By Nate Hinkel
As teaching hospitals continue trending toward patient- and family-centered care, health care leaders are realizing the benefits of a team-based approach.
“All the evidence available suggests patients will get better care and be treated more efficiently if there is communication between different members of a health care team,” said Nicholas Lang, M.D., chief medical officer of the UAMS Medical Center. “Patient- and family-centered care is the direction we’re trying to drive the whole institution. Everything we do is being done under that umbrella and will continue to become more ingrained in the culture here.”
And at the root of a culture change, Lang said, is education.
By definition, interprofessional education occurs when students from various professions or specialties learn each other’s routines and mission to improve collaboration and, ultimately, quality of care.
“Better teamwork and communication provides coordination that can prevent any aspect of a patient’s care from being overlooked or any corners being cut,” Lang said. “When you have a better-rounded health care team around a patient, everybody wins.”
While the benefits are well-known, Lang said, implementing the necessary changes will take some time.
“As an institution we’re all on the same page,” he said. “Now it’s a matter of implementation. We have success stories and hope to keep those coming.”
Clinically, the nursing staff is benefitting from a teamwork system specially designed for health care workers by the U.S. Department of Defense, called TeamSTEPPS.
“We’ve implemented this system in several areas of the hospital including the operating room and the emergency department, but we’ve seen the most success in the maternal-infant areas,” said Mary Helen Forrest, R.N., chief nursing officer of UAMS Medical Center. “There’s been a clear difference in the quality of service we can provide patients when we’re working under a teamwork model.”
The evidence-based teamwork system includes ready-to-use materials and a training curriculum to successfully integrate teamwork principles into the mission at UAMS. It was developed by the Department of Defense’s Patient Safety Program in collaboration with the Agency for Healthcare Research and Quality.
At its core, Forrest said, is the goal of patient-centered care by which her nursing staff can confidently and effectively communicate with the other medical professionals treating a patient.
Lang said UAMS Medical Center has also begun interdisciplinary rounding, which matches medical students with physicians, bedside nurses, discharge nurses, clinical nurse specialists, case managers, pharmacists and social workers to ensure patients are surrounded by a team of professionals on the same page toward their recovery in the hospital and at home.
“We are fine-tuning that process and use it as a model for what we aim to do on other units throughout the hospital,” Lang said. “We will continue this trend until we have it rolled out everywhere at UAMS.”
Education is Key
While TeamSTEPPS and interdisciplinary rounding are more focused on implementing interprofessional teamwork with an already-established group of health care workers, Lang recognizes the need to start at the beginning.
“We have some students involved in the interdisciplinary rounding effort, but the next step will be to incorporate those goals into the medical curriculum,” Lang said.
At UAMS Northwest, leaders are aiming to incorporate a teamwork culture as the regional campus begins to grow its colleges and programs. A primary care elective course began last fall that includes colleges of Pharmacy and Medicine students at the same time.
“It’s the first time we’ve had third-year students from both colleges participating in the same classroom,” said Scott Warmack, Pharm.D., associate dean of the UAMS College of Pharmacy. “In the future, we hope to add nursing students into the mix. It’s been very successful and met with great enthusiasm from faculty and students.”
Jeanne Heard, M.D., Ph.D., vice chancellor for academic affairs at UAMS, says collaboration across campus is important.
“Getting students across all colleges at UAMS more involved with each other is key to implementing a true patient- and family-centered care experience,” Heard said.
For the last two years students in all colleges have participated in an interprofessional seminar series. Currently, an interprofessional team of educators is preparing further curricular elements so all students can develop the core competencies necessary to enter collaborative practice settings. One opportunity, led by the College of Pharmacy, will occur in a new community health and wellness center to open in July 2012. This setting will provide experiences for students through student-led interprofessional health care services and education in order to improve the health of the surrounding community.