Transcript Interspecialty Learning: Breaking the Barriers between

Interspecialty Learning: Breaking the
Barriers between Primary and
Secondary Care
Saif Ahmad, Prit Chahal, Jane Little
Introduction
• An effective primary-secondary care interface
is of growing significance to professionals and
patients
• An understanding of commissioning and NHS
management is important for doctors
Interspecialty learning
• Parallels with interprofessional learning
• Evidence- surprisingly scarce
Aims
• Evaluate a novel interspecialty learning
exercise designed to educate GP and medical
trainees on NHS management and
commissioning
What was done
• 74 GP and medical trainees attended
• “NHS Management Structures and Service ReDesign”
• Whole day (not on hospital site)
The Intervention
• 6 mixed, randomly allocated groups
• Asked to re-design a service
– E.g. Heart failure, diabetes
• Internet, consultants and expert patients
The Intervention
• Each group then pitched their business case to
a commissioning panel
– Dragons’ Den
“Dragons’ Den”
Questionnaires
• Pre- and post event (100% compliance)
• Assessed
– 1) Perceived knowledge and skills
– 2) Attitudes
Results...
Multiple variables pre- and post
5
Pre
Post
4.5
A- Combined teaching
helpful
4
3.5
Understanding of
B- Patient centred
approach to service
design
C- Evidence based
approach
D- Primary-secondary
care interface
E- NHS management
structures
3
Likert
score
2.5
2
1.5
1
0.5
0
A
B
C
D
E
Would recommend to colleague
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Comments
• “Revolutionary way of learning”.
• “An excellent approach to teaching a relatively
unfamiliar, drab subject”
• “...helped me to understand how both primary
and secondary care can be integrated for the
interest of the patient”.
Comments
• “Secondary care physicians seemed to blame
problems on inappropriate GP referrals ie its
all the GPs fault. Felt that day was focused on
sorting out inadequacies in primary care. It
was quite demoralising spending time
working out ideas for them to be completely
ripped apart”
Potential Partners
• Medics with A&E doctors
• Surgeons with
anaesthetists
• GPs with anyone
• List is endless....
Ken Currie, Three Oncologists
Scottish National Portrait
Gallery © KEN CURRIE
Conclusion
• Interspecialty learning may modify trainees’
knowledge, skills and attitudes
• Regular exercises are likely to reinforce these
benefits
• Potentially improve collaboration and patient
care
Acknowledgements
•
•
•
•
Mrs Karen Montrose
Mrs Jane Hind
Dr Nohaid Ilyas
Dr Jonathan Corne
References
• 1. Lingard, L., et al., The rules of the game:
interprofessional collaboration on the
intensive care unit team. Crit Care, 2004. 8(6):
p. R403-8.
• 2. Pollard, L.C., et al., Perceived barriers to
integrated care in rheumatoid arthritis: views
of recipients and providers of care in an innercity setting. BMC Musculoskelet Disord, 2011.
12: p. 19.