Preparing New Learners for an Interprofessional Clinical Learning Environment

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Preparing New Learners for an Interprofessional

Clinical Learning Environment

AOGME Webinar March 3, 2021

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Presenters

Morgan Passiment Executive Director NCICLE

Director, Outreach and Collaboration

Accreditation Council for Graduate Medical Education Kristen K. Will, PhD(c), MHPE, PA-C

Director, Clinical Programs and Accreditation Clinical Associate Professor

Arizona State University I College of Health Solutions

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Disclosures Neither presenter has any disclosures

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The National Collaborative for Improving the Clinical Learning Environment (NCICLE)

provides a forum for organizations committed to

improving the educational experience and patient care outcomes within clinical learning environments.

NCICLE seeks to simultaneously improve the quality of

learning and patient care within CLEs through shared

learning and collaborative practice among its member

organizations.

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37 Member Organizations

Accreditation Council for Continuing Medical Education (ACCME) Accreditation Council for Graduate Medical Education (ACGME) Accreditation Council for Pharmacy Education (ACPE)

Alliance of Independent Academic Medical Centers (AIAMC) American Association for Physician Leadership (AAPL)

American Association of Colleges of Nursing (AACN)

American Association of Colleges of Osteopathic Medicine (AACOM)

American Association of Colleges of Pharmacy (AACP) American Board of Medical Specialties (ABMS)

American Dental Education Association (ADEA) American Hospital Association (AHA)

American Medical Association (AMA)

American Nurses Credentialing Center (ANCC)

American Organization for Nursing Leadership (AONL) American Osteopathic Association (AOA)

American Society of Health-System Pharmacists (ASHP)

Assembly of Osteopathic Graduate Medical Educators (AOGME) Association for Hospital Medical Education (AHME)

Association for Nursing Professional Development (ANPD) Association of American Medical Colleges (AAMC)

Association of Post Graduate APRN Programs (APGAP) Association of Post Graduate PA Programs (APPAP) Council of Medical Specialty Societies (CMSS)

Council on Social Work Education (CSWE)

Health Professions Accreditors Collaborative (HPAC) Health Resources and Services Administration (HRSA)

Institute for Healthcare Improvement (IHI)/National Patient Safety Foundation (NPSF)

Institute for Safe Medication Practices (ISMP) Liaison Committee on Medical Education (LCME) National Board of Medical Examiners (NBME)

National Center for Interprofessional Practice and Education Organization of Program Director Associations (OPDA)

Quality and Safety Education for Nurses (QSEN) Initiative The American Red Cross

The Joint Commission

Veterans Health Administration (VA)

Vizient, Inc.

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NCICLE.org

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Definition:

Clinical Learning

Environment

Hospitals, medical centers, ambulatory care centers and other clinical settings in which clinicians train and practice.

Weiss K, Passiment M, Riordan L, Wagner R. Achieving the Optimal

Interprofessional Clinical Learning Environment: Proceedings From an NCICLE Symposium.; 2019. 221 doi:10.33385/NCICLE.0002

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Patient Safety

Disch J, Kilo CM, Passiment M, Wagner R, Weiss KB; National Collaborative for Improving the Clinical Learning Environment. The Role of Clinical Learning Environments in Preparing New Clinicians to Engage in Patient Safety. http://nicicle.org. Published September 27, 2017.

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Role of

Leadership

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New Clinician

Skills

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Clinical Learning

Environment

Role

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Goal developed from NCICLE Guidance.

Create a patient safety program designed to inspire learners to engage in patient safety behaviors

throughout their training and career.

 Using the NCICLE framework, the collaborative will develop models that orient new learners to systems-based approaches to reducing harm and optimizing patient care.

• All PGY-1 and first year fellows participate in a real small event analysis in the first 12-months at the CLE.

ACGME Patient Safety Collaborative

12 https://www.acgme.org/Portals/0/PDFs/PEISummary1PatientSafety.pdf

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New Clinician

Skills

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Quality of PSE Analyses

Bagian, J.P., King, B.J., Mills, P.D., McKnight, S.D. (2011). Improving RCA performance The Cornerstone Award and the power of positive reinforcement. BMJ Qual Saf, 20, 974-982.

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Quality

Improvement

Casey BR, Chisholm-Burns M, Passiment M, Wagner R, Riordan L, Weiss KB for the NCICLE Quality Improvement: Focus on Health Care Disparities Work Group. The Role of the Clinical Learning Environment in Preparing New Clinicians to Engage in Quality Improvement Efforts to Eliminate Health Care Disparities. http://ncicle.org. Published January 15, 2019.

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Definitions

 HEALTH EQUITY [The] attainment of the highest level of health for all people. Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable

inequalities, historical and contemporary injustices, and the elimination of health and healthcare disparities.

 HEALTH CARE DISPARITIES Health care disparities are a unique component of health disparities and reflect differences in the care delivered.

Healthy People 2020. Disparities. US Office of Disease Prevention and Health Promotion website.

https://www.healthypeople.gov/2020/about/foundation-health-measures/ Disparities.

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Role of

Leadership

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New Clinician

Skills

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www.NCICLE.org

Clinical

Learning

Environment

Role

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www.NCICLE.org

ACGME Collaborative Preparing New

Clinicians to Engage in QI to Eliminate Health Care Disparities

Develop and align strategic goals and priorities to identify and eliminate differences in the care

delivered within the CLE through QI.

Promote awareness and recognition of cultural humility across the CLE that reflects the cultural diversity of its workforce and patient population.

Educate new clinicians on identifying health care disparities occurring within the CLE and the patient populations at risk for these disparities, which

includes an understanding of both health and health

care disparities.

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Observations

Strategic Plan

• Be deliberate about inclusion. Who is missing from the table, what voices are not being included, and seek them out.

• Concisely frame the case for providing organizational value.

• Be transparent about the process and communicate early and often.

Cultural Humility

• Leverage existing expertise and resources - give credit and voice to those who have already been doing this work.

• Obtain clear buy-in from highest level of leadership, to prevent multiple groups from producing potentially conflicting trainings.

Educate New Clinicians

• Start wherever you can, no data collection effort is too small.

• Data on health care disparities needs to be paired with education on root cause analysis, so it can be interpreted and acted upon.

• The organization should be prepared to be transparent, embrace its own disparities, and commit to eliminating them or the data will be buried, and nothing will change.

ACGME Collaborative Observations

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