Interdisciplinary Case Discussion

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Interdisciplinary Case Discussion

• Rural Health School
• Don Uden, PharmD, College of Pharmacy

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Objectives

• Students
• Understand the case format and your
  responsibilities so as to effectively participate
  in the case discussions in the RHS sessions.

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Interdisciplinary case studies

• Are designed to
• have many issues
• have aspects that all disciplines can relate to

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Interdisciplinary case studies

• Are used to
• stimulate discussion
• familiarize students to other disciplines
• give a personalized, clinical or community
  oriented view of a topic
• Broaden horizons for ALL disciplines

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Interdisciplinary case studies

• Are NOT
• puzzles to solve
• tests of technical knowledge
• There is no correct answer!!

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The big question

• How do we merge the strengths of each discipline
  to achieve the best overall care for a
  patient/client/family?
• Especially important in rural or under-served
  areas

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Models of care

• Medical model --gt
• in search of the correct diagnosis
• Nursing model --gt
• in search of the best health

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Models of care

• Pharmacy model--gt
• in search of the best drug therapy
• Social work model --gt
• in search of the best overall person-environment
  fit

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Models of care

• When assessing an individual or family all
  disciplines have
• an assessment
• care planning
• follow-up or evaluation component.

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Case example

• John is a 35 year old married farmer. He has 3
  children ages 7, 10, and 12. His wife Mary works
  with him on their 200 acre farm. They milk 50
  dairy cattle with the help of his brother who
  owns the next farm.

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Case example

• John has not felt well for the past 2 months. He
  did not feel he could take off time to go to the
  physician because it was during the haying
  season. The nearest physician is an hour drive
  away. When he finally went, he heard the
  diagnosis leukemia.

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Case example

• He will need to be treated with chemotherapy, on
  an outpatient basis, for the next 6 weeks. The
  family canceled its insurance last year because
  of an inability to pay the premiums. The nearest
  town (pop 1,200) is 25 minutes away and it has a
  pharmacy.

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OSCE (objective structured clinical examination)

• A way to assess the state of interdisciplinarines
  s of a team
• Goal is to work as a team and, in a set time,
  assess a standardized patient and develop a
  comprehensive interdisciplinary health-care plan.

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OSCE - What do you have to do?

• Near end of session
• Assessment of stdized patient - 45 minutes
• Care plan discussion - 45 minutes

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OSCE - Assessment

• Comprehensive and focused providers
• Social aspects
• Community resources
• Traditional assessment
• History
• Review of systems
• Physical examination
• Diagnostic testing
• Diagnosis/impression

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OSCE - Discussion

• Goal determination
• Diagnostic/ psychosocial issues
• Disease treatment/interventions and drug therapy
• Education/Disease prevention/Health promotion
• Consults or referrals
• Follow-up