IPE375 final study guide

get the facts

What facts are unknown? Can I learn more about the situation? Do I know enough to make a decision? What are the relevant facts of the case? What individuals and groups have a stake in the outcome? Are some concerns more important? Why? What are the options for acting? Have all the relevant persons and groups been consulted? Have I identified creative options?

the good common approach

onnects to teachings of ancient philosophers - Plato, Aristotle, Cicero; and contemporary ethicist - John Rawls "There are certain general conditions that are equally to everyone's advantage" (Rawls) Application: Idea that social policies, systems, institutions, and environments are beneficial to all We should view ourselves as members of the greater community Choose to further the goals we all have in common Safety, health, peace, etc. Actions should consider the community of people and what is best for all "What is ethical is what advances the common good"

cross monitoring

process of monitoring unfolding actions against the established plan of care to avoid errors Helps maintain accurate situation awareness Way of "watching each other's back" Gives team members a way to monitor patient care and give constructive feedback

evaluate alternaitve action

Evaluate the options by asking the following questions: Which option will produce the most good and do the least harm (The Utilitarian Approach)? Which option best respects the rights of all who have a stake (The Rights Approach)? Which option treats people equally or proportionally (The Justice Approach)? Which option best serves the community as a whole, not just some members (The Common Good Approach)? Which option leads me to act as the sort of person I want to be (The Virtue Approach)?

development of inter professional competencies

Exposure Early stage in building interprofessional competencies. Students explore concepts, values and contexts; practice skills. Immersion Application of IP competencies. Students apply knowledge and skills; analyze concepts, values, and contexts. Integration Interprofessional competency focused on Integrating and adapting knowledge and skills in practice; translating knowledge; seeking new knowledge; acting for change

gibbs reflective cycle

Graham Gibbs has also published about the reflection and developed his Reflective Cycle as model for reflection. Encourages systematic thought about the "phases" of an experience Characterized as "Learning by Doing" Learning from mistakes; particularly useful in repeating situations (situations encountered regularly) Six stages in the cycle: Description (what happened?) Feelings (how did you feel/think about it?) Evaluation (what was good/bad about the situation) Analysis (how can I make sense of the situation?) Conclusions (what else/more could have been done?) Actions/Action plans

storming

Members are sizing each other up and may feel more comfortable and voice their views Members may compete for team roles May argue about goals or how they should be accomplished May choose sides

performing

Members make contributions and are motivated by results Leadership is shared according to members knowledge and skills Norms and culture are well understood Tasks get accomplished effectively and efficiently

ethics

Moral principles that govern a person's or group's behavior (Oxford Dictionary)" Standards of behavior that tell us how people should act Ethics is NOT: Feelings Religion Law Culturally acceptable norms Science

leadership

Multi-faceted construct, making it difficult to define One study discovered over 90 variables comprise leadership Various theories of leadership, each with its own pros and cons Is it different from management or administration? Answer depends on one's beliefs about leadership Not all leaders are managers/administrators and vice versa Managers are trained, but leaders develop Leadership focuses on vision and has a future-orientation Difficult to study - typically qualitative research methods rather than quantitative A leader is one or more people who selects, equips, trains, and influences one or more follower(s) who have diverse gifts, abilities, and skills and focuses the follower(s) to the organization's mission and objectives causing the follower(s) to willingly and enthusiastically expend spiritual, emotional, and physical energy in a concerted coordinated effort to achieve the organizational mission and objectives...."

5 core concepts of IPE

Mutual Respect Role Knowledge and Clarification Patient-Centered Care Interprofessional Team Communication Collaboration (five components of collaboration) Sharing Partnership Power Interdependency Process

norming

Once issues are resolved, agreement occurs around team norms and expectations Trust and common interests are developing Roles and objectives are clarified and understood

uniprofessional

One provider/professional working independently to care for a patient. There is little awareness or acknowledgment of practice outside one's own profession; activity contained within one profession only. Health professional practice that "involves functioning in isolation... there is no coordination or communication among those professions; they operate strictly in silos" (Ray, p. 1370-1371).

leaderships theories

Path-Goal Theory: Leaders motivate better performance by acting in ways that convey the message that valued/important outcomes are achievable through hard work. Situational factors determine what leader behaviors should be demonstrated. Leader must be able to demonstrate four different styles of behavior: Directive - Provides clear instruction and specific feedback that enables employees to achieve goals/perform tasks Supportive - Demonstrate concern for well-being and support employees as individuals Participative - Seek input/feedback from subordinates and allow them to participate in decisions Orientation toward achievement - set challenging, yet attainable goals, encourage goal attainment, emphasize improvement in work performance Several limitations associated with this theory, including the fact that leaders have to possess all behaviors listed, assumes subordinate motivation is the reason why a leader is effective; ignores other factors such as situational factors that may influence whether or not a leader is successful. Transformational Leadership "Leadership is the process of inspiring a group to pursue goals and attain results" (Muchinsky, 2003). About exerting influence by empowering subordinates to lead the transformation process (transform the organization from good to great); a shared process among leaders at different levels of the organization. Four components Charismatic Leadership "Leadership is the product of charisma, a trait that inspires confidence in others to support the ideas and beliefs of an individual who possesses this trait" (Muchinsky, 2003). Belief that the leader is "larger than life"; revered. Idolize the leader and follow him/her unquestionably. Implicit Leadership Theory

huddle

Problem Solving Hold ad hoc, "touch-base" meetings to regain situation awareness Discuss critical issues and emerging events Anticipate outcomes and likely contingencies Assign resources Express concerns

situational awareness monitoring

Process of actively scanning behaviors and actions to assess elements of the situation or environment Fosters mutual respect and team accountability Provides safety net for teams and patient Includes cross-monitoring Components of Situation Monitoring Status of patient/client Team members Environment Progress toward goal

collaborative patient centered care

Promotes the active participation of each health care discipline in patient care. It enhances patient and family-centered goals and values, provides mechanisms for continuous communication among caregivers, optimizes staff participation in clinical decision-making within and across disciplines and fosters respect for disciplinary contributions made by all professionals" (CIHC).

ajourning

Recognition of the team's achievement Disengagement of relationships

pharmacist

Roles/Responsibilities Pharmacists dispense prescription mediations to patients and provide expertise in safe use of prescriptions. Some pharmacists formulate prescriptions or provide immunizations. Entry-level degree needed to practice: Doctor of Pharmacy (Pharm.D.) - a 4 year professional degrees A bachelor's degree is usually but not always required if prerequisite courses are completed Most programs require applicants to take the Pharmacy College Admissions Test (PCAT) Accrediting Organization: Accreditation Council for Pharmacy Education (ACPE) National Examination or Certification: R.Ph. North American Pharmacist Licensure Exam (NAPLEX) Multistate Pharmacy jurisprudence Exam (MPJE) or a state-specific test on pharmacy law Licensure: All states require licensure NAPLEX and MPJE or state-specific test Number of hours as an intern varies by state Board of Pharmacy Specialties: Certifications Ambulatory Care Pharmacy Critical Care Pharmacy Nuclear Pharmacy Nutrition Support Pharmacy Oncology Pediatric Pharmacy Psychiatric Pharmacy Pharmacotherapy Work Environment: Pharmacies Hospitals Retail settings Other healthcare settings Professional Association American Pharmacists Association (APhA)

physician assistant

Roles/Responsibilities Physician Assistants practice medicine as a part of a healthcare team with collaborating physicians and other providers. Entry-level degree needed to practice: Master's Degree from an accredited program; at least 2 years in length Accrediting Organization: Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) National Examination or Certification Physician Assistant National Certifying Examination (PANCE) from the National Commission on Certification of Physician Assistants (NCCPA) Licensure: All states require licensure PANCE examination Credential: Physician Assistant-Certified (PA-C) Maintenance of certification: 100 hours of continuing education every 2 years Specialties: PAs work in every specialty Specialty Certifications: Certificate of Added Qualifications (CAQ) Cardiovascular and Thoracic Surgery Emergency Medicine Hospital Medicine Nephrology Orthopedic Surgery Pediatrics Psychiatry Work Environment: Hospitals Physicians' offices Other healthcare settings Professional Association American Academy of Physician Assistants (AAPA

physician

Roles/Responsibilities Physicians diagnose and treat illnesses or injuries. Physicians examine patients; order, perform and interpret diagnostic tests; prescribe medications; and may perform procedures. Entry-level degree needed to practice: There are two types medical schools - MD or Allopathic and DO or Osteopathic school. Either an MD or a DO from an accredited program; usually 4 years post-baccalaureate although there a some 6 year programs in which a students ears both the BS or BA and MD degree Admission generally requires scores from the Medical College Admission Test (MCAT) Accrediting Organization: Accreditation of allopathic schools is by the Liaison Committee on Medical Education (LCME) Accreditation of osteopathic schools is by the Commission on Osteopathic College Accreditation (COCA) National Examination or Certification MD students take the U.S. Medical Licensing Examination (USMLE) Steps I, II and III licensing exams. DO students take the Comprehensive Osteopathic Medical Licensing Examination (COMPLEX) Levels 1,2,3 Licensure: All states require licensure but requirements vary by state Must graduate rom an accredited medical school and complete residency training in their specialty Must pass a standardized national licensure exam. Credential: Medical Doctor (MD) or Doctor of Osteopathy (DO) Specialty Board Certifications: Residency training varies with specialty Candidate must pass a specialty certification exam Numerous specialties and subspecialties Work Environment: Hospitals Medical offices Other healthcare settings Professional Associations: American Medical Association (AMA) American Osteopathic Association (AOA)

5 basic approaches to ethical decision making

The Utilitarian Approach The ethical action is the one that provides the greatest balance of good over harm The Rights Approach The ethical action is the one that respects the moral rights of those affected The Fairness or Justice Approach All equals should be treated equally The Common Good Approach Compassion for all others, especially the vulnerable The Virtue Approach Actions should be consistent with ideal virtues

behavioral approach

The actions performed on the job and related behaviors displayed speak to the effectiveness of the leader Task-oriented behaviors People-oriented behaviors Types of leadership behavior related to effectiveness See Yukl's Taxonomy of Leader Behaviors on the following slide

interprofessional

The approach to work and learning that requires integration and collaboration to incorporate the perspectives of more than one profession" (OHSU Interprofessional Initiative common Glossary). "Interprofessional care is the provision of comprehensive health services to patients by multiple health caregivers who work collaboratively to deliver quality care within and across settings" (Health Force Ontario, 2007)

communication

The process by which information is clearly and accurately exchanged between two or more team members in the prescribed manner and with proper terminology and the ability to clarify or acknowledge the receipt of information."

handoff

The transfer of information (along with authority and responsibility) during transitions in care across the continuum; to include an opportunity to ask questions, clarify, and confirm. Transfer of responsibility and accountability Clarity of information Verbal communication of information Responsibility- Accountability Acknowledgment by receiver Opportunity to review

myths about teamwork

There are no leaders on teams; everyone is equal If we just work together, we will eventually become a high performance team Everyone is accountable for everything on teams Teams take a long time to get up and running All team decisions must be made by consensus On the best teams, everyone likes everyone else The most important work takes place in team meetings Confrontation means conflict

theoretical approaches to leadership

Trait Approach Behavioral Approach Power and Influence Approach Situational Approach

collaboration

Two or more individuals work together cooperatively, including sharing responsibilities for solving problems and making decisions to formulate and carry out plans.

successful team functioning

Understand the process of team development Develop a set of principles for working together that respects the ethical values of members Effectively facilitate discussions and interactions among team members Participate, and be respectful of all members' participation, in collaborative decision-making Regularly reflect on their functioning with team and working relationships Respect team ethics, including confidentiality, resource allocation, and professionalism

call-out

A strategy used to communication important or critical information Informs all team members simultaneously during emergency situation Helps team members anticipate next steps

what is a team

A team is two or more individuals who: Interact dynamically, independently, and adaptively Have a common goal/mission Have been assigned specific tasks Possess specialized and complementary skills

make a decision and test it

Considering all these approaches, which option best addresses the situation? If I were to tell someone I respect which option I have chosen (or which decision I have made), what would he or she say?

framework of ethical decision making

Effective exploration of ethical dilemmas and ethical decision making can be guided by the following framework: Recognize an Ethical Issue/Identify the Problem Get the Facts Evaluate Alternative Actions Make a Decision and Test it Act and Reflect on the Outcome

reflective learning

"Reflection - in - action" "Thinking on our feet"; building new understandings to inform actions in the situation that is unfolding; Reflects on the situation Reflects on prior understandings Reflection - on - action - occurs after an encounter Reflection is an important aspect of successful interprofessional education and practice. Defined as "knowing in action" Emotional component to reflection; need to have some sort of emotional/affective response to a situation Use reflection to reframe troubling situations so that solutions can be generated and problem-solving can commence "Doing and thinking are complementary" Guide for "reflecting in action" 1. Choose an incident/define a problem 2. Think about the situation before and after an intervention 3. "Consider" the thought process that led you to "fill in the gaps" between the before and after 4. Summarize the situation

speciality

A branch of a professional field that requires completing an advanced program of study, passing an examination for the specialty, and/or gaining experience through extensive practice in the specialty.

subspecialty

A focused area of a specialty field/area of practice that requires extensive study and mastery of specialized knowledge and skills.

SBAR

A framework for team members to effectively communicate information to one another Situation - What is going on with the patient? Background - What is the clinical background or context? Assessment - What do I think the problems is? Recommendation/Request - What would I recommend? What do I need from you?

profession

A profession is an occupation or career that requires extensive study and mastery of specialized knowledge prolonged training, and formal qualification. Generally, those in a profession will provide a service to someone.

9 central values of professionalism

Altruism - placing the patient's interests above self-interest Accountability - acceptance for the responsibility for professional roles, obligations, actions, and behaviors Excellence - behavior that adheres to, exceeds, or adapts best practices to provide the highest quality Caring - to take care of others Duty - to carry out duties and obligations Service - to be of service to others Integrity - exercise good judgment in professional practice; adhere to ethical principles Respect for others - to respect the rights and property of others Ethical and moral standards - reflects the values and guidelines governing decisions in health care practice

discipline

An broad area of academic study; the study of an academic subject chemistry, physics, sociology, psychology

transprofessional practice

An individual from one professional group assumes the roles/tasks of another profession, although traditionally outside the scope of practice, because s/he has the expertise to complete them. Health professional practice that "involves team members from different professions who share knowledge and skills. As a result, traditional boundaries between professions become less rigid, allowing members of the team to work on problems not typically encountered by or seen as the responsibility of their discipline" (Ray, pp. 1370-1371).

attitude for effect teamwork

Appreciation for value of team decisions Respect for team members Mutual trust Openness to feed back Reflection on group process and interest in improving Shared vision

interporfessional professionalism

As posted on the site referenced below: "Consistent demonstration of core values evidenced by professionals working together, aspiring to and wisely applying principles of, altruism and caring, excellence, ethics, respect, communication, accountability to achieve optimal health and wellness in individuals and communities (Stern, 2006)."

assessing team performance

Assessing team performance can be carried out In the workplace In simulated environments Through observing teamwork exercises Teamwork can be assessed by external experts or by peer observation

the virtue apprach

Assumes we should strive toward certain IDEALS Ideals in this case relate to the "human potential"; we should strive to become the people we have the potential to become Virtues - attitudes/characteristics that allow us to behave in ways that would evoke our highest potentials Honesty, courage, fidelity, fairness, self-control, generosity, prudence, compassion, etc. Become like habits - once acquired, they become ingrained in our behaviors Once virtuous, will act in a way consistent with moral principles; the virtuous person is a moral person Application: What kind of person should I be? What will promote the development of my character? Focused on attitudes, charactistics, personalities that enable us to act in ways that fulfill our potentials "What is ethical is what develops moral virtues in ourselves and our communities"

types of teams

Athletic team - people working together to win a gam Natural Work Group - people working together every day in the same office with similar processes and equipment Business team - a cross-functional team overseeing a specific product line or customer segment Improvement Team - ad hoc team with responsibility for improving an existing process Healthcare team - several healthcare professionals working closely together for the benefit of a patient or group of patients

moral principle son ethical guidelines

Autonomy - individual freedom of choice Non-maleficence - not causing harm to others; "above all do no harm" Beneficence - the healthcare professional's responsibility to do good, be proactive, and to prevent harm Justice - "treating equals equally and unequally but in proportion to their relevant differences" Fidelity -loyalty, faithfulness, and honoring commitments

the rights approach

Based upon original philosophies of Immanuel Kant Focused upon the individual's right to choose/free will It is the right of the person to have his/her choices respected Right = "A justified claim on others" Application: When making a decision, ask: Does the action respect the rights of everyone? Actions that violate the "rights" of others are considered wrong In this case, "rights" are moral rights as well as rights according to the law It is difficult to determine/agree upon what "rights" one may have The more serious the "violation", the more "wrong" the action is considered to be "An action or policy is morally right only if the persons affected by the decision are not used merely as instruments for advancing some goal, but are fully informed and treated only as they have freely and knowingly consented to be treated." Problems Conflicts of rights Justice may be ignored Limits ideas of morality

situational apprach

Effectiveness of leader is influenced by the context/situation in which s/he leads Environment can severely hinder or facilitate effectiveness

utlitatrain approach

Based upon utilitarianism, which is attributed to Jeremy Bentham and John Stuart Mill Created as a way to help legislators make laws that were morally responsible Utility = well-being Decision produces the "greatest good" and does "the least harm" for all parties involved Outcome results in the best balance of "good and evil" Focuses upon "consequences" of action "Of any two actions, the most ethical one will produce the greatest balance of benefits over harms" Application: Assess all courses of action Determine all parties who are reasonably affected Determine harms/benefits of each action being considered Select the action that results in most benefit with least amount of harm Problems Assigning value to benefits/harms is difficult Ignores justice

blooms taxonomy theory

Bloom's Taxonomy is named for its developer, Benjamin Bloom. He proposed a way of organizing educational objectives with increasing complexity. Bloom's levels were later revised by Krathwohl. In this course you will be expected to know and use the revised terminology for the levels. Basics: Like Maslow's Hierarchy of Needs, Blooms Taxonomy is also typically organized in a pyramid Created in collaboration with Max Englehart, Edward Furst, and David Krathwohl and initially known as "Taxonomy of Educational Objectives" Initially consisted of SIX major categories: Knowledge - "involves the recall of specifics and universals, the recall of methods and processes, or the recall of a pattern, structure, or setting" Comprehension - "refers to a type of understanding or apprehension such that the individual knows what is being communicated and can make use of the material or idea being communicated without necessarily relating it to other material or seeing its fullest implications" Application - "use of abstractions in particular and concrete situations" Analysis - "breakdown of a communication into its constituent elements or parts such that the relative hierarchy of ideas is made clear and/or the relations between ideas expressed are made explicit" Synthesis - "putting together of elements and parts so as to form a whole" Evaluation - "judgments about the value of material and methods for given purposes" Categories following "knowledge" are considered "skills and abilities"; idea is that knowledge is necessary to acquire, hone, and apply new skills Revised in 2001; renamed - A Taxonomy for Teaching, Learning, and Assessment Revision is meant to highlight the dynamism of the concepts (original version seemed static, whereas the new version is meant to show that concepts are constantly changing/evolving; this is why "ing" verbs/gerunds were used Still highlights the cognitive processes used when thinking/learning, but action-oriented. Below you will see each level as well as what occurs during that time period (there is an added explanation that may help clarify what is occurring at each stage) Remembering Recognizing and Recalling Recall of basic facts/concepts Understanding Interpreting, exemplifying, classifying, summarizing, inferring, comparing, explaining Explanation of ideas/concepts Applying Executing, implementing Use information in new settings Analyzing Differentiating, organizing, attributing Draw connections between and among ideas Evaluating Checking, critiquing Make a decision and support it Creating Generating, planning, producing Produce new/original work Knowledge is the basis of the revised edition of the Taxonomy, but there is a SEPARATE taxonomy that describes the different types of knowledge: Factual knowledge Knowledge of terminology, specific details, and elements Conceptual knowledge Knowledge of classifications and categories; principles and generalizations; theories, models, and structures Procedural knowledge Knowledge of subject-specific skills and algorithms; subject-specific techniques and methods; criteria for determining when to use appropriate procedures Metacognitive knowledge Strategic knowledge; knowledge of cognitive tasks, appropriate contextual and conditional knowledge; self-knowledge Organized educational objectives according to their cognitive complexity Higher order thinking is dependent on the level that precedes it. Revised in 2001 and renamed "A Taxonomy for Teaching, Learning, and Assessment

teamwork communication too

Briefs-planning Debrief - problem solving Huddle - process improvement Situational Awareness & Monitoring Mutual Support

stages of team development

Bruce W. Tuckman was a respected educational psychologist who first described four stages of group development in 1965. He refined and developed the model in 1977 in conjunction with Mary Ann Jensen, adding a fifth stage. Commonly accepted steps in team development are: Forming Storming Norming Performing Adjourning

CUS

CUS C- I am Concerned U - I am Uncomfortable S - This is a Safety Issue

techniques to help members speak out

CUS technique The Two Challenge Rule DESC script or DESC-It

barriers to teamwork in healthcare

Changing roles Medical hierarchies Individualistic nature of medicine Lack of team stability

check back loop

Check-Back is a communication strategy used to verify and validate information exchanged. It can be used by team members with each other or by patients and team members. This slide illustrated why this is considered a "closed-loop" strategy and the sender initiates a message, The receiver accepts the message and provided feedback confirmation, which is followed by the sender verifying the message received. TeamSTEPPS provide this example of a check-back: Team member calls out: "BP is falling, 80/48 down from 90/60." 2nd Team member (receiver) verifies and validates receipt of the information: "Got it; BP is falling and at 80/48, down from 90/60." 1st Team member (sender) complete the loop by saying: "Correct

collaborative practice

Collaborative Practice in health care occurs when multiple health workers from different professional backgrounds provide comprehensive services by working together synergistically along with patients, their families, caregivers, and communities to deliver the highest quality of care across settings (World Health Organization, 2008).

communication challneges

Communication challenges among team members include: Language barriers - when patients and staff members do not speak English there is an opportunity for miscommunication. Distractions - anything that diverts attention of the staff can cause communication issues. A common example is emergencies, which cause staff to redirect their attention to another task Physical proximity - It is important to observe cultural differences in physical proximity to avoid discomfort. Personalities - sometimes individuals have difficulty communicating due to differences in personalities. It is essential that health care workers learn to work with all personality types. Workload- health workers frequently experience periods of heavy workload that can result in failure to communicate all of the necessary details or not taking time to verify them. Varying communication styles - health professionals from various professions may have been trained in different communication styles. Conflict - disagreements among health professionals may interfere with effective communication among team members. Lack of verification of information - failure to verify information communicated can result in errors. Shift change - the change of personnel caring for patients occurs when a new team takes over after a shift change . Communicating essential information is key during shift changes.

standards of effective communication

Complete Communicate all relevant information Clear Convey information that is plainly understood Brief Communicate the information in a concise manner Timely Offer and request information in an appropriate timeframe Verify authenticity Validate or acknowledge information

ineffective approaches

Compromise - both parties settle for less Avoidance - Issues are ignored or sidestepped Accommodation - focus is on preserving relationships Dominance -Conflicts are managed through directives for change

fairness/justice appraoch

Connects back to the teachings of Aristotle: Principles of justice "Equals should be treated equally; unequals unequally" Different types of justice Distributive Justice Retributive/corrective Justice Compensatory Justice Application: How fair is the action? Are all parties treated in the same way? Favoritism and discrimination are morally wrong Fairness requires consistency "Treat people the same unless there are morally relevant differences between them"

types of team in healthcare

Core Teams are involved in the direct care of the patient. The members include direct care providers and continuity providers, such as case managers. The Core Team is based where the patient receives care. Coordinating Teams are composed of work area members with strong clinical backgrounds. The Coordinating team is responsible for: 1) day-to-day operational management, 2) coordination functions, and 3) resource management for the Core Team. Contingency Teams are formed for emergent or specific events. They are time limited—for example, a Code Team or a Disaster Response Team. They are generally composed of team members drawn from a variety of Core Teams, and are responsible for immediate, direct patient care during emergency situation requiring more resources than are available to the Core team. They are generally composed of team members drawn from a variety of Core Teams. Ancillary services provide direct, task-specific, time-limited care to patients. Examples include laboratory, x-ray, pharmacy, radiology or pathology. Support Services provide indirect service-focused tasks that help facilitate the optimal health car experience for patients and their families. Their mission is to create efficient, safe, comfortable,a nd clean health care environments. Support services including housekeeping, sterile processing, bioengineering, and human resource management. The Administrative Team includes the executive leadership of a facility and has overall accountability for the management of the organization. This team has no responsibility in the direct delivery of care but provides the structure and guidance to ensure that each team understands its role and responsibility and has access to the resources necessary to succeed.

recognize and ethical issue/identify the probelm

Could this decision or situation be damaging to someone or to some group? Does this decision involve a choice between a good and bad alternative, or perhaps between two "goods" in between two "bads"? Is this issue about more than what is legal or what is most efficient? If so, how?

debrief checklist

Debrief Checklist ___ Was communication clear? ___ Were roles and responsibilities understood? ___ Was situation awareness maintained? ___ Was workload distribution equitable? ___ Was task assistance requested or offered? ___ Were errors made or avoided? ___ Were resources available? ___ What went well? ___ What should improve

effective team leaders coordinate and facilitate teamwork by

Delegating tasks or assignments Conducting briefs, huddles, debriefs Empowering team members to speak freely and ask question Organizing improvement activities and traning for the team Inspiring "followers" and maintain a positive group culture Accepting the leadership role Calling for help appropriately Constantly monitoring the situation Setting priorities and making decisions Utilizing resources to maximize performance Resolving team conflicts Balancing the workload within a team

desc script

Describe the specific situation. Express your concerns about the action. Suggest other alternatives. Consequences should be stated

transformational leadership theory

Described in terms of the leader's effect on subordinates/followers "Activate" the higher-order needs of followers (Maslow's Hierarchy) Shift primary concern to the organization rather than the self Followers trust and respect the leader and are motivated to do more than what was originally expected Four components: Idealized influence Inspirational motivation Intellectual stimulation Individualized consideration Transformational Leadership "Leadership is the process of inspiring a group to pursue goals and attain results" (Muchinsky, 2003). About exerting influence by empowering subordinates to lead the transformation process (transform the organization from good to great); a shared process among leaders at different levels of the organization. Four components: Idealized influence - leaders behave in ways that make them role models. Followers want to emulate leaders; they are admired and respected by subordinates. Inspirational motivation - act in ways that motivate and inspire followers by providing meaning and challenge to subordinates' work. Intellectual stimulation - stimulate innovation and creativity by questioning followers' assumptions, reframing problems, and approaching old situations in new ways. Individualized consideration - attend to followers' needs for growth/advancement by coaching/mentoring; recognize differences between followers and accepts these. Leadership scale developed to assess the factors above - Multifactor Leadership Questionnaire.

debrief

Description/Goals Brief, informal information exchange and feedback sessions Occur after an event or shift Designed to improve teamwork skills Designed to improve outcomes Recognize good team contributions or catches

types of team leaders

Designated Situational Effective Team

trait approach

Emphasizes personal attributes of the leader Some qualities thought to be related to success: High energy Tolerance for stress/resilient Competitive Visionary/open to new ideas Self-confidence/outgoing Motivation/dedicated to achieving goals

5 personal values that characterize members of high functioning tram

Honesty Team members value effective communication within the team Transparency about aims, decisions, uncertainty, and mistakes Discipline Team members carry out their roles and responsibilities with discipline, even when inconvenient Team seek out and share new information Creativity Team members are excited about finding creative solutions to new or emerging problems Humility Team members recognize differences in training Team members recognize they are human and will make mistakes Team members rely on each other to help recognize and prevent failures Curiosity Reflect upon lessons learned for continuous improvement

act and reflect on the outcome

How can my decision be implemented with the greatest care and attention to the concerns of all stakeholders? How did my decision turn out and what have I learned from this specific situation?

leadership and healthcare

How does "leadership" differ in healthcare? Complex industry Environmental challenges Regulatory influences Organizational challenges Hierarchies Coordination issues Divide between clinicians and administrators Healthcare Leadership Alliance (HLA) Five competency domains among healthcare administrators Communication and relationship management Professionalism Leadership Knowledge of the industry Business skills and knowledge Healthcare Leadership Alliance (HLA) is a consortium of healthcare administration associations. Goal is to "pursue common interests and advance the healthcare management profession". Member organizations: American College of Healthcare Executives American Organization of Nurse Executives Healthcare Financial Management Association Healthcare Information and Management Systems Society Medical Group Management Association We already know about competency modeling (IPEC, CIHC). This competency model was developed in much the same manner as the previous models studied. The five competency domains proposed as part of the model include: Communication and relationship management "The ability to communicate clearly and concisely with internal and external customers, to establish and maintain relationships, and to facilitate constructive interactions with individuals and groups." Professionalism "The ability to align personal and organizational conduct with ethical and professional standards that include a responsibility to the patient and community, a service orientation, and a commitment to lifelong learning and improvement." Leadership "The ability to inspire individual and organizational excellence, to create and attain a shared vision, and to successfully manage change to attain the organization's strategic ends and successful performance." Knowledge of the industry "The demonstrated understanding of the healthcare system and the environment in which healthcare managers and providers function" Business skills and knowledge "The ability to apply business principles, including systems thinking, to the healthcare environment; basic business principles include (a) financial management, (b) human resource management, (c) organizational dynamics and governance, (d) strategic planning and marketing, (e) information management, (f ) risk management, and (g) quality improvement" -----------------------------------------------------------------------------------------------------------------------------------------------------------

mallows hierarchy of learning

Human actions are directed toward goal attainment Five levels of needs—typically represented as a pyramid People aim to meet basic needs before seeking the highest level, self-actualization. Maslow's Hierarchy of Learning was proposed by Abraham Maslow in 1943. You have probably studied this in Introductory Psychology and perhaps in other courses as well. Please review this theory to refresh your understanding of it. Basics: Human behavior/action is goal-directed (or is directed toward goal-attainment) Organized in hierarchical fashion and presented (typically) as a pyramid Four "lower order" needs (physiological, safety, love/belonging, esteem) Considered "deprivation" or "deficiency" needs because lacking in these needs creates an imbalance/deficiency that motivates one to achieve these needs Most obviously you could think of this as a hunger. If you're hungry, you're going to seek food (you have a deficiency you wish to rectify) One "growth" need (self-actualization) Also known as "self-fulfillment" Behavior is not motivated by deprivation/deficiency, but by the desire to grow/improve Very few people, according to Maslow, achieve this level of thought/behavior Lower order needs must be satisfied before higher order needs can have an impact upon behavior When applying this theory to the classroom, we find that the lower level needs can be distractions that can impact the attention given to the material. We also find that the social situation of the classroom can help satisfy some of the needs an individual may have.

effective team leaders

Identify a goal and define a plan to achieve the goal Assign and delegating tasks and responsibilities Share the plan Monitor the plan and progress toward the goal Modify the plan and communicate changes to a all team members Review the team's performance Conducting briefs, huddles, debriefs Empowering team members to speak freely and ask question Organizing improvement activities and training for the team Inspiring "followers" and maintain a positive group culture

goals of IPE

Improve overall quality of community health Improve quality of healthcare provided Improve patient safety Emphasize patient-centered care Improve and increase communication among various providers Lower cost of healthcare

system level barriers

Inadequate interprofessional education and training Sub-optimal funding Lack of appropriate monitoring and evaluation to inform change Inadequate interprofessional education and training Possible Solutions Integrate IPE education into academic preparation Employee continuing education in IPE and IPP Sub-optimal funding Possible Solution Reallocation of funds to support Lack of appropriate monitoring and evaluation to inform change Possible Solutions Improved monitoring and evaluation

barriers to Interprofessional practice

Individual Level Practice Level Systems Level Individual-level Lack of role clarity & trust Difficulty managing and optimizing roles with the team if there is limited knowledge and understanding of other team members' knowledge, skills and scopes of practice Perceived and projected professional hierarchy Difficult to eliminate - legal responsibilities of physicians Tradition Language use Communications

interdisciplinary

Individuals from different disciplines who work collaboratively towards a common purpose

multidisciplinary

Individuals from two or more disciplines working alongside one another, but independently toward a common purpose.

interprofessional competencies in healthcare

Integrated enactment of knowledge, skills, and values/attitudes that define working together across the professions, with other health care workers, and with patients, along with families and communities, as appropriate to improve health outcomes in specific care contexts. Involves a loosely organized group of individuals from different health and social care professions who meet and work together on a periodic basis (University of Arkansas Medical Science, 2016).

two challenge rule

It is your responsibility as a team member to assertively voice concern at least two times to ensure that it has been heard The first challenge should be in the form of a question The second challenge should provide some support for your concern The team member being challenged must acknowledge the concern If the outcome is still not acceptable, utilize supervisor or chain of command

briefs

Key Information Team membership and roles Designate team roles and responsibilities Establish climate and goals Engage team in short- and long-term planning Briefing Checklist Who is on your team? All members understand and agree upon goals? Roles and responsibilities understood? Staff availability? Workload? Available resources? Review of the day's patients?

patient centered care

The Institute of Medicine (2001) defines PCC as "a partnership among practitioners, patients, and their families (when appropriate) to ensure that decisions respect patient's wants, needs, and preferences and that patients have the education and support they need to make decisions and participate in their own care" (p.7).

barriers to IPE education

Lack of funding for training and for faculty development Limited administrative support/buy-in Lack of coordination between units Geographical separation of programs Curricular overload/Inhibitive Curricular Structure Accreditation standards Professional Culture Lack of funding for training and for faculty development Possible solution Grant funding to support faculty development and training Limited administrative support/buy-in Possible solution Education of administrators Lack of coordination between units Potential Solution Organization of IPE leadership teams Geographical separation of programs Potential Solution Co-location of programs Increased IPE training opportunities Accreditation standards in some professions may make interprofessional education more difficult Potential Solution Emphasis on IPE in accreditation standards Incorporating standards requiring IPE experiences Holding programs accountable (ensures the issue is at least addressed Curricular Overload/Inhibitive Curricular Structure Possible Solutions Early exposure to other disciplines Common course offerings Interdisciplinary faculty working teams Student involvement in curricular design Promotion of standards by accrediting bodies Professional Culture "Profession-centrism" Possible Solutions Application of the "IDEA" Framework Interaction - students have the opportunity to work with or learn directly with individuals from other health professions Data - obtaining accurate information about other health professions Expertise - allows students the chance to communicate clearly, and effectively with other professions concerning the values and processes of patient care Attention - students reflect upon their professional culture (assumptions and biases) as well as the cultures of other professionals

practice level

Lack of governance structure and leadership to manage complex practices Insufficient space and time for communication and collaboration Difficulty establishing appropriate skill mix and team size Inadequate communication mechanisms and technology Lack of governance structure and leadership to manage complex practices Potential Solution Training in facilitation and collaboration Insufficient space and time for communication and collaboration Potential Solution Co-location in early stages Difficulty establishing appropriate skill mix and team size Potential Solution Research and evaluation to inform decisions Inadequate communication mechanisms and technology Potential Solutions Interprofessional case conferences; "clinic huddles"? Electronic medical records, video-conferences, telehealth Others??

individual level

Lack of role clarity & trust Difficulty managing and optimizing roles with the team if there is limited knowledge and understanding of other team members' knowledge, skills and scopes of practice Potential Solution Continuing education for team with an emphasis on Interprofessional Education Perceived and projected professional hierarchy Difficult to eliminate - legal responsibilities of physicians Tradition Language use Communications Potential Solutions Communication training Clarification of legal responsibilities Lack of role clarity & trust Difficulty managing and optimizing roles with the team if there is limited knowledge and understanding of other team members' knowledge, skills and scopes of practice Perceived and projected professional hierarchy Difficult to eliminate - legal responsibilities of physicians Tradition Language use Communications

charismatic leadership theory

Leader's ability/position is a result of his/her charisma Influence results from the followers' perception of him/her - revere the leader as "gold standard" Behaviors typical of charismatic leaders: Impression management to maintain follower confidence Articulation of an appealing vision that defines task in terms of ideological goals Communication of high expectations for followers Expression of confidence in followers' ability Charismatic Leadership "Leadership is the product of charisma, a trait that inspires confidence in others to support the ideas and beliefs of an individual who possesses this trait" (Muchinsky, 2003). Belief that the leader is "larger than life"; revered. Idolize the leader and follow him/her unquestionably. "Dark side" to charismatic leadership - problems that can result: Start grandiose projects that is meant to bring them glory Enjoy spending time "selling" a vision to the public, but don't want to spend the time developing the steps necessary to implement the vision Fail to develop competent successors

power and influence apprach

Leader's power influences subordinates, peers, superiors, and people external to the organization Types of power Reward Coercive Legitimate Expert Referent Leader-Member Exchange Theory (LMX) Mutual influence

path goal theory

Leaders motivate performance by modeling behaviors; acting in ways that inspire employees to achieve goals Four styles of behavior: Directive Supportive Participative Achievement-oriented Path-Goal Theory: Leaders motivate better performance by acting in ways that convey the message that valued/important outcomes are achievable through hard work. Situational factors determine what leader behaviors should be demonstrated. Leader must be able to demonstrate four different styles of behavior: Directive - Provides clear instruction and specific feedback that enables employees to achieve goals/perform tasks Supportive - Demonstrate concern for well-being and support employees as individuals Participative - Seek input/feedback from subordinates and allow them to participate in decisions Orientation toward achievement - set challenging, yet attainable goals, encourage goal attainment, emphasize improvement in work performance Several limitations associated with this theory, including the fact that leaders have to possess all behaviors listed, assumes subordinate motivation is the reason why a leader is effective; ignores other factors such as situational factors that may influence whether or not a leader is successful.

engagement theory

Main premise: Students should be meaningfully involved in their learning through interactive and worthwhile tasks. Engagement theory suggests that learning experiences focus on the following three elements/ideas: 1) Relate: learning through collaboration; emphasizes teamwork 2) Create: project-based learning; "students are working on a creative and purposeful activities" 3) Donate: projects should have an authentic focus; they should be seen as useful to an "outside customer" from the community Technology is not required but can facilitate engagement Kearsley and Shneiderman's engagement theory has been applied to interprofessional education and practice. Proposed by Shneiderman as the "teaching/learning philosophy for the cyber-generation" Three key elements are Relate, Create and Donate. This theory is frequently associated with the use of technology. Although technology is not required, it can facilitate engagement.

athletic training

Roles/responsibilities: Athletic trainers specialize in examining, diagnosing and treating athletes and other active individuals with muscle or bone injuries. They emphasize prevention of injuries Collaborate with physicians (as well as other providers) Entry-level degree needed to practice: Through Fall 2022, the entry-level degree for practice is the Bachelor of Athletic Training. The profession is transitioning to an entry-level Master's degree currently Accrediting Organization: CAATE - Commission on Accreditation of Athletic Training Education National Credentialing Exam: Board of Certification for the Athletic Trainer (BOC) Licensure: Most states require licensure or certification for athletic trainers, but requirements vary. Most states require graduation from a CAATE accredited program and a passing score on the BOC. Continuing education required for professionals in this field Specialties Residencies available in areas such as advanced training in musculoskeletal evaluation and treatment Work Environment: Educational settings—colleges and high schools Hospitals/clinics Physicians' offices College Athletics Professional sports teams and with professional athletes Performing arts Military Corporate/industrial setting Professional Association National Athletic Trainers' Association (NATA)

audiologist

Roles/responsibilities: Audiologists examine, diagnose, and treat patients with hearing, balance, and ear problems. They may fit hearing aids, relieve vertigo and balance issues, and fit cochlear implants. Entry-level degree: Doctor of Audiology (AuD) - 4 years A Bachelor's degree is needed for admission to AuD programs. Accrediting Organization: Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA-ASHA) Accreditation Commission on Audiology Education (ACAE) National Examination or Credential Certificate of Clinical Competence in Audiology (CCC-A) from the American Speech-Language-Hearing Association National Examination - Praxis - Audiology Licensure: Required in all states but some requirements vary All require the doctorate degree Board Certifications: American Board of Audiology Board Certified in Audiology Specialties Pediatric Audiology Specialty Certification (PSAC) Cochlear Implant Specialty Certification (CISC) Work Environment: Hospitals Physicians' office Audiology clinics Professional Association: American Speech-Language-Hearing Association (ASHA) Academy of Doctors of Audiology (ADA) American Academy of Audiology (AAA)

dentist

Roles/responsibilities: Dentists identify, diagnose, and treat oral conditions, perform clinical procedures such as fillings, crowns, implants, and extractions. They also provide oral health advice and education. Entry-level degree: Doctor of Dental Surgery (DDS), Doctor of Dental Medicine (DDM), or Doctor of Medical Dentistry (DMD) A Bachelor's degree with required pre-requisite courses and the Dental Admission test (DAT) are usually required for admission. Accrediting Organization: Commission on Dental Accreditation National Examination or Credential National Board Dental Examinations Parts I and II administered by ADA's Joint Commission on National Dental Examinations Licensure: Requirements vary by state but include a DDS, DDM 9 dental specialties require 2-4 year residencies Dental Public Health Endodontics Oral and Maxillofacial Pathology Oral and Maxillofacial Radiology Oral and Maxillofacial Surgery, Orthodontics and Dentofacial Orthopedics Periodontics Pediatric Dentistry Prosthodontics Work Environment: Dentist's Offices- private practice Dental Schools Military Professional Association: American Dental Association (ADA) American Dental Education Association (ADEA) http://www.adea.org/

occupational therapist

Roles/responsibilities: Occupational Therapists injured, ill, or disabled patients develop, recover, and improve through the therapeutic use of activities. Entry-level degree needed to practice: A master's degree in occupational therapy is CURRENTLY the entry level degree Profession will require a doctoral degree as the entry-level degree effective 2027 Accrediting Organization: ACOTE: Accreditation Council for Occupational Therapy Education. National Examination National Board for Certification in Occupational Therapy (NBCOT) exam Licensure: OT practice is regulated in all states although requirements vary The State of Missouri requires licensure Nine Certification Areas: Board Certification Gerontology (BCG) Mental Health (BCMH) Pediatrics (BCP) Physical Rehabilitation (BCPR) Specialty certification Driving and Community Mobility (SCDCM) Environmental Modification (SCEM) Feeding, Eating, and Swallowing (SCFES) Low Vision (SCLV) School Systems (SCSS) Work Environment: Hospitals Home healthcare services Nursing care and rehabilitation facilities Schools Community and governmental agencies Professional Association American Occupational Therapy Association (AOTA)

optomerist

Roles/responsibilities: Optometrists examine, diagnose and treat the eyes and other parts of the visual system. They prescribe eyeglasses or contact lenses when needed. Entry-level degree needed to practice: Doctor of Optometry (O.D.) - degree requires 4 years of study Applicants must have completed at least 3 years of study; generally have a bachelor's degree; Applicants must take the Optometry Admission Test (OAT) Accrediting Organization: Accreditation Council on Optometric Education (ACOE) (http://www.aoa.org/optometrists/for-educators/accreditation-council-on-optometric-education?sso=y) National Certification or Examination: National Board of Examiners in Optometry (NBEO) exam successfully (http://www.optometry.org/) Licensure: All states require licensure Must have O.D. from accredited school Passing score on the NBEO Some states require an additional clinical exam All require continuing education to renew licenses Specialties Optional 1 year residency in family practice; low vision rehabilitation; pediatric optometry; geriatric optometry; ocular disease. Certification by the American Board of Optometry - demonstrates that they exceed entry-level requirements American Board of Optometry Board Certification Exam Work Environment: Offices of optometry Physicians' offices Retail stores. Professional Association: American Optometric Association (AOA

physical therapist

Roles/responsibilities: PTs help patients with injuries or illnesses improve movement and manage pain. Entry-level degree needed to practice: Doctor of Physical Therapy (DPT) degree; 3 years of study beyond the bachelor's degree Accrediting Organization: CAPTE: Commission on Accreditation in Physical Therapy Education National Examination or Certification National Physical Therapy Examination (NPTE) administered by the Federation of State Boards of Physical Therapy (FSBPT) Licensure: All states require physical therapists to be licensed Varies by state but all include passing the NPTE Specialties - American Board of Physical Therapy Specialties Cardiovascular and Pulmonary Clinical Electrophysiology Geriatrics Neurology Oncology Orthopedics Sports Women's Health Work Environment: Private offices and clinics Hospitals Physicians' offices Rehabilitation facilities Long term care facilities Professional Association American Physical Therapy Association (APTA)

dietician

Roles/responsibilities: RDNs are experts in the use of food and nutrition to promote health and manage disease. Entry-level degree needed to practice: A Bachelor's degree from an accredited Coordinated Program in Dietetic that incorporate clinical experience and didactic education OR Completion of an accredited bachelor's Didactic Program in Dietetics plus an accredited Dietetic Internship (typically 1 year) Note: This profession is moving to the Master's degree as the entry-level requirement effective 2024 Accrediting Organization: ACEND - Accreditation Council for Education in Nutrition and Dietetics National Examination: Commission on Dietetic Registration - Registered Dietitian Exam; Credential: Registered Dietitian RD or Registered Dietitian Nutritionist RDN Licensure: Most states (including Missouri) require licensure in order to practice. Some states require only state registration or certification to use certain titles. A few states have no regulations. Licensure requirements vary by state but most require graduation with a bachelor's degree from an accredited program, supervised practice, and passing the RD examination. Specialties: CDR offers certifications in: Sports dietetics Nutrition Support Pediatric Nutrition Renal Nutrition Diabetes Education Work Environment: Hospitals, HMO's, & other health facilities Business and Industry Nursing care facilities Private practice Community and public health settings Educational Institutions Professional Association: Academy of Nutrition and Dietetics

registered nurse

Roles/responsibilities: Registered nurses (RNs) provide and coordinate patient care, patient education, and emotional support. Entry-level degree needed to practice: BSN Bachelor of Science in Nursing (4 years); ADN Associate Degree in Nursing, (2 years); hospital Diploma in Nursing approved by a State Board of Nursing (2 yrs) National Accrediting Organization: CCNE - Commission on Collegiate Nursing Education Accredits bachelor's and graduate degree programs and residencies ACEN- Accrediting Commission for Education in Nursing (ACEN is described as a subsidiary of the National League for Nursing -NLN located in Atlanta, Georgia. ACEN accredits practical, diploma, associate, baccalaureate, master's including post master's certificate, and clinical doctorate nursing programs. ACEN also functions in the capacity of being an "institutional" accrediting agency and as such the nursing program offered by the "institution" can be eligible for Title IV funds. CNEA - National League for Nursing Commission for Nursing Education Accreditation (Established in Sept 2013; autonomous accreditation division of NLN headquartered in Washington, D.C.) Accredits LPN/LVN, diploma, associate, bachelor, master's and clinical doctorate degree programs NOT for Title IV purposes. State Board Approval - nursing programs must have state board approval National Examination: NCLEX-RN (National Council License Examination for RN's) administered by the NCSBN (National Council of State Boards of Nursing) Licensure: All states require licensure Must have passed the NCLEX-RN Specialties: Specialties at the BSN level include Ambulatory Care Nurse, Cardiac Care Nurse, Cardiac Cath Lab Nurse, Diabetes Nurse, Flight/Transport Nurse, Geriatric Nurse, and many other Some specialties require the MSN or DNP

speech language pathologist

Roles/responsibilities: SLPs identify, assess and treat language problems and swallowing disorders in patients Entry-level degree needed to practice: Master's degree Accrediting Organization: Council on Academic Accreditation (CAA) of the American Speech-Language-Hearing Association (ASHA) National Certification Exam: Praxis Speech-Language Pathology exam Licensure/certification: Almost all states require licensure At least a master's degree and supervised clinical experience Some states (although Missouri does not) require teaching certification for SLPs who work in schools Specialties SLPs may specialize in working with specific age groups such as children or with swallowing disorders Work Environment: Schools Hospitals Home healthcare services Professional Association: American Speech-Language-Hearing Association

social worker

Roles/responsibilities: Social Workers help people of all ages solve problems in their lives; clinical social workers also diagnose and treat mental, behavioral, and emotional issues. Entry-level degree needed to practice: The level of degree varies by state and type of practice: Bachelor of Social Work (BSW) - the most common requirement for entry level positions Master of Social Work degree (MSW) - required for entry-level positions in some states MSW degree with two years of post-master's supervised experience - typically required for entry-level clinical social workers MSW degree with two years of post-master's direct clinical social work experience Accrediting Organization: Council on Social Work Education (CSWE) National Certification Exam: Although there is no national certification exam that is required for all social workers, most states require scores from applicable ASWB exams. .Board certification for clinical social workers is available through the American Board of Examiners in Clinical Social Work Licensure/certification: All states require licensure for clinical social workers. Some require licensure or certification for all social workers. Specialties Child and Family Social Workers Clinical Social Workers School Social Workers Healthcare Social Workers Geriatric Social Workers Hospice and Palliative Care Social Workers Medical Social Workers Mental Health and Substance Abuse social Workers Work Environment: State or local government Individual and family services Ambulatory healthcare services Hospitals Military bases and correctional facilities Nursing and residential care facilities Professional Association: More than two dozen professional associations for social workers. National Association of Social Workers is the largest organization for professional social workers

6 aims of healthcare

Safe Effective Equitable Timely Patient-centered Efficient

information exchange strategy

Situation-background-Assessment-Recommendation (SBAR) Call-Out Check-Back Handoff

adult learning theory

Six Assumptions: 1. Need to Know: Adults need to know why they need to learn something 2. Self-Concept: Adults are self-directed (ready to learn) and like to be involved in planning and evaluation; 3. Life Experience: Adults bring life experience to learning (adults have diverse experience; learning can draw on experience; learning needs to be associated with existing knowledge; sometimes "unlearning" is required) 4. Readiness to Learn: Adults are interested in learning that can be applied to their career or personal life 5. Orientation to Learning: problem solving rather than simply learning content 6. Motivation Malcolm Knowles is known for his development of adult learning theories, also known as andragogy. Adult learning theory is especially appropriate for traditional and non-traditional students preparing for health disciplines. Basics: The term "andragogy" means "the art and science of helping adults learn"; contrasted with the term "pedagogy" ("the art and science of helping children learn") Knowles suggests that adult educators: Establish a climate of cooperation for learning Meet the learner where he/she is by assessing his/her needs Present materials sequentially/use activities that allow for sequential application of information Seek input from the learner to determine appropriate teaching methods, materials, and instruction resources Evaluate the learning experiences had by students and make adjustments based upon feedback A lot of self-directed learning happens with this population (adults)

transdisciplinary practice

Someone representing one disciplinary group takes on roles/tasks of another disciplinary group; the assumption is that person is qualified to do this (has the expertise). An example of this may be a faculty member who teaches psychology, but actually has a degree in child and family development

performance requirements

Students can apply teamwork principle in their interactions with other students, and Through observing and being part of health-care teams

unidisciplinary

Students from a single discipline learning/working with minimal contact with other students outside of that discipline; activity occurs in one discipline alone. Historically, this is the most standard structure seen in higher education

TEAM

T - Together E - Everyone A - Achieves M - More

ethical apprach

Tavistock Group, Revised statement, June 1999 Six principles form the foundation of the "Shared Statement of Ethical Principles for the Health Care System": Health care is a human right The care of the individual is at the center of health care, but the whole system needs to work to improve the health of populations The health-care system must treat illness, alleviate suffering and disability, and promote health Cooperation with each other, those served, and those in other sectors is essential for all who work in health care All who provide health care must work to improve it Do no harm

team STEPPS

Team Strategies and Tools to Enhance Performance and Patient Safety AHRQ/DoD evidence based public domain curriculum to improve team Coordination Knowledge Skills Attitudes

forming

Team members are introduced and begin getting to know each other Goals and tasks are established Generally polite behavior among members Norms are not understood

mutual support

Team members foster a climate in which it is expected that assistance will be actively sought and offered as a method for reducing the occurrence of error Includes the ability to anticipate the needs of other team members through knowledge of their tasks and responsibilities Protects team members from work overload situations that may reduce effectiveness and increase the risk of error

how teamwork can improve healthcare

Teams represent a practical way to improve patient care Teams can improve care at the levels of: the organization (hospital, clinic, home health, etc) The patient -outcomes and safety The team as a whole The individual team member

team member use communication effectivley

Techniques that promote communication in health care: SBAR or SBARQ Situation - What is going on with the patient? Background - What is the clinical background or context? Assessment - What do I thnk the problems is? Recommendation and Request - What would I do to correct it? Questions - An opportunity to ask or answer any questions Call-out - used to communicate important information to all team members simultaneously Check Back - closed-loop communication to ensure that information conveyed by the sender is understood by the receiver as intended (i.e. restate what was said) Handover/handoff

triple aim

The "Triple Aim" represents the goal of IPE. It refers to the three main focuses of IPE use/implementation: improving patient experience of care, improving the health of the population, and reducing the per capita cost of care. The idea of "Triple Aim" was created by the Institute for Healthcare Improvement. We like to include the visual representation above to help students better conceptualize an idea that can seem a bit complex. If you visit the Institute for Healthcare Improvement website, you'll find many resources that further detail the Triple Aim concept - http://www.ihi.org/engage/initiatives/TripleAim/Pages/default.aspx. Again, we are showing you this to help you remember the three goals of IPE - better care, better overall health, and less cost.