Interprofessional population health advocacy: Developing and implementing a panel management curriculum in five Veterans Administration primary care practices

Abstract

Health care systems expect primary care clinicians to manage panels of patients and improve population health, yet few have been trained to do so. An interprofessional panel management (PM) curriculum is one possible strategy to address this training gap and supply future primary care practices with clinicians and teams prepared to work together to improve the health of individual patients and populations. This paper describes a Veterans Administration (VA) sponsored multi-site interprofessional PM curriculum development effort. Five VA Centers of Excellence in Primary Care Education collaborated to identify a common set of interprofessionally relevant desired learning outcomes (DLOs) for the PM and to develop assessment instruments for monitoring trainees' PM learning. Authors cataloged teaching and learning activities across sites. Results from pilot testing were systematically discussed leading to iterative revisions of curricular elements. Authors completed a retrospective self-assessment of curriculum implementation for the academic year 2015-16 using a 5-point scale: contemplation (score = 0), pilot (1), action (2), maintenance (3), and embedded (4). Implementation scores were analyzed using descriptive statistics. DLOs were organized into five categories (individual patients, populations, guidelines/measures, teamwork, and improvement) along with a developmental continuum and mapped to program competencies. Instruction and implementation varied across sites based on resources and priorities. Between 2015 and 2016, 159 trainees (internal medicine residents, nurse practitioner students and residents, pharmacy residents, and psychology post-doctoral fellows) participated in the PM curriculum. Curriculum implementation scores for guidelines/measures and improvement DLOs were similar for all trainees; scores for individual patients, populations, and teamwork DLOs were more advanced for nurse practitioner and physician trainees. In conclusion, collaboratively identified DLOs for PM guided development of assessment instruments and instructional approaches for panel management activities in interprofessional teams. This PM curriculum and associated tools provide resources for educators in other settings. ARTICLE HISTORY

Organizational climate and teamwork at the Family Health Strategy

“…In Brazil, professional training of health workers does not encourage the experiences in interdisciplinary teams (22) . Differently, in other realities that are seeking this approach, interdisciplinarity is seen as a tool for improving collaborative skills and essential for the practice of quality care (23)(24) .…”

“…Moreover, there should be addition of new models and shared management strategies to the FHS teams so that there is a greater interrelation of knowledge and cohesion among their members, such as shared leadership. Providing professionals with the opportunity to participate in decisions and goals contributes positively to team identification and performance (23) . This reality points to the need for major changes in the training of human resources for health, in order to raise awareness, in particular, of social, structural and cultural dynamics, from interprofessional educational modules for students.…”

From Provider to Advocate: The Complexities of Mild Traumatic Brain Injury Prompt the Evolution of Provider Engagement

“…Becoming an effective patient advocate requires skill, training and practice [6][7][8][9]. However, patients and their families clearly value advocacy on their behalf [10][11][12]. Furthermore, it is becoming clear that the TBI care team of the 21 st century is optimally not only an interdisciplinary one [13][14][15][16][17][18], but may also be the best paradigm to reduce the high societal costs of TBI [19][20][21][22].…”