NCA Postgraduate Residency Collaborative Session 10 June 6 2017
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Transcript of NCA Postgraduate Residency Collaborative Session 10 June 6 2017
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AGENDA- Learning Collaborative Session 10 June 6, 3:00-4:30pm (EST)
Welcome
Portfolios and Reflective Journals
Graduation, Orientation , Accreditation
Updates and Questions
Celebration and Wrap upLast Weekly CallJune 28th
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Shout out to the Coaches!
HEALTH CENTER COACH
Avenal Community Health Center Veronica Vo Lumley
Central City Concern Lauren Land/ Beth Williams
CHAS Health Marcus Riccelli/ Cornell Cook
Lamprey Health Care Evalie Crosby
Lyon Martin Health Services Nina Soares
Menominee Tribal Clinic Diane Hietpas
Johnson City Community Health Center- Betsy Kappes
Petaluma Health Center Carlin Chi
Rutgers Community Health Center Mary DiGuilio
The Children’s Clinic Jack Tsai
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Let’s Review..
-Program Drivers-Mission/Vision-Resource Assessment
-Leadership/BOD Support-Marketing-Program Goals and Objectives
OCTOBERSEPTEMBER-Curriculum Development-Marketing and Recruitment-Interviewing
NOVEMBER
-Curriculum Mapping-Applications and Interviews
DECEMBER
-Curriculum Mapping-Program Staff Roles and Responsibilities-Communication
JANUARY-Developing Curriculum Into Schedule-Interview and Selection Process
FEBRUARYMARCHAPRIL
-Program Policies and Procedures-Evaluation of the Learner
-Contracts and Agreements-Licensing and Credentialing-Evaluation of the Program
MAY JUNE
-Preparing for Q1-Evaluation Overview-Precepting Panel
-Resident Portfolio and Journals-Graduation, Orientation, Accreditation
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NP Residents’ Portfolio• Residents receive a portfolio that includes all
of their patient visit data, as well as all of their reflective journals.
– # of visits
– #of procedures
– Panel size
– Breakdown of patient by age, common conditions, etc.
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NP Residents’ Journals• Why assign reflective journals?
– key component of evaluation of residents and of the program
– weekly self-reflection in the context of real-time communication
– bi-directional evaluations between preceptors and NP Residents
– self-assessment of competency
– are read and responded to by a designated NP program leader
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What are the lessons learned from the journals?
Flinter, M. & Hart, A.M. (2016). Thematic elements of the postgraduate NP residency year and transition to the primary care provider role in a Federally Qualified Health Center. Journal of Nursing Education and Practice, 7(1), 95-106.
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Flinter & Hart, 2016 study
• Question: What is the experience of the transitionfrom academic graduate education to practice in an FQHC?
• Qualitative content analysis of journals submitted by five cohorts of Residents 2008-2013
• De-identified journals from 24 Residents (100% of the possible subjects)
• Total of 1,200 reflective journal entries
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Theory of Transition
Meleis, A.I. et al. (2000) Experiencing Transitions: An Emerging Middle-Range Theory Adv Nurs Sci 23(1):12–28
Two outcome indicators:
1. Mastery of new skills needed to manage a transition
2. Development of a fluid yet integrative identity
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Theory of Transition con’tEssential properties of transition experiences:
• awareness
• engagement
• change and difference
• time span
• critical points and events
Personal, community, or societal conditions may facilitate or constrain the processes of healthy transitions and the outcomes of transitions.
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Back to Flinter & Hart, 2016 study
First quarter (Sept-Nov)
• From euphoria and gratitude for the opportunity to be in the residency
• To shock and awe of just how sick people seen in FQHC primary care can be, by complexity of the health care system.
• Major challenge: Patients seeking opioids for pain
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Flinter & Hart, 2016 studySecond quarter (Dec–Feb)
• From exhaustion and astonishment at how hard the work of a PCP is
• To heads above water with flickering sense of increasing feelings of competence and confidence, begin to reap the satisfaction and joy of managing their “own” panel of patients
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Third quarter (March–May)
• Managing complexity and challenged to develop ease in managing episodic, acute, and chronic problems and feelings of sadness at the impact of trauma, poverty, and stress on individuals and families
• to awareness of emerging competency thatbrings an awareness and focus on the future, and next career steps
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Flinter & Hart, 2016 study
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Flinter & Hart, 2016 studyFourth quarter (June–Aug)
Comfort with NP role and commitment to primary care for the underserved and anticipating the future
“What was once overwhelming is
now just a busy day”
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Flinter & Hart, 2016 studyFacilitators
• Engaged preceptors
• Didactic sessions
• Specialty rotations
• Building a panel
• Learning procedures
• Community events
Persistent stressors
• Managing chronic pain and requests for opioids
• Insufficient clinical support staff
• Impact of poverty and social determinants of health on individual health and on health care in general
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Graduation Planning
Start planning early
Assemble a team
Create a task list with timeline
Document everything
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Graduation Planning Considerations
3-4 months Check-list
Set a date and time
Send Save-the-Date
Budget
Venue
Guest List
Food
Begin thinking about Program & Gift
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Graduation Planning Considerations2-3 month check-list Review and finalize your Guest List Send invitations Plan your Program Photographer Create Certificates & Get Signatures Order Gifts Finalize menu Decorations
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After the Event Debrief – Meet with key individuals to
celebrate successes and review lessons learned for next time.
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Orientation
• Intensive orientation • To the PROGRAM• To the ORGANIZATION• To the COMMUNITY
• The basics• Takes place over the course of 3 to 4 weeks• Includes both organizational and clinical trainings • Completed in person at the service delivery site
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Residency Program Orientation
• CHCI starts with Residency Program Orientation • Introduction to program, organizational history, residency
specifics, and clinical didactic trainings
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Employee Orientation
• Residents should go through your normal employee orientation that all new staff go through
• Some organizations choose to start with employee orientation
• Will cover organizational trainings, policies and procedures, technical training
• Coordinate with your HR team to know what they cover in orientation – reduce any redundancies between program and employee orientation
• Should include intensive EMR training
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Community Orientation
• Introduction to UDS data
• Community Tours – meetings with community leaders and key stakeholders
• Community Immersion Excursion – walking tour of community
• Stand Down
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National Nurse Practitioner Residency and Fellowship Training Consortium
Accreditation Program
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Accreditation DefinedExternal, independent review of a health care training program against nationally-accepted standards and its own policies, procedures, processes and outcomes (AAAHC)
Peer-reviewed, voluntary program evaluation
Practice-based determination of adherence to National Standards
Public recognition of excellence
National acknowledgement of quality
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USDE Accreditation Process
6 Major Steps
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Standard 1: Mission, Goals and Objectives
Standard 2: Curriculum
Standard 3: Evaluation
Standard 4: Program Eligibility
Standard 5: Administration
Standard 6: Operations
Standard 7: Staff
Standard 8: Postgraduate Trainee Services
NNPRFTC’s Standards Driving Excellence in Program Design
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The 4 Cs:
Cut—Program Configuration
Color—Specialty
Clarity—Transparency
Carat—Program Size
A multi-faceted DiamondAccreditation Drives Excellence in Program Development
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Accreditation Process
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Benefits of Accreditation
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Accreditation Anchors Program Development
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Contact info:
Candice S. Rettie, PhDExecutive Director
[email protected]: 202-780-9651Twitter: @nppostgrad
www.nppostgradtraining.com
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Updates and Questions
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CELEBRATE!
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Next Steps
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• Bi-Weekly Coach/Mentor meetings through 6/28• Project Checklist completed for 6/30/17• Post-Collaborative Communication:
-August Office Hours -September check-in meeting for launched programs-January check-in meeting for soon-to-be launching programs-One-on-One support as needed