12 months across all 4 subscales. Study results suggest that IPCP teams can function effectively through adversity. The IPCP model seemed to bolster resilience making it a viable model for ambulatory practices caring for vulnerable populations.

Providing occupational and physical therapy services in a free community-based interprofessional primary care clinic

ABSTRACT Interprofessional care provided in a free community-based clinic that focuses on chronic health conditions and health promotion provides an innovative solution to improve societal health. Many existing clinics provide a range of professions, but few include allied health services such as occupational and physical therapy. This paper provides a description of the development and implementation of an expanded faculty-guided student-led community-based primary care clinic that includes occupational and physical therapists as part of an interprofessional collaborative practice model. A detailed description and explanation of the partners involved, the institutional missions that drive this work, the logistics completed that enabled the ‘doors to open,’ faculty and student roles, and initial outcomes will be provided. A review of the service delivery model, lessons learned, and future directions for the clinic will also be offered.

Interprofessional Collaboration Between Audiologists, SLPs

Interprofessional Collaboration Between Audiologists, SLPs

Sustainability of an Interprofessional Collaborative Practice Model for Population Health.

Sustainability is an important concept in implementation science, yet little about sustainability is published in leadership journals. Leaders are charged on a daily basis with initiating programs that make a difference; however, they are often not well prepared to design effective strategies to sustain their efforts. In a value-based health care industry where facilitating access to care, enhancing the patient experience, improving health outcomes, and reducing the cost of care are imperative, creating sustainability strategies that achieve these results is key. In this article, we describe the successful efforts within an academic-practice partnership to implement a sustainable interprofessional collaborative practice model emphasizing transitional care coordination in chronic disease management for advancing population health with underserved populations. A sustainability framework is presented along with lessons learned.

Impact of Interprofessional Primary Care Practice on Patient Outcomes: A Scoping Review

Systematic reviews have provided some insight into the impact of interprofessional collaborative practice on patient outcomes. Despite strong interest in interprofessional collaborative practice, relatively little is known about its impact in primary care settings. This scoping literature review describes the essential elements of an interprofessional primary care practice and explores what is known about its impact on patient care including clinical, humanistic, and economic outcomes. We completed a review of the literature examining the breadth of knowledge related to interprofessional collaborative practice in primary care settings. A search was conducted to identify studies based on predefined criteria. A total of 51 studies met the criteria. A total of 27 studies reported a significantly positive clinical outcome with the interprofessional collaborative practice model, 27 studies reported no difference, and one study reported negative outcome in mortality. A total of 15 studies reported a significantly positive humanistic outcome. There was little to no difference in economic outcomes. This study provides new insights for future research that examines the impact of interprofessional primary care practice.

Interprofessional Collaborative Practice Model to Advance Population Health

The purpose of this paper is to describe the development, implementation, and lessons learned associated with an interprofessional collaborative practice (IPCP) care delivery model initiated at the University of Alabama at Birmingham (UAB). The model emphasizes transitional care coordination in chronic disease management for underserved and vulnerable populations. The model operates within a clinic environment with care providers from a variety of disciplines who integrate individual case management and actualize leadership taken by the appropriate discipline based on the needs of each patient. Two clinics will be discussed - Providing Access to Healthcare (PATH) and Heart Failure Transitional Care Services for Adults (HRTSA) - both of which leverage the resources of an existing academic-practice partnership between the UAB School of Nursing and UAB Hospital (UABH) and Health System. Clinic target patient populations are uninsured adults with diabetes (PATH Clinic) and uninsured or underinsured adults with heart failure (HRTSA Clinic) who are discharged from UABH with no source for ongoing care. The model uses a nurse-led, team-based approach that involves multiple professions working together to provide care for high-need, high-cost patients. Clinics use 4 simultaneous bundles of care that include evidence-based treatment guidelines, transitional care coordination activities, patient activation strategies, and behavioral health integration. Engaged patients indicate very high levels of satisfaction with care and improved physical and mental health outcomes resulting in significant cost savings for the health system. Finally, IPCP team members report joy in their work within the clinics.

A MIXED-METHODS EVALUATION OF A NURSE-LED INTERPROFESSIONAL INTERVENTION FOR COMMUNITY-DWELLING OLDER ADULTS

This study aims to assess the relationship between an Interprofessional Collaborative Practice (IPCP) intervention for community-dwelling older adults, Geriatric Outreach and Training with Care! (GOT Care!), and the observed 26% reduction in Emergency Department (ED) visits for the 51 older adults who participated. This study utilized a convergent parallel mixed-methods design that included a historical prospective matched cohort study and semi-structured interview surveys. The 51 GOT Care! participants were retrospectively matched to 51 control participants on several variables and ED visits were assessed for each group at 6, 8 and 12 months. Mixed effects generalized linear modeling, with a Poisson response, a log link function, and a random effect for pair, was conducted to analyze the quantitative data. Stakeholders, including hospital administrators and faculty clinicians, of GOT Care! responded to electronic semi-structured interview surveys regarding the relationship between GOT Care! and the observed reduction in ED visits. Content analysis of the responses was completed. The themes from the stakeholder interviews were integrated into the historical prospective matched cohort study to further explore the relationship between GOT Care! and the reduction in ED visits. The results of this study are still pending. This study has implications regarding the utilization of an IPCP model within an academic-practice partnership in the aim of reducing ED visits for vulnerable community-dwelling older adults. Hospital administrators can also utilize the results of this study to gauge the value of IPCP models within their hospital systems.

Integration of Authentic Leadership Lens for Building High Performing Interprofessional Collaborative Practice Teams.

Interprofessional collaborative practice (IPCP) models facilitate collaboration and teamwork across the health care continuum. Success of high performing IPCP teams is dependent on compassionate, authentic leaders who invest in helping their teams thrive amidst complexity. This article presents the integration of an authentic leadership lens for building high performing IPCP teams. Using their experience with implementation of an innovative IPCP model to improve health outcomes for an underserved patient population in the southeastern United States, the authors share targeted strategies using an authentic leadership lens to develop high performing teams. Data collected for 3 years reflect positive team performance outcomes related to collaboration and teamwork, which contributed to enhanced access to care, exceptional patient experience, improved physical and mental health outcomes, reduced hospital readmissions, and decreased cost of care. An innovative IPCP model of care is an effective approach to improve health outcomes and care transitions. However, it may not be fully successful if health care professionals practicing within these models cannot collaborate effectively or maintain personal well-being. The value of using an authentic leadership lens to guide IPCP team development cannot be underestimated.

Test of an interprofessional collaborative practice model to improve obesity-related health outcomes in Michigan

Abstract The purpose of the study was to test the effectiveness of an interprofessional collaborative practice (IPCP) education program on clinicians' and students' knowledge and attitudes toward IPCP and to determine the effectiveness of an IPCP weight loss program in two nurse-managed centers. The study team used the Midwest Interprofessional Practice, Education, and Research Center (MIPERC) collaborative practice education program that consists of online learning modules followed by daily huddles and collaborative care planning. The obesity intervention program was implemented by faculty and staff practitioners and students in two clinics with very different patient populations (community residents and college students). Staff/faculty practitioners and students demonstrated statistically significant knowledge gains as a result of online learning modules (Introduction to IPE p .05). The study demonstrated the potential of an IPCP program to affect weight loss in two populations.

Improving Population Health Among Uninsured Patients with Diabetes.

Diabetes is a leading cause of morbidity and mortality; prevalence of diabetes is especially high in the southeastern United States among minority populations and those from lower socioeconomic sectors without access to health care services. The purpose of this project was to evaluate the clinical and financial outcomes of a nurse-led, interprofessional collaborative practice model that provides care coordination and transitional care for uninsured patients with diabetes. Data for this study were collected and evaluated from medical records of patients seen at the Providing Access to Health Care (PATH) Clinic between August 1, 2015, through May 30, 2017. Clinical outcomes were evaluated by comparing hemoglobin A1c (HbA1c) values before and after referral to the PATH Clinic. Cost savings to the academic medical center were evaluated by comparing costs associated with inpatient or emergency department encounters before and after referral to the PATH Clinic. A significant decrease in HbA1c (P < .0005) was noted for patients attending the PATH Clinic. In addition, financial analyses revealed a 55% decrease in pre to post PATH Clinic patients' direct costs. Similarly, a 42% decrease in the pre to post PATH Clinic patients' direct cost per encounter was noted. Average length of stay also was reduced when these patients were readmitted to the academic medical center. Results from this study support the effectiveness of the PATH Clinic model in caring for uninsured patients with clinically complex medical and social needs, often with behavioral health problems, who incur high health care spending and are often readmitted.

Providing primary care using an interprofessional collaborative practice model: What clinicians have learned.

This article details a nurse-led, interprofessional collaborative practice (IPCP) model that was developed to provide primary care to a medically indigent population in Birmingham, Alabama. Funding to develop and implement this project came from a federal Nurse Education, Practice, Quality and Retention award to the University of Alabama at Birmingham (UAB) School of Nursing, with additional support coming from the UAB Hospital and Health System. The clinic is housed within a local community-based, non-profit organization and all services, including supplies and pharmaceuticals, are provided free of charge to this vulnerable population. The IPCP model that was developed includes three primary care teams and incorporates faculty clinicians from a variety of disciplines, including nursing, medicine, optometry, nutrition, mental health, social work and informatics. Evaluation of the project has included annual structured interviews of project personnel, a variety of survey instruments completed electronically at various intervals, and assessments by students as well as patients experiencing team-based care. The focus of this article is the qualitative data collected from structured interviews of clinician faculty annually over the three years of the funded project. The learning, understanding and growth that have taken place by the experienced clinicians from multiple disciplines regarding IPCP are detailed.

Integration of Clinical Pharmacist Services into an Underserved Primary Care Clinic Utilizing an Interprofessional Collaborative Practice Model.

This report describes the role of a clinical pharmacist serving onsite in an interprofessional collaborative practice care model at an urban underserved primary care clinic. It also overviews current health care legislative policy as it relates to expanding pharmacists roles as an integrated team member in medically underserved, vulnerable populations.

Evaluation of Team-Based Care in an Urban Free Clinic Setting.

This article reports the experiences of a school of nursing, academic health center, and community-based organization working via an interprofessional collaborative practice model to meet the mutual goal of serving the health care needs of an indigent, largely minority population in Birmingham, Alabama. The population suffers disproportionately from chronic health problems including diabetes, obesity, cardiovascular disease, asthma, and mental health disorders. The program emphasizes diabetes management because the academic health center recognized the need for transitional and primary care, including mental health services, for the increasing numbers of uninsured patients with diabetes and its comorbidities. Half of the clinicians involved in this project had no prior experience with interprofessional collaborative practice, and there was confusion regarding the roles of team members from the partnering institutions. Activities involving care coordination consistently received low scores on weekly rating scales leading to the creation of positions for a nurse care manager and pharmaceutical patient assistance program coordinator. Conversely, shared decision making and cooperation ratings were consistently high. Evaluation identified the need for reliable, accessible data and data analysis to target clinically effective interventions and care coordination and to assess cost effectiveness. The strengths, challenges, lessons learned, and next steps required for sustainability of this alignment are discussed.

Testing an Interprofessional Collaborative Practice Model to Improve Obesity-related Health Outcomes with a Statewide Consortium

s / Journal of Interprofessional Education & Practice 1 (2015) 48e77 66 multiple disciplines to work side-by-side with a patient will be an impediment to adopting inter-professional care models in their own future practices.