Corporate Interprofessional Education Disclosure of Adverse Events

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Corporate Interprofessional Education Disclosure
of Adverse Events

• Glenna Churchill, RN, BNSc, MSN, CGN(C)
• Constance Sunderland, RN, BSN, MA (Ed), CEC

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Partner
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Prince Edward

• Fort Henry
• June 5, 2008 and
• MHS War ship 1780 located in Lake Ontario recently

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Kingston

• Canadas first parliament
• Population 117,207
• gt Than 55 years 42,040 or 36

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Kinston General Hospital

• 456 bed tertiary hospital
• Affiliated with Queens University
• Serves more than 550,000 in Southeastern Ontario
• Is the community based hospital for the area
• 3400 full time and part time employees
• 1200 healthcare students

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IPE Group
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Corporate Interprofessional Education
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Southeast Local Integrated Health Network
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Stimulus for Considering IPE

• Identified need for corporate approach to
  education if policies crossed many disciplines.
• Education not considered as policy being
  developed delaying the education.
• Standardized process for future education across
  the organization.

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Inter-Professional Education

• IPE definition
• Occasions when two or more professions learn
  with, from and about each other to improve
  collaboration and the quality of care (CAIPE,
  2002)

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Collaboration

• IPE involves collaboration in the learning
  process
• Socialize professionals in working together
• shared problem solving
• shared decision making
• Develop mutual respect and understanding for each
  others roles/ disciplines
• Desired outcome collaborative practice and
  enhanced benefits for patients

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Collaborative Patient-centred Practice

• Defined as
• An interprofessional process of communication
  and decision making that enables the separate and
  shared knowledge and skills of healthcare
  providers (collaboration) to synergistically
  influence client/patient care
• (Way Jones, 2000)

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Elements of Collaboration

• Communication
• Mutual trust and respect
• Autonomy
• Cooperation
• Coordination
• Responsibility
• Assertiveness
• Way Jones, 2000

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Potential Barriers

• Are you able to identify potential barriers to
  collaboration?

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Barriers to Collaboration

• Organization structuralism
• Power imbalances
• Role socialization
• (Orchard et al, 2005)

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Objectives

• Content
• - Will be able to explain the policy and where to
  locate it
• -By the end of the disclosure of adverse events
  learning session learners will be able to clearly
  articulate the concept of adverse event and the
  relationship to the patient or family and
  disclose to them.

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IPE Objective

• By the end of the disclosure of adverse events
  learning session, all of the learners will be
  able to identify, practice and evaluate through
  self-reflection their role and roles of others in
  the process

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• OUR IPE PROJECT

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• Regional Stroke Strategy leaders in IPE
• Queens University has an IPE Department
• Lee Ann Fox and Dr S. Watson developed oncology
  specific IPE for the program

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Purpose of the Project

• To develop an interprofessional teaching and
  learning experience for KGH when corporate
  initiatives require broad education across
  disciplines and departments within the
  organization.

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How were staff selected?

• Invitation to leaders in the organization to
  identify someone in their department to
  participate.
• Requirement would be short term
• Time was valued and maximized with each meeting
• Potentially commitment was 4 meetings (1 hour) to
  achieve the curriculum

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Interprofessional Working Group

• Janine Schweitzer, Director Risk Management
• Kim Smith, Physiotherapist
• John McBride, Director Pharmacy
• Vero Briggs, Professional Practice Leader,
  Pharmacy
• Karen Pearson, Director Imaging
• Deborah Elliot, RIT, Nuc. Med.
• Lin Arthur, Manager
• Glenna Churchill, RN, BNSc, MSN
• Constance Sunderland, RN, BSN, MA (Ed), CEC

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Purpose of the Working Group

• Develop a curriculum for the Disclosure of
  Adverse events
• Limit time to deliver the education
• Develop interprofessional expertise to support
  the delivery of the program across the
  organization
• Respect participant time in developing the
  education
• Pilot the new curriculum in two areas for
  evaluation of the design

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Purpose of the Working Group cont

• Make changes to the design based on feedback of
  participants and facilitators
• Plan to rollout learning session across the
  organization
• Plan to develop three action Vignettes with
  Physician/manager role modeling disclosure of
  adverse event to patient and or family
• Plan to make available on Intranet

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Curriculum Developed

• Disclosure of Adverse Events Curriculum (20-30
  Minutes)
• Introduction
• Beyond Blame DVD
• Discussion
• Resources
• Handouts
• Mission Statement
• Evaluation

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Pilot Sites

• Sites included
• Kingston General Hospital
• Connell 10- 3 sessions
• Hotel Dieu Hospital
• Acute Mental Health Care Team 1 session

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Challenges

• Time constraints
• Staff workload at the time the sessions were
  scheduled
• Equipment failure at the time of sessions
• Matching Facilitators schedules to the education
  schedule and meeting the units best time or
  preferred education time

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Evaluation of the Sessions
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Readiness for IPE
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Evaluation Comments

• Helpful to hear comments from others to gain
  interprofessional understanding.
• Understanding of other professionals role.
• Always improves discussion with different walks
  of life.
• Discuss scenarios and responsibilities within
  those scenarios, both medication issues, as well
  as less serious issues
• Some role play to practice breaking the news to
  family/patient.
• More group discussion.
• Add more disciplines to different sessions.
• All corporate education should be
  inter-professional to ensure understanding
  between disciplines.

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Communication Strategy

• Professional Practice Council
• Nursing Practice Council
• Program Operational Director Program Medical
  Director Council
• At each session we invited others to be
  facilitators or as this unfolds to let us know if
  someone in the group wanted to be a facilitator.

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Current Challenges

• Facilitators have changed roles or left on
  maternity leave
• Recruiting new facilitators
• Education of the new facilitators
• Meeting times are sometimes outside normal work
  hours
• Standardization of equipment not complete so
  technology can be a challenge
• Meet with facilitators to provide the opportunity
  for norming within facilitators and develop
  comfort level
• Organize for experienced and new facilitators to
  present and get feedback from each other for the
  next presentation

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Education Presentations

• ICU Unit Based Council
• OR at HDH
• SPA Council KGH
• We will present by invitation to any group with 2
  facilitators from different disciplines. We
  encourage invites to interprofessional groups to
  promote discussion and appreciation for each
  other roles within the organization.

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Next Steps

• Continue to develop interprofessional teaching
  and learning experiences with future KGH
  corporate learning needs.
• Plan interprofessional education early in the
  development process of corporate learning
  initiatives.
• Developed a vignette with a physician disclosing
  an adverse event to patient and family

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Vignette Preparation

• Time to coordinate 5 people
• Length to film 30 minutes
• Review time 3 hours
• Debut and feedback from small group
• Final changes 5 minutes and time to overwrite
  voice

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Contacts

• Constance Sunderland
• sunderlc_at_kgh.kari.net
• Glenna Churchill
• churchig_at_kgh.kari.net