Transforming Care Conferences through Interprofessional Teams
MidMichigan Stratford Village
Patients in long-term care settings can require very intensive care from a variety of health care professionals: physical and occupational therapy, nursing, social work, medicine, and pharmacy. Unlike in acute-care settings, most of the clinicians do not spend the majority of their time within the long-term care facility, making coordinating care difficult.
MidMichigan’s Stratford Village responded to low patient satisfaction scores around goal settings, discharge planning, and family updates by implementing interprofessional care coordination sessions and better communicating with the patient and family members during these times.
Bringing together the patient’s nursing, social work, physical, occupational, and speech therapy providers, along with the director of nursing and the administrative director of the facility required tremendous support across the organization to improve the patient experience.
Furthermore, the staff developed scripting for each conference team member and used a focused agenda, making the best use of time and giving patients and family members opportunities to provide feedback and ask questions.
Team members have supported this initiative because it helps address difficult conversations with patients and families by bringing the entire health care team together to develop the full picture of the patient’s care plan.
Prior to implementing this plan, the Stratford Village facility ranked behind its peers for patient satisfaction scores on progress towards rehab goals, setting discharge goals, and commitment to family updates. After implementing this change, Stratford Village scored five points above of peer facilities on all three metrics.
Wayne State University: Interprofessional Team Home Visit Program Fostering a Collaborative Approach to Patient Care
Wayne State University
Caring for older adults in their home makes sense: patients are happier, families have an easier time, and it saves everyone money. Wayne State University interprofessional student care teams visited 450 older adults to assess how their health and social needs interact with their home environment.
More than 800 students from a wide range of disciplines participated in the project: second year medical students, second and third year pharmacy students, social work, occupational and physical therapy, physician assistant, and nursing students all participated in the project.
Through a one hour long home visit and half-hour follow up visits, students lead health assessments with the patients, but also learned more about the education and training of their fellow students.
Each student team typically had three different student types and now interprofessional care concepts are part of regular coursework for students.