Research demonstrates that Interprofessional (IP) teams can improve transitional care, reduce re-admissions and improve patient health, contributing to reduction in disparities and healthcare cost. This is important for complex healthcare systems delivering care to patients with chronic illness from underserved and underinsured populations. The SHARP program was designed to help students learn about working in IP teams as they educate and support patients at risk of poor health outcome through complex ambulatory care experiences. SHARP provides opportunities for students to work in IP teams as they support patients with chronic illness in the community to improve their health. Students interact with patients, health systems, community resources and each other, as they progress toward mastery of their IPEC competencies.
Methods:
An IP team of educators developed and integrated SHARP within existing clinical courses. A prospective mixed methods pilot was designed to assess student learning of IP teamwork, patient experiences, health outcomes and logistical factors. Student groups met formally on four occasions during the program. They communicated informally with their assigned patients, developed educational materials and shared information based on individual patient needs. The Interprofessional Attitudes Scale (IPAS) was used to assess student’s change in knowledge of and attitudes towards IP teamwork. Patient health literacy was assessed using the self-report BRIEF tool. Patient satisfaction with student interactions was assessed using qualitative open response survey questions.
Results:
The SHARP pilot involved 30 students of nursing (n=10), medicine (n=12) and social work (n=8), and nine patients diagnosed with heart failure. IPAS baseline scores were high with small positive improvements including changes in perceptions of Interprofessional Bias (p=0.054).Students highlighted three main areas of need for patients; nutrition, physical activity and social support. For each area, students described barriers and recommendations for activities to seek improvements for their patient. Students identified that different taste of healthy food, unhealthy eating habits and food environment were barriers to healthier eating. To help patients overcome these barriers they searched for and provided information about recipes for healthy but tasty food. To support patients to increase physical activity, students developed planned exercise programs to match the patient’s ability and lifestyle. Nursing and medical students looked to social work students to help identify community resources to support patients. Program feedback from students and patients included improvements in structure and logistics including pre-program curriculum, additional teambuilding experiences and expanding opportunities for students to communicate with patients and each other.
Conclusion:
IP educational programs connected with chronically ill community-dwelling patients can provide much needed support while demonstrating the need to work effectively with other professions to address social determinants of health and improve outcomes. There is an urgent need to educate a new generation of healthcare providers about the value of IP teamwork in supporting patients through challenging health transitions. SHARP allows students to be immersed in developing their IPEC competencies while simultaneously helping patients achieve their personal health goals. SHARP has potential to reach diverse patient groups to improve outcomes, reduce healthcare costs, and help student develop of IP skills.