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Regional Workshops Enhancing Interdisciplinary Collaboration in Primary Health Care (EICP) Initiative Canadians Expect… • Access to services 24 hours a day/seven days a week • Services delivered in community non-hospital settings • More emphasis on prevention and health promotion • Better continuity of care and chronic disease management www.eicp-acis.ca Working together… Canadian Coalition on Enhancing Preventative Practices of Health Professionals www.eicp-acis.ca EICP Background • $6.5M Contribution Agreement from Health Canada (PHCTF) with 10 National Health Care Associations to Support Change Process • Defined: Primary Health Care, Interdisciplinary Collaboration • Principles and Framework, How to Tool Kit • Research, Consultations, Interactive Website • 16 Regional Consultations in September www.eicp-acis.ca EICP Objectives • To develop a set of Guiding Principles and a Framework to enhance interdisciplinary collaboration in Primary Health Care (PHC) • To have the Principles and Framework broadly supported by PHC practitioners, as evidenced through ratification by the national organizations; and • To support the national organizations and other stakeholders in the implementation of the Principles and Framework www.eicp-acis.ca Introductions at your Tables • Your name • Practice/professiona l/work setting www.eicp-acis.ca Regional Workshop Objectives • To provide context for the EICP Initiative; • To provide an update on the EICP research on interdisciplinary collaboration; • To review and validate the principles of interdisciplinary collaboration developed thus far; • To review and confirm the desirable future for interdisciplinary collaboration in Primary Health Care in 2015; • To discuss the challenges and opportunities for supporting interdisciplinary collaboration; and • Identify directions for interdisciplinary collaboration in Primary Health Care. www.eicp-acis.ca Expectations My principal objective for this session is… ________________________ ________________________ ________________________ ________________________ www.eicp-acis.ca Agenda for the Workshop Morning • Introductions and Context For Day • EICP Research Update and Discussion • Primary Health Care And Interdisciplinary Principles in 2015 www.eicp-acis.ca Afternoon • Challenges To The Future • Moving Toward The Future- Developing Directions (Framework Elements) For Interdisciplinary Collaboration In Primary Health Care • Next Steps All I Really Needed to Know – I Learned in Kindergarten R. Fulghum • • • • • Share everything Play fair Don’t hit Put things back Say sorry when you hurt someone • Clean up your own mess • Flush www.eicp-acis.ca • When you go out in the world, watch out for traffic, hold hands and stick together Research Dialogue • What parts of the research in the Regional Workshop Snapshot really caught your attention? • What parts of the research snapshot excited you? • What parts of the research snapshot left you with questions? • What major themes did you draw from this research snapshot? www.eicp-acis.ca Conceptual Framework Definition, objectives, examples in Canada, costeffectiveness, impact on patient/client outcomes. Policy Context Population health, public access to PHC services, public perception of IDC and PHC. Individuals & Families Public Health & Social Context www.eicp-acis.ca PHC structures, providers’ payment mechanisms, liability and regulatory frameworks, PHC reform. Individual Providers & Health Service Organizations Attitudes and perceptions, quality of life, job satisfaction, continuing education, operational issues. Objectives for Research Update • Describe health professional consultation analysis • Describe patient/client consultation analysis • Explain research reports • Discuss workbook analysis • Explain on-line survey • Discuss integration of research into EICP initiative www.eicp-acis.ca Desirable Future From National Synopsis (Provider Consultations): • Timely and appropriate treatment • Multiple points of entry into the ‘system’ • Recognition of the ‘patient’ as part of the PHC team • Adequate resources to deliver services • Equitable sharing of responsibility and liability • Sustainable funding • Increased focus on health promotion and prevention • Single, confidential, accessible health record • Providers skill and services utilized appropriately • Population health focus with targeted outcomes • Grassroots approach to reform • Support for the administrative components www.eicp-acis.ca Principles of IDC From consultations/reports/workbook and literature: • • • • • • • • • • • Defined visionary leadership and coordination Client centered focus Accountability and responsibility delineated Team ‘skills’/Communication soft skills Effective education and professional development Holistic care Appropriate professional 24/7 access Evidence based Professional trust and respect Health promotion/population health approach www.eicp-acis.ca Framework - Challenges • From consultations/reports/workbook and literature: • • • • • • • • • • • • • • Leadership from national associations and government Organizational structure Education Communication ‘soft skills’ Human resources and technology Respect Power issues/Turf wars Inexperience Scope of practice/ Liability and regulatory issues Accessibility Time management Population health approach to funding Demonstration projects to build evidence Social and cultural elements www.eicp-acis.ca National ConsultationsWorkbook Common Themes: • • • • • Increased effectiveness Increased satisfaction Improved quality of care Increased awareness and understanding Allows for a more holistic outlook • Increased health promotion and prevention • Understanding of professional expertise www.eicp-acis.ca Research Report - Highlights A definition of interdisciplinary collaboration needs to recognize the centrality of : • Optimum involvement of the client and his/her family; • Multi-faceted strategy to ensure quality of care and client/community responsibility for health; • Support and structures to implement and maintain interdisciplinary collaboration; • Training for health care providers to learn about collaboration; • Ongoing assessment to learn about what works and ensure that future work builds on lessons learned. www.eicp-acis.ca On-line Survey Update • Two on-line surveys (providers and public) – Provider – from EICP Workbook (merged and simplified) – Public – same as the consultation questionnaire – questions simplified • Live = Nov 04 • Will continue until ~ Feb 05 • To validate other research data • Proactive Communication Strategy www.eicp-acis.ca Integration of Research Data • The research data is used to drive/support the consultation and change management process • The ongoing consultations are part of the research (participatory action research) • The research data and analysis is an enabler for the dialogue that takes place www.eicp-acis.ca Research Dialogue • What parts of the research in the Regional Workshop Snapshot really caught your attention/excited you? • What parts of the research snapshot left you with questions? • What major themes did you draw from this research snapshot? www.eicp-acis.ca Next Steps • • • • • • • • Disseminate research reports Regional Workshops (Nov/Dec 04) Report from Regional Workshops (mid-Dec) Continue analysis of research data Barriers and Facilitators Focus Groups (Jan 05) Regional Workshops 2005 Principles and Framework – ratified May 05 Development of ‘toolkit’ www.eicp-acis.ca www.eicp-acis.ca Primary Health Care and Interdisciplinary Principles 2015 • To review and validate the principles of interdisciplinary collaboration developed thus far and • To review and confirm the desirable future for interdisciplinary collaboration in Primary Health Care in 2015. www.eicp-acis.ca Primary Health Care and Interdisciplinary Principles 2015 "Creating a positive future begins in human conversation. The simplest and most powerful investment any member of a community or an organization may make in renewal is to begin talking with other people as though the answers mattered." www.eicp-acis.ca Review of the Principles and Desirable Future • Three rounds of conversation in the World Cafe • Rounds #1 and #2 Principles of Interdisciplinary Collaboration and the Desirable from the Practitioners Consultations and the research • Round # 3—Creating Your Perspective www.eicp-acis.ca National Synopsis - Principles • Shared, common vision, values and philosophy • Climate of trust, respect, shared decision-making, mutual support, flexibility • Respect for autonomous choice of client; respect for dignity of individual; commitment to the values of acceptance; self-determination and respect • Accessibility to appropriate health professional at the right time and in the right place • Population health approach that addresses the determinants of health and needs of the population • Balance between work and non-work time of professionals (Work-Life balance) • Accessibility (by actions of 24/7 service, right provider, right time, no physical barriers, and no financial barriers) www.eicp-acis.ca National Synopsis Snapshot – Desirable Future • • • • • • • • • • • • Timely and appropriate treatment Multiple points of entry into the ‘system’ Recognition of the ‘patient’ as part of the PHC team Adequate resources to deliver services Equitable sharing of responsibility and liability Sustainable funding Increased focus on health promotion and prevention Single, confidential, accessible health record Providers skill and services utilized appropriately Population health focus with targeted outcomes Grassroots approach to reform Support for the administrative components www.eicp-acis.ca Reviewing the Principles and Desirable Future – Rounds 1 and 2 1. What stands out for you in the Principles of Interdisciplinary Collaboration and Desirable Future from the Regional Snapshot? 2. What do you like and what concerns you? 3. What one or two modifications would your table group suggest? – add, delete, or change. www.eicp-acis.ca Creating Your Perspective Round #3 Thinking about the principles of interdisciplinary collaboration and the desirable future, what modifications do you suggest? www.eicp-acis.ca Synthesizing our Conversations Does this synthesis reflect you discussions this morning? What is missing? Is it challenging enough? Is it realistic? www.eicp-acis.ca Filling in the details Good work but I think we need a little more detail right here! www.eicp-acis.ca Turning to One Another - M. Wheatley • We acknowledge one another as equals • We try to stay curious about each other • We recognize that we need each other’s help to become better listeners • We slow down so we have time to think and reflect • We remember that conversation is the natural way humans think together • We expect it to be messy. www.eicp-acis.ca Challenges – Elements of the Framework 1. Education and continuing education 2. Funding 3. Effective and efficient use of resources 4. Legislation 5. Regulation 6. Liability 7. Information system – planning and evaluation 8. Organizational practices and design www.eicp-acis.ca 9. Human resource development 10. Outcome based accreditation 11. Citizen engagement 12. Quality assurance accountability 13. Evidence based care, research 14. Access – multi points of entry to system 15. Professional attitudes Challenges 1. Do you agree that these are important challenges impeding movement towards the principles and the desirable future and … www.eicp-acis.ca Challenges 1. What other challenges impede the realization of the principles of interdisciplinary collaboration and the desirable future? 2. Prioritize the challenges! www.eicp-acis.ca Moving Towards the Future 1. What are the underlying root causes, conditions, trends, influences for the existence of this challenge to realizing the Desirable Future and the supporting Interdisciplinary Collaboration Principles for Primary Health Care? 2. For each challenge identify up to 6 – 8 causes in a scatter gram. www.eicp-acis.ca What You Will Return with to the Group Session DESCRIPTION OF THE UNDERLYING CAUSES, CONDITIONS, TRENDS OF THE CHALLENGE www.eicp-acis.ca I/VI Moving Towards the Future – Critical Actions What are the critical actions you would recommend to overcome the challenges assigned to your group? www.eicp-acis.ca www.eicp-acis.ca www.eicp-acis.ca