Pew Health Professions Commission Research Articles

Communication Commentary: It Takes a Village: Effective Interprofessional Collaboration in Health Care Teams

Health care is changing. The technologies available for diagnostics are improving. The methods of acquiring and sharing information are burgeoning with the advent of the electronic medical record and information technology. Care is expected to be patient-centered, ensuring that the patient and familyunderstandtheoptionsavailable for treatment and are the decision-makers guiding care. In addition, health care is increasingly team-based. A broadly accepted definition of team-based health care is “the provision of health services to individuals, families, and/or their communities by at least two health providers who work collaboratively with patients and their caregivers—to the extent preferred by each patient—to accomplish shared goals within and across settings to achieve coordinated, high-quality care” (1). “The high-performing team is now widely recognized as an essential tool for constructing a more patient-centered, coordinated, and effective health care delivery system” (2, p. 3). With the literature burgeoning with new research findings, and with the research evidence that serves as the metric for quality of care continually changing, no single physician can absorb all of this information. Physicians must rely on specialists in other fields. Patient consumers are frequent utilizers of physician services. For example, the “typical Medicare beneficiary visits two primary care clinicians and five specialists per year,” as well as utilizing the ancillary services of diagnostic radiology, laboratory testing, pharmacy, and other services (3). Individuals suffering frommultiple

Pharmacy School Provenance and Pharmacy Practice

Pharmacy School Provenance and Pharmacy Practice

How to Achieve a High-Performance Health Care System in the United States

Letters6 May 2008How to Achieve a High-Performance Health Care System in the United StatesHarvey S. Zarren, MDHarvey S. Zarren, MDFrom Integrative Medicine Alliance, Arlington, MA 02474.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-9-200805060-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The single biggest issue in the quality of health care is the failure to provide adequate time for caregivers to spend with patients (and even with colleagues). Time for quality history assessment, thorough examinations, and careful formulation of diagnosis and treatment plans is not being reimbursed adequately.Single-payer health insurance makes great sense, and there must also be a shift in reimbursement away from testing and procedures toward adequate time for physicians and nurses to form the relationships with patients that are the essence of health care that heals. In 1994, the Pew-Fetzer Task Force report (1) ...Reference1. Pew-Fetzer Task Force on Advancing Psychosocial Health Education. Health Professions Education and Relationship-Centered Care. San Francisco: Pew Health Professions Commission; 1994. Google Scholar Author, Article, and Disclosure InformationAuthors: Harvey S. Zarren, MDAffiliations: From Integrative Medicine Alliance, Arlington, MA 02474.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAchieving a High-Performance Health Care System with Universal Access: What the United States Can Learn from Other CountriesHow to Achieve a High-Performance Health Care System in the United States Jack A. Ginsburg , Robert B. Doherty , and J. Fred Ralston Jr. How to Achieve a High-Performance Health Care System in the United States S. Ward Casscells and MG Elder Granger How to Achieve a High-Performance Health Care System in the United States Arvind R. Cavale How to Achieve a High-Performance Health Care System in the United States Richard S. Leff How to Achieve a High-Performance Health Care System in the United States Richard L. Cruess and Sylvia R. Cruess How to Achieve a High-Performance Health Care System in the United States Thomas James III Metrics 6 May 2008Volume 148, Issue 9Page: 711-712KeywordsCaregiversConflicts of interestHealth careHealth care qualityHealth insurance ePublished: 6 May 2008 Issue Published: 6 May 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Perspectives on multi-professional education (MPE) in the Faculty of Health Sciences, University of the Free State

Greater specialisation of healthcare professionals and more complex and holistic patient care present a pressing requirement for cohesive teamwork among health professionals. This concept was also highlighted in the Cape Town Declaration and the Pew Health Professions Commission, which list multi-professional competencies as one of its 21 health professional competencies. A study by Leaviss showed that negative attitudes about professions were formed during undergraduate training. The challenge to the educator is to engage students in training that facilitates cross-disciplinary respect and outlooks. (Read more in full text)

Medical Licensure and the Federation of State Medical Boards

The Federation of State Medical Boards (FSMB) is the membership association of the nation’s licensing regulatory authorities. The 70 member boards consist of representatives from each of the 50 states, 14 of the states having a separate board for osteopathic physicians. The 4 territories of Puerto Rico, Guam, the Virgin Islands, and the Northern Mariana Islands are also members. The final 2 members are Washington, DC, and a second board from New York. The state of New York is unique in that it has 2 seats in the House of Delegates of the FSMB because it has a board of discipline that reports to the Department of Health and a board of licensure that reports to the Department of Education. All other jurisdictions have a single reporting authority for licensing and regulation. The FSMB was formed in 1912 for the purpose of providing information to the various licensing authorities regarding disciplinary actions. The mission of the FSMB is to ensure continual improvement in the quality, safety, and integrity of health care through the development and promotion of high standards for physician licensure and practice. The FSMB is organized with a house of delegates that meets annually and establishes policy. The House of Delegates elects a 13-member board of directors from the membership, who have the responsibility of overseeing the work of the FSMB, including hiring the CEO who manages the organization and its 145 employees out of the offices in Dallas, Tex. The FSMB offers a number of services to the state medical boards and helps draft policy to improve the licensure and regulatory process in this country. Among those services is maintaining the nation’s largest database on disciplinary actions by physicians. In addition, the FSMB operates a disciplinary alert service in which state medical boards are notified any time a disciplinary action is taken against a licensee in that state. Approximately 80% of physicians who have disciplinary actions against them have licensure in multiple states. The disciplinary alert service provides notification to all the states in which a physician is licensed at the time of the disciplinary action. A data-sharing relationship with the American Board of Medical Specialties (ABMS) provides for notification also to the ABMS any time a diplomate of one of the specialty boards has a medical board disciplinary action taken against him or her.

Strategies to increase success of underrepresentedMinorities in nursing

A major concern for the nursing profession and nurse executives is the need to increase diversity in the registered nurse workforce to better mirror the U.S. population. Although the size of the RN workforce continues to be inadequate to meet societal needs, there are also particular issues related to the composition of the nursing workforce. A diverse workforce is important both to provide culturally and linguistically appropriate services (CLAS) to diverse clients and help reduce health disparities. 1 O'Neill EH, Pew Health Professions Commission. San Francisco: Pew Health Professions Commission; 1998. Google Scholar

Undergraduate community health in the first semester: opportunities and challenges.

In the current health care environment, there is a trend for care to move from acute hospital settings to community settings. The Pew Health Professions Commission and the American Association of Colleges of Nursing identified a need to modify health care professional education to meet the needs of the changing health care system and diverse demographics in the United States. In traditional baccalaureate nursing programs, the community health nursing course typically is taken in the last year, after students have completed medical-surgical nursing courses. This article describes a curriculum that begins with the community health nursing course. Many opportunities and challenges related to this placement are described.

Challenges of Providing Interdisciplinary Mental Health Education

SUMMARY Recommendations and implications of the Pew Health Professions Commission's fourth and final report emphasized the importance of developing interdisciplinary competencies for health professionals (Bellack & O'Neil, 2000). Headrick and Moore (1999) reported to the Association of Academic Health Centers that interprofessional collaboration has not been easy, in part, because most health professional faculty are products of individual, discipline specific models for education. This article provides a conceptual foundation for interdisciplinary health care education at the graduate level based on findings from an interdisciplinary course in child/family mental health at East Carolina University. Classroom challenges affecting interdisciplinary offerings and specific problems that preclude integration of medical students are addressed. The article offers strategies to create a positive interdisciplinary learning climate for pre-professional education. Evidenced-based medicine is discussed as a mechanism to remove discipline specific barriers.

Professional Preparation of Allied Health Practitioners and Special Educators Using a Collaborative Transdisciplinary Approach

This article presents a curriculum model that emphasizes the development of transdisciplinary teaming skills for therapeutic recreation students and students from other related services professions. While health care professionals are often required to work in teams, professional preparation programs provide limited instruction and few experiences that prepare graduates for truly collaborative models of service delivery (Golightly, 1987; Orelove, 1994; Rainforth, York & Macdonald, 1992; Strawderman & Lindsey, 1995; Pew Health Professions Commission, 1991, 1993, 1995). Recent developments in health care reform are emphasizing the need for professionals in allied health to work in a more integrated and collaborative style than ever before. The need for disciplines to be more integrated in their approach to treatment is becoming the benchmark for qualified professionals. The Project TEAM (Transdisciplinary Education and Mentoring) model presented here provides students in communication disorders, early childhood/special education, occupational therapy, and therapeutic recreation with discipline-specific knowledge and skills, as well as a core of cross disciplinary courses and experiences, that prepares them to work effectively as transdisciplinary team members.

A proposed framework for differentiating the 21 Pew competencies by level of nursing education.

Now nearly a decade old, the original Pew Health Professions Commission Competencies have stood up well to the test of time. The competencies were designed to provide all health professionals, from physicians to physical therapists, with a general guide to the values, skills, and knowledge they would need to be successful in the health care system that was beginning to emerge in the late 1980s. They have been used across the range of health professions and in many practice settings to create a framework for curricular change, work redesign, and assessment of professional competence. The interpretation of the competencies offered here should prove to be a useful tool to nurses and health system leaders as they carry on the hard work of adapting the current model of nursing practice to the demands and realties of the contemporary and continually evolving health care environment. This work is important for two reasons. First, many of the skills and attributes of the professional nurse are not adequately used or valued by the health care system because the profession is both fragmented and poorly differentiated and articulated. Without markers that define and promote collaborative practice within nursing, the full potential of nurses at all levels of preparation will continue to be inadequately and inappropriately deployed. This model exacerbates the current nursing shortage because it fails to use nurses in appropriate, well-delineated, and challenging roles. Without this kind of differentiation, one that can be owned and supported by all nurses, there will continue to be suboptimal use of the nursing workforce in the United States. The framework of differentiated Pew competencies and the companion teaching-learning strategies proposed here offer one approach to rationalizing both nursing education and practice, with the potential for improving the quality of care, and reducing fragmentation, cost, and public confusion.

"Enter to learn, go forth to serve": service learning in nursing education.

The Pew Health Professions Commission (1998) has recommended community-based service learning as an integral part of nursing education. Service learning activities in a baccalaureate nursing program with an integrated curricular model are described with a women's health elective used as one example of the integration of service learning with clinical experiences. Based on clinical journal entries, students identified benefits of service learning including (1) a sense of personal satisfaction, (2) professional growth, (3) a higher level of critical thinking skills, (4) preparation for nursing practice in a dynamic and diverse health care delivery system, and (5) an increased awareness of unmet needs in clients, families, communities, and populations. Students are truly engaged because they have the opportunity to apply theoretical concepts in giving service, creating a "capacity for connectedness," and learning social responsibility as professionals.

A vision for health professions regulation in the new millennium: recommendations from the Pew Health Professions Commission.

A vision for health professions regulation in the new millennium: recommendations from the Pew Health Professions Commission.

Charting the Demand for Pharmacists in the Managed Care Era

OBJECTIVE: To describe the activities and conclusions of the Pharmacy Manpower Project (PMP) and its Subcommittee to Study Demand Issues. RESULTS: The PMP evolved out of concerns raised in the late 1980s when the demand for pharmacists exceeded the supply. PMP collects, analyzes, and disseminates data on pharmacy work force variables. PMP's Subcommittee to Study Demand Issues was formed after the publication in 1995 of the Pew Health Professions Commission report projecting dramatic surpluses of pharmacists. In 1996-1997, the PMP subcommittee held a series of sessions to discuss the future demand for pharmacists and their services. The panel identified a wide range of work force projections. CONCLUSIONS: The PMP subcommittee concluded that medication management problems in the context of increasing prescription numbers and the emergence of data-driven health care support a scenario of a steadily increasing demand for pharmacists and pharmaceutical services. The data did not show that higher penetration by managed care is associated with smaller pharmacy staffs or job loss in institutions. There is little reason to expect the dramatic downsizing of the pharmacy work force predicted by the third report of the Pew Commission. However, retaining pharmacy roles that are useful to the system and satisfying to pharmacists will require a continuation of current proactive measures by the profession.

Charting the demand for pharmacists in the managed care era

The demand for pharmacists in the changing health care market is discussed. The Pharmacy Manpower Project (PMP) evolved out of concerns raised in the late 1980s, when the demand for pharmacists exceeded the supply. PMP collects, analyzes, and disseminates data on pharmacy work force variables. PMP's Subcommittee to Study Demand Issues was formed after the publication in 1995 of the Pew Health Professions Commission report projecting dramatic surpluses of pharmacists. In 1996-97, the PMP subcommittee held a series of sessions to discuss the future demand for pharmacists and their services. The panel identified a wide range of work force projections, but it concluded that medication management problems in the context of increasing prescription numbers and the emergence of data-driven health care support a scenario of a steadily increasing demand for pharmacists and pharmaceutical services. The data did not show that higher penetration by managed care is associated with smaller pharmacy staffs or job loss in institutions. There is little reason to expect the dramatic downsizing of the pharmacy work force predicted by the third report of the Pew Commission. However, retaining pharmacy roles that are useful to the system and satisfying to pharmacists will require a continuation of current proactive measures by the profession.

Curriculum trends in nurse practitioner programs: current and ideal.

The purpose of this study was to ascertain the extent to which nurse practitioner (NP) education programs are addressing curriculum topics related to practice competencies needed for the next century as recommended by the Pew Health Professions Commission and other professional organizations, including the American Association of Colleges of Nursing and the National Organization of Nurse Practitioner Faculties. The study was part of a comprehensive survey of 11 health professions education programs. NP program directors indicated greatest dissatisfaction with curriculum coverage of "use of electronic information systems" and "business management of practice." The three most important curriculum topics identified by respondents were "primary care," "health promotion/disease prevention," and "effective patient-provider relationships/communication," identical to the three topics rated most important by all groups combined. The most significant barriers to change identified by the respondents included "an already crowded curriculum" and "limited availability of clinical learning sites." Findings show that NP program directors perceive that they are doing an effective job addressing most of the 33 curriculum topics, but they also recognize a need to continue to improve their curricula in response to the ever-changing health care environment. Barriers to achieving the desired curricular improvements, however, may be significant. Recommendations for overcoming these barriers to change are offered.

New Pew Health Professions Commission report released

AORN JournalVolume 69, Issue 1 p. 260-262 Department New Pew Health Professions Commission report released Candace L. Romig, Candace L. Romig Health Policy Analyst/Legislative Program CoordinatorSearch for more papers by this author Candace L. Romig, Candace L. Romig Health Policy Analyst/Legislative Program CoordinatorSearch for more papers by this author First published: 01 January 1999 https://doi.org/10.1016/S0001-2092(06)62775-0Citations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume69, Issue1January 1999Pages 260-262 RelatedInformation

The Allied Health Core Curriculum

ABSTRACT.A core curriculum for allied health can serve as a catalyst for health care reform and address many of the issues identified by the Pew Health Professions Commission, the National Commission on Allied Health, and the National Health Care Skill Standards Project. A review of the recommendations calling for health care reform and outlining the desired knowledge, skills, and values for health care workers offers a basis upon which to design a core curriculum and to understand the core curriculum concept.

The ramifications of regulatory reform.

This article examines the regulatory reform proposals for the health care workforce recently proposed by politicians and members of the Pew Health Professions Commission. These proposals attempt to address issues related to state practice acts, competence, advanced practice, "boundaryless" practice, the disciplinary process, consumerism, and umbrella legislation. Questions are presented for each issue to guide practitioners when deliberating about possible actions professional organizations can take in proposing legislation at the state level. Various external forces shape each issue and lead to the need to seek such regulatory reform as improving disciplinary processes and activity, assessing competence beyond the entry level, and increasing involvement of consumers. However, there are risks associated with any proposed regulatory reform, particularly if one realizes the potential financial costs associated with competency assessment and advanced-practice regulation. We must also carefully examine any reform proposals that advocate title protection and the licensing of invasive procedures in place of licensing professionals. The fact remains that the impact on quality of care and long-term cost-effectiveness from the unrestricted use of less qualified professionals and unlicensed aide-level personnel to provide skilled services has not been adequately determined.

Curriculum trends in nurse-midwifery education: Views of program directors

/ %The purpose of this study was to determine the extent to which nurse-midwifery education programs are addressing the practice competencies that have been recommended by the Pew Health Professions Commission and others as essential for effective practice in the 21st century. This study was part of a larger survey of eleven health professions education programs. The 56 nurse-midwifery program directors whose names and addresses were provided by the American College of Nurse-Midwives were surveyed by mailed questionnaire, with a response rate of 59% (n = 33). The study sought to identify current and ideal emphasis placed on 33 broad topics, most important curriculum topics, and barriers to curriculum change as perceived by respondents. Findings revealed that nurse-midwifery program directors would like to see greater emphasis placed on every topic except one (tertiary/quaternary care). Desired increases ranged from .04 to 1.36. The overall mean rating for all topics was 3.51 for current emphasis (5-point scale) and 4.18 for ideal emphasis, both of which were higher than any other survey group. The greatest desired increases (> 1.00) were for “primary care,” “managed care,” “use of electronic information systems,” and “business management of practice.” Respondents identified “primary care,” “health promotion/disease prevention,” and “accountability for cost-effectiveness and patient outcomes” as the most important topics. The top three barriers to curriculum change were identified as “already crowded curriculum,” “inadequate funding,” and “limited availability of clinical learning sites,” the last being statistically significant compared with other survey groups. Findings indicate that nurse-midwifery program directors perceived that they are adequately addressing most of the curriculum topics, while continuing to focus on the need for curriculum change as the health care environment changes.

Said another way. Is the ADN graduate prepared to practice in community settings?

The downsizing and closing of acute care facilities and the movement to community-based healthcare services are decreasing the need for RNs in acute care facilities. In the past, the associate-degree nurse (ADN) has filled the majority of positions in acute care. With the trend to provide health services in community setting, will the ADN be prepared for positions in community facilities? ADN educators must reevaluate how they are educating students for practice. The author reviews the 1995 recommendations from the Pew Health Professions Commission and relevant current directives from the National League for Nursing.