Draft Nexus Principles - Amazon Web Services...Principle 4 – it Is not clear how the bullet point...
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General comment: “Overall, the statements address key principles and importantly are grounded in the context of national quality goals. I think there are a number of things that would improve its clarity and role in establishing foundational principles. I would include a brief explanation of Nexus and include the definition of Interprofessional Practice along with the definition of IPE. I would also include a statement of objective and scope - why are these principles needed? What’s the focus, what is purposely outside of scope? I would suggest a format that makes it easy to identify core principles and attributes, such as: (1) Background, National quality goals, Nexus, Definitions (2) Core principles for practice and education, Commitment to shared goals, Mutual respect and trust, Support and respect for the need for collaborative as well as independent practice (3) Principles for Implementation and planning: Choose 1-2 words to label principle followed by description, e.g. authentic, balanced, high value, integrated… (4) Principles of Developing, Measuring and Improving Interprofessional Competence.” Suggestion for Additional References • Macy Foundation reports on Alignment, Patient and Family Centered Care, Technology • Mitchell, P, et al (2012) Core principles and values of effective team-based health care. Discussion Paper, Institute of Medicine, Washington, DC. This paper seems foundational to the current work. 1.) The Nexus Principles will help create a shared understanding of interprofessional practice and education. YES – 10 NO – 0 Comments: • “These principles will help guide institutions and coalitions as they plan their work together.” –Carla Dieter • “I like them. They are clear and straightforward.” –Betsy Clark • “Ultimately yes - I think it would help to include a brief explanation of the concept of Nexus as well as the definition of interprofessional practice along with the definition of IPE. More detail and explanation will be needed to achieve this aim.” –Gerri Lamb 2.) The Nexus Principles represent current thinking about IPE. YES – 10 NO – 0 The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067. The National Center is also funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation and the University of Minnesota. © 2015 Regents of the University of Minnesota, All Rights Reserved [email protected] @nexusipe Nexus Principles Feedback Summary
Transcript of Draft Nexus Principles - Amazon Web Services...Principle 4 – it Is not clear how the bullet point...
Generalcomment:
“Overall,thestatementsaddresskeyprinciplesandimportantlyaregroundedinthecontextofnationalqualitygoals.Ithinkthereareanumberofthingsthatwouldimproveitsclarityandroleinestablishingfoundationalprinciples.IwouldincludeabriefexplanationofNexusandincludethedefinitionofInterprofessionalPracticealongwiththedefinitionofIPE.Iwouldalsoincludeastatementofobjectiveandscope-whyaretheseprinciplesneeded?What’sthefocus,whatispurposelyoutsideofscope?Iwouldsuggestaformatthatmakesiteasytoidentifycoreprinciplesandattributes,suchas:(1)Background,Nationalqualitygoals,Nexus,Definitions(2)Coreprinciplesforpracticeandeducation,Commitmenttosharedgoals,Mutualrespectandtrust,Supportandrespectfortheneedforcollaborativeaswellasindependentpractice(3)PrinciplesforImplementationandplanning:Choose1-2wordstolabelprinciplefollowedbydescription,e.g.authentic,balanced,highvalue,integrated…(4)PrinciplesofDeveloping,MeasuringandImprovingInterprofessionalCompetence.”SuggestionforAdditionalReferences
• MacyFoundationreportsonAlignment,PatientandFamilyCenteredCare,Technology• Mitchell,P,etal(2012)Coreprinciplesandvaluesofeffectiveteam-basedhealthcare.DiscussionPaper,
InstituteofMedicine,Washington,DC.Thispaperseemsfoundationaltothecurrentwork.
1.)TheNexusPrincipleswillhelpcreateasharedunderstandingofinterprofessionalpracticeandeducation.YES–10NO–0Comments:
• “Theseprincipleswillhelpguideinstitutionsandcoalitionsastheyplantheirworktogether.”–CarlaDieter• “Ilikethem.Theyareclearandstraightforward.”–BetsyClark• “Ultimatelyyes-IthinkitwouldhelptoincludeabriefexplanationoftheconceptofNexusaswellasthe
definitionofinterprofessionalpracticealongwiththedefinitionofIPE.Moredetailandexplanationwillbeneededtoachievethisaim.”–GerriLamb
2.)TheNexusPrinciplesrepresentcurrentthinkingaboutIPE.YES–10NO–0
The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067. The National Center is also funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation and the University of Minnesota. © 2015 Regents of the University of Minnesota, All Rights Reserved
@nexusipe
Nexus Principles Feedback Summary
Comments:• “Ithinkitisconfusingtousetheacronym"IPE"twodifferentways.Thefirstastheacronymmostcommonly
usedintheliterature-IPE=interprofessionaleducation.Thesecondasyouhavereferencedinyourprinciples-IPE=interprofessionalpracticeandeducation.”
• “Ibelievetheycapturewhereweare.”
• “Ithoughtconcepts/attributeslikeauthenticity,patientengagementetc.wereagoodstartbutneedstogofurtherinidentifyingthemorecomprehensivedomain-agoodanalogyformeisthesixaimsofthehealthcaresysteminCrossingtheQualityChasm-thesesixaimscapturedtheessenceofwhatwasimportanttoenvisionwhereweweregoing.”
3.)TheNexusPrincipleswillhelpguidethefuturedevelopmentIPE.YES–10NO–0Comments:
• “These,aswritten,remainfocusedmoreonacademiaandthestudentlearner.Theylessreflectthepracticingclinicianlearnerinthepracticesetting.Theyarebothimportant.”
• “I'mnotascertainaboutguidingthefuturedevelopment.Theyareagoodbaseline,however.”
• “Yes-assumingtheycapturethemostimportantelements.Iwonderedwhythefocuswaslimitedtoplanning,implementation,andmeasurement-whataboutimprovement,evolution,andsustainability?”
Critiques/RecommendationsforSpecificPrinciples:
Generalcommentonthissection:“Thepointabouttheimportanceofindependentaswellascollaborativeworkisimportant.Ithinkmoreneedstobesaidaboutthis–andthefactorsthatmightcomeintodeterminingtheappropriatebalance.”
• Principle1:Interprofessionaleducation“occurswhenstudentsfromtwoormoreprofessionslearnwith,about,andfromeachothertoenableeffectivecollaborationandimprovehealthoutcomes”(adaptedfromWorldHealthOrganizations,2010).
o “True.Wouldadddefinitionorprincipletoincorporatepracticinghealthcareproviderlearnerasreferencedabove.”
o “BecausesomanyofusseehealthprofessionseducationthroughthelensofUME/GME/CMEand
The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067. The National Center is also funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation and the University of Minnesota. © 2015 Regents of the University of Minnesota, All Rights Reserved
[email protected] @nexusipe
• Principle2:InterprofessionalPracticeandEducation(IPE):1.Supportsallstakeholderstodevelopmutualrespect,understandingandtrust–thefoundationofsuccessfulinterprofessionalcollaborativepractice—withinandacrossprofessionalandorganizationalboundaries2.Aimstoinspirehealthprofessionalstoastrongcommitmenttoimprovehealthandcarethroughcollaborative,aswellasindependent,work3.Fostersanenvironmentinwhichallstakeholders(patientsandclients,familiesandcommunities,students,teachers,)learnandteacheachother.
o “Seeaboveregardingacronymusedtwodifferentways.Principlesthemselvesarefine.”
o “3rdbulletpoint:includehealthcareprofessionals.”
o “Suggestadd'from'to"learnfromandteacheachother".”
o “Perhapsabetterphrasingwouldbeteach,andlearnfrom,eachother.”PrinciplesofIPEPlanningandImplementation
Generalcommentonthissection:
“Iwouldtranslateeachoftheprinciplesintooneortwowordphrases(similartohowtheIOMReportframedthesixaimsforthehealthcaresysteminCrossingtheQualityChasm)e.g.Authenticity,patientengagement,balance–wouldaddaprincipleofintegrationacrosseducationandpractice.Ithinkthiswouldmaketheprinciplesclearerandeasiertoremember.Principle3seemstobeaboutbeingflexible,adaptive-wouldemphasizethisandframepositivelyastherestoftheprinciples(ratherthanstartingwith“noonepurpose.Principle4–itIsnotclearhowthebulletpointunderthisprincipleisrelevanttoengagingpatientsandtheirfamilies.”
• Principle3:NoonepurposeunderliesallIPEplanning,butallIPEplanningisbasedononeormorefoundationaltheoriesorconceptsappliedoradaptedtothespecificsituation,suchasaccesstocare,patientsafety,qualityorcommunityengagement.
o “Agree.”
o “Iassumequalityreferstoqualityofcare.”
The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067. The National Center is also funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation and the University of Minnesota. © 2015 Regents of the University of Minnesota, All Rights Reserved
[email protected] @nexusipeo “Thisprinciplemayassumelineardevelopmentofformalinstructionstrategies.Workplacelearningactivitiesmustbedesignedtoincludereflectionandadjustmentofteamperformanceinthecourseoftheirrealwork.Sowhilethisiscertainlyplanned,theresolutionandconsensusprocessispartoftheeducationalprocess,nottheplanningprocess,andiscontinuouslyrevisited.”
o “Thisisanimportantaspectthatneedstobeincorporatedinallplanning.”
o “Isconsensustheaccurateterm?Whathappensifconsensusisnotreached?Doesitactuallymeanreachtreatmentdecisionsratherthanconsensus?”
o “Notclearhowthebulletpointisrelevanttoengagingpatientsandtheirfamilies”
• Principle5:Planningandimplementationprovideforauthenticcollaborativeworkexperiencesthatbringtogetherprofessionslikelytoworkcollaborativelytogetherincurrentandfuturepractice.
o “Wouldprobablytakeout"work"fromcollaborativeworkexperiencesandjustleavecollaborativeexperiences.”
o “RhetoricalobservationthatpriorPrinciplesincludedsubjectofinterprofessionaleducationandcollaborativepracticebutPrinciples5,6omitthat.”
o “Smallpoint,butthesecond"together"seemsunnecessary.Doesn'tcollaborativemeanworktogether?”
• Principle6:Planningandimplementationrequirebalancebetweentheneedsandstandardsofhealthandeducationsystemsandstudentacademicrequirements.
o “Academiafocusedonly.Howabout"andlearnerrequirements"”
o “PlanningandimplementationofIPErequirebalancebetweentheneedsofthepatientsandhealthcaresystems,healthcareprofessionals,andstudents.”
The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067. The National Center is also funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation and the University of Minnesota. © 2015 Regents of the University of Minnesota, All Rights Reserved
o “Idon'tthinkthatthisshouldbeanaspiration.Iwouldpreferthatfoundationaleducationincorporateinterprofessionalprinciples.Forexample,casestudiescanbevettedtoassurethattheyproperlyillustraterolesofotherprofessionsinvolvedinthecareofapatient.ProfessionalidentityformationbeginsonthefirstdayofprogramentryandIPEobjectivesshouldnotbedeferred.”
PrinciplesofDevelopingandMeasuringInterprofessionalCompetence
Generalcommentonthissection:
“TheseprinciplesseemtoaddressmostlytheacademicsideoftheNexus-needtomakesurethepracticesideisaddressedandinbalancewiththeacademicside.Iwouldexpandtheseprinciplestoinclude“improving”IPcompetence–highlightingthegoaltodevelopcollaborationreadystudentsandpractitioners.Mightwanttoaddaprinciplerelatedtotheneedforsoundstructuralandprocessmeasures;whilethepriorityremainsonimpact(Principle14).ConsiderincludingtheroleoftechnologyinsupportingIPEandevaluation(seelatestMacyreportonTechnologyinHealthProfessionsEducation).”
• Principle8:Ongoingevaluationoftheimpactofinterprofessionaleducationandcollaborativepracticeonlearningandhealth-relatedoutcomesiscritical.Evaluationinvolvestheuseofavarietyofmethodsandmetricsselectedandtailoredforthespecificsituation.
o (N/A)
• Principle9:IPElearninggoalsaredescribedascompetenciesorcapabilities.Theyguideeducationalplanning.
o “IPElearninggoalsaredescribedascompetenciesorcapabilities'ofthehealthcareteam'.”
o “Unsurewhythisisstated?Ultimately,behavioriswhatmattersofcourse.Soistheideathatthingslikeknowledgeandattitudesororganizationalculturedon'tmatter?”
@nexusipe
The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067. The National Center is also funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation and the University of Minnesota. © 2015 Regents of the University of Minnesota, All Rights Reserved
[email protected] @nexusipe
The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067. The National Center is also funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation and the University of Minnesota. © 2015 Regents of the University of Minnesota, All Rights Reserved
@nexusipe
• Principle11:Interprofessionalcurriculahelplearnersrecognizeandunderstandpoliciesandotherenvironmentalfactorsthatmaysupportorhindercollaborativepractice.
o “Agree,butmightadd"policies,practices,andotherenvironmentalfactors."”
o “Termcurriculaimpliesundergraduatelevel.Isthereawaytoencompass'undergraduate,graduateandpracticeinterprofessionaleducation'…maybestateitthisway?”
o “Thepointofthisprincipleisn'tclear.Isthegoaltoincorporateleadershipandimplementationskills
inIPEcurricula?Ifso,thisobjectivewillhavevaryingobjectivesacrossthespectrumofacademiclevels.”
• Principle12:IPElearnersarecontinuouslyassessedandprovidefeedbackontheirattainmentofinterprofessionalcompetencies.Self-reflectionisintegratedintoassessmentmethodologies.
o (N/A)
• Principle13:Interprofessionalcurriculaandlearningactivitiesaredesignedtodeveloppracticebehaviorsthatsetthestageforlifelonglearningandcontinuousprofessionaleducation.
o “I'mnotwildaboutphraseof'curriculaandlearningactivities'.Thisgetsintosemanticsthatmightbetoofussy.But...Ithinkofacurriculumconsistingofthedevelopmentoflearningobjectives,theinstruction,andassessmentoftheextenttowhichtheinstructionaccomplishedtheobjectives.Therefore,it'sredundanttodiscuss'curriculaandlearningactivities'.Thenthesemanticsof'teaching'vs'learning'reappear.Thisisanimportantissueinworkplacelearning,astheenvironmentthatcausespeopletolearnthingsthatwedon'tmeantobeteaching(e.g."hiddencurriculum").”
• Principle14:Interprofessionalpracticeandeducationoutcomesaremeasuredagainsttheimpacton:individualhealth,population/publichealth,organizationalchange,systemefficiencies,andcosteffectiveness.
o “Iwouldarguethattheyarealsomeasuredagainsttheimpactofhealthcarepractitionerperformance.Note:D.Moorecommentsre:ownmodelofevaluation.”
o “Mycommentisan"and"regardingPrincipal14.Weshouldrecognizeoutcomesonlearners,asindividualsandteams,inmorespecificwaysthanarementionedinPrincipals11,12,and13.IPEshouldchangelearnerknowledge,attitudes,andbehaviorsasindividualsaswellasinteams.”
