Preparing Health Care and Public Health Professionals for Team Performance: The Community as Classroom

Abstract

Today, team-based health care is no longer an innovation or even a choice. Increasingly, providers are using a team-based approach to deliver care, and the complexity of health problems facing many Americans, combined with the specialization of health professionals, makes teamwork and team training essential. This is especially true for dealing with factors that contribute to chronic conditions and for treating people with multiple chronic diseases-a group already comprising one-fourth of all Americans and two-thirds of people of age 65 or older (CDC, 2013, p. 6). For individuals and families, health-related interactions occur in multiple settings. While these interactions often involve physicians and nurses in various disciplines and types of positions, they also involve physician assistants, pharmacists, dietitians and nutritionists, oral health professionals, eye care professionals, podiatrists, rehabilitation therapists, social workers, mental health and substance abuse therapists and counselors, health educators, speech-language-hearing pathologists, along with arrays of technologists and technicians, nursing assistants and aides, facilitators of health insurance coverage and socially aware care, clerks, translators, and administrators. Growing evidence suggests that to achieve the Triple Aim of improving the experience of care, improving the health of populations, and reducing percapita costs of health care (Berwick et al., 2008), these health care professionals and workers must function interdependently, supporting and communicating with one another, coordinating services efficiently, and focusing their attention on the whole patient. In the public health sphere, too, success is increasingly a function of teamwork. The ecological model of public health emphasizes interactions on the individual, organizational, community, and policy levels that affect multiple determinants of health, including social factors. These complicated interactions require multifaceted interventions (IOM, 2002) that recognize "a web of causation, in which multiple different influences interact to produce good or poor health" (Russo, 2011, p. 87). Broad population health improvement initiatives often focus on partnerships. For example, the National Diabetes Prevention Program includes public-private partnerships of community organizations, private insurers, health care organizations, employers, and government agencies to promote local evidence-based lifestyle change programs for people at high risk of type 2 diabetes (NDIC, 2013; CDC, 2014). Conceivably, this model could be replicated across other chronic diseases and be expanded broadly. Another example is Million Hearts®, a national initiative that combines actions by layers of organizational partners on the national, state, and local levels to prevent heart attacks and strokes (HHS, 2014a). Public health practitioners also collaborate on specific projects with community development practitioners, such as bankers and other financial agents, housing officials, educators, and recreat...

Current Response and Management Decisions of the European Union to the COVID-19 Outbreak: A Review

“…Examples of relief assistance include supporting 30,000 EU tourists who were stranded in Morocco to be able to return home, as well as support in repatriating around 10,000 British, Norwegian, and Swedish citizens [1]. Similar assistance was delivered to EU citizens in Africa, Asia, and the Pacific, as well as Latin America and the Caribbean.…”

“…The primary treatments of patients presenting for healthcare worldwide are managed by individual practitioners trained in "one-on-one care focused on individual patient interactions and encounters with ill individuals" [1]. Increasingly, especially in hospital settings, a wide variety of health professions now practice team-based care, but the focus remains on individual patient interactions [1]. Population-based medicine/management (PBM) places the individual within the context of a broader community, composed of both ill and well individuals when the entire population is at risk.…”

Interprofessional Education in U.S. Dental Hygiene Programs: Program Director Responses Before and After Introduction of CODA Standard 2–15

“…Professional identity development is a crucial component of health professions education; however, it can result in generalizations or stereotypes about one's own profession as well as others that can support or hinder IPC 37 , 40 , 42 . One of the key ways to progress in this new paradigm is to have accreditation standards that require future practitioners to learn to treat patients collaboratively and for educators to implement the appropriate curriculum changes needed to graduate future practitioners who are competent to do so 2 , 9 …”

“…In 2015, the Institute of Medicine highlighted the fact that providers were rarely educated together nor did they learn the skills and norms for IPC and team‐based approaches 7 , 8 . Team‐based care involves the patient and providers from at least two professions or disciplines for coordinated patient care and outcomes, 1 , 9 while IPC has been defined as the optimal provision of patient care via the contribution of areas of specialization and the use of evidence‐based decision making 10 . Health professions education must evolve by shifting from “siloed” learning to interprofessional education (IPE) to provide a strong foundation for IPC in clinical practice 7 , 11 …”

Interprofessional Education Collaborative Competencies and the Public Health Professional

“…Breaking down silos in order to work within interprofessional health care teams and population-based collaborative teams depends on a culture change toward interprofessional teamwork and communication. A reorganization of health professions education that integrates interprofessional education from health professions student training through provider continuing education is, therefore, recommended (Graffunder & Sakurada, 2016).…”