Interdisciplinary partnerships for rural older adults’ transitions of care

Abstract

Purpose-Integrated transitions of care for rural older persons are key issues in policy and practice. Interdisciplinary partnerships are suggested as ways to improve rural-care transitions by blending complementary skills of disciplines to increase care's holistic nature. Yet, only multidisciplinary efforts are frequently used in practice and often lack synergy and collaboration. The purpose of this paper is to present a case of a partnership model using nursing, gerontology and public health integration to support rural-residing elders as a part of building an Adult-Gerontology Acute Care Nurse Practitioner program. Design/methodology/approach-This paper uses the Centre for Ageing Research and Development in Ireland/O'Sullivan framework to examine the creation of an interdisciplinary team. Two examples of interdisciplinary work are discussed. They are the creation of an interdisciplinary public health course and its team-based on-campus live simulations with a panel and site visit. Findings-With team-building successes and challenges, outcomes show the need for knowledge exchange among practitioners to enhance population-centered and person-centered care to improve health care services to older persons in rural areas. Practical implications-There is a need to educate providers about the importance of developing interdisciplinary partnerships. Educational programming illustrates ways to move team building through the interdisciplinary continuum. Dependent upon the needs of the community, other similarly integrated partnership models can be developed. Originality/value-Transitions of care work for older people tends to be multi-or cross-disciplinary. A model for interdisciplinary training of gerontological practitioners in rural and frontier settings broadens the scope of care and improves the health of the rural older persons served.

Leveraging a contextually sensitive approach to rural geriatric interprofessional education

“…This is due to the fact that older patients often have more complex needs that require an interprofessional approach. 2,3,16,29,30 Such is especially the case in rural communities, where older adults are more likely to have chronic conditions and co-morbidities 30 which are further exacerbated by low socioeconomic status and weak social support networks. 3 The World Health Organization emphasizes that IPE initiatives can more effectively support the health complexities of rural older adults, which leads to increased patient satisfaction, improved access to care, and decreased patient complications.…”

“…Since a lack of health team collaboration can pose a significant risk to older adult patients, it has been proposed that rural IPE initiatives that centralize around the geriatric population can emphasize to learners the importance of an interprofessional approach. 2,3,16 For example, Brewer outlines that in Warsaw, New York, slightly modifying traditionally provided education placements to include a rural geriatric component helped to address the negative stereotypes of working with older adults and provided opportunities for learners that fostered a more holistic method of interprofessional care. Due to the high proportion of older adults who require care in rural communities, IPE initiatives that are focused on rural gerontological health have then been presented as mutually beneficial.…”

“…Due to the high proportion of older adults who require care in rural communities, IPE initiatives that are focused on rural gerontological health have then been presented as mutually beneficial. 2,3,16,30 The need to contextualize IPE Despite the plethora of studies in support of IPE, some scholars argue that IPE initiatives are not universally effective. Lapkin et al indicate that learner outcomes such as improved communication, decision-making, and attitudes towards other professionals differ greatly between studies due to learnerspecific factors such as gender and the learners' profession.…”

“…In addition, very few studies have shown the transferability of IPE learning outcomes on clinical practice over the longterm, indicating that more work is needed to adequately prepare health professionals for practice, 6,[11][12][13][14][15] especially with older adults in rural communities. 3,16 As such, a shift is transpiring in IPE research to better reflect the complexities of context. In particular, the literature has begun to acknowledge that IPE initiatives require continuous improvement to adapt to the multi-leveled, ever-changing healthcare system that is influenced by environmental, institutional, and professional contexts.…”

“…[5][6][7][8][9][10] Although IPE has gained recognition on a national and international level, the mixed effectiveness of IPE initiatives has acted as a barrier to adequately prepare health professionals for practice, 6,[11][12][13][14][15] especially with older adults in rural settings. 3,16 Despite contemporary scholars emphasizing the importance of aligning IPE initiatives with complex healthcare contexts, [17][18][19][20][21] a gap still remains regarding how to develop effective rural geriatric IPE initiatives. 3 This paper aims to close this gap by first reviewing the IPE movement that supports the symbiotic relationship between IPE initiatives and rural older adult care and then examining how contextually sensitive rural gerontological health research can enhance IPE initiatives.…”