Interprofessional Geriatric Home Visits: Learning Teamwork for Improved Patient Safety

Sunday, November 1, 2009

Janet A. Head, RN, MS, EdD1
Stephanie A. Powelson, RN, MPH, EdD2
Brenda K. Wheeler, MSN, BSN, RN2
1Area Health Education Center, A. T. Still University, Kirksville, MO
2Nursing, Truman State University, Kirksville, MO

Learning Objective 1: discuss the need for and benefit of interprofessional clinical education for nursing students at the undergraduate level.

Learning Objective 2: describe how a longitudinal interprofessional clinical education experience could be implemented in an undergraduate nursing curriculum.

Building effective communication between disciplines is essential for patient safety.  The purpose of this project was to build effective communication among disciplines through interprofessional clinical education experiences. Health discipline programs from two midwestern universities collaborated on a geriatric interprofessional home visiting program. Each interprofessional team included students from medicine, nursing, and health sciences who visited one client for 4 visits over 14 months.  
Faculty from the involved disciplines solicited student volunteers and senior citizens for patient home visits focused on health promotion and disease prevention.  Interprofessional teams included a first year medical student, a junior nursing student, and a health science student. The curriculum included patient assessment, various screenings, and patient education. Teams met with faculty after each visit to discuss patient findings and interprofessional team dynamics. 
Over four years, the program grew from 7 to 20 interprofessional teams. Students noted program benefits included changing attitudes about other disciplines, a new appreciation for the contributions of other disciplines, and gaining new perspectives on patient care. Students reported the opportunity for interprofessional geriatric home visits helped in developing shared leadership.  
The Institute of Medicine's 2001 report, Crossing the Quality Chasm, described challenges in improving patient safety. Health Professions Education: The Bridge to Quality (IOM, 2003) outlined strategies for health professions educators as they prepare future practitioners to improve patient safety. Both volumes documented the critical importance of cooperation between disciplines, effective collaboration, and good communication as preconditions to improved patient outcomes. Restructuring clinical education to include opportunities to learn about and practice effective communication and collaboration should begin at the undergraduate level for nursing students. Expanding these interprofessional clinical experiences should be considered for promoting cooperation between disciplines. The ultimate goal is improving patient outcomes.