Evaluation of patient perceptions of team based care in a Geriatric Oncology Clinic

Purpose: To measure patient perceptions of collaborative practice in an interprofessional team providing geriatric oncology assessments to older patients with cancer. Background: The Senior Adult Oncology Clinic (SAOC) at Thomas Jefferson University’s Kimmel Cancer Center utilizes an interprofessional team approach to provide comprehensive geriatric oncology assessments and treatment plans for older patients with cancer. The importance of team-based healthcare delivery is well documented, however, experts agree that there is a need for more tools to assess the skills required to become a high-functioning team and a need to study the impact of collaborative practice on patient reported outcomes and satisfaction. For this study, we sought to evaluate patients’ experience and perception of our SAOC team function. Description of Intervention: Upon completion of a SAOC visit, patients were asked to participate in a short voluntary survey to assess team performance. The Jefferson Teamwork Observation Guide (JTOG) is a validated survey used with learners that has been adapted to elicit patient perspectives of five domains of interprofessional collaborative practice, including communication (C), values/ethics (V/E), teamwork (T), roles/responsibilities (R) and patient-centeredness (PC). The Patient JTOG includes eight competency–based Likert Scale questions as well as one open-ended question. The survey was administered on secure mobile tablets by trained research assistants (RAs) who were not part of the healthcare team. The study received exempt approval by our Institutional Review Board. Results: A total of 13 patients completed the survey. Seven respondents were female, and six were male. Seven identified as Caucasian, four as African American and two as other. One hundred percent responded “Strongly Agree” to a global question about the importance of teamwork in patient care (mean 4.0). Overall satisfaction with the SAOC team was 3.92 out of 4.0. For the eight questions relating to each of the five collaborative practice competencies noted above, the team received an average score ranging from 3.69 to 3.77 out of 4.0, for a global score of 29.66 (out of 32 possible), placing this team in the highest quartile of teams surveyed at our institution to date (n=407). In addition, all 13 respondents completed the open-ended qualitative comments with 12 out of the 13 being positive with multiple references to effective listening and communication, team coordination, and patient-centered care. Conclusion: The SAOC has a relatively unique model of providing interprofessional geriatric oncology assessments. The Patient JTOG tool was easy to incorporate into a busy clinic and provided valuable feedback to our providers, demonstrating that our patient’s perceive the team as highly functioning and effective. Based on these early results, our high functioning interprofessional consultative team model may serve as a model for replication for team based care delivery at other institutions Relevance: Incorporation of an easy to use tool to assess interprofessional team function and patient perceptions of collaborative practice Learning Objectives: Define methods for evaluating patient perceptions of collaborative practice in an outpatient geriatric oncology practice (Knowledge) Describe a replicable model for interprofessional collaborative practice (Comprehension/Application) Apply lessons learned for engaging students in and preparing faculty for interprofessional team-based care delivery (Comprehension/Application

iPads, iBooks, Apps! What\u27s all the iFuss about?

The iVolution is here. It is iThis and iThat every way you turn. Is this just another iFad, or is it truly revolutionizing education? In a recent survey conducted by EDUCAUSE Center for Analysis and Research on undergraduates and technology, 31% of students reported owning tablet technology a 15% increase from the previous year and 76% of students reported owning smart phones. This finding was a 14% increase from the previous year. Students also reported using smart devices in class to access material, participate in activities, look up information and photograph material as learning strategies. Thomas Jefferson University is riding the iWave and taking strides to better integrate technology at all levels of medical training; leading the forefront of the iVolution, syllabi, course materials, and textbooks are now delivered in some of our courses via iPads. In the past few years, the Jefferson Health Mentors Program has embraced the use of new technologies, including Wikis, online discussion boards, Google docs, and Skype platforms to facilitate asynchronous IPE interactions. These platforms have helped to promote IPE by easing scheduling logistics and by allowing students to collaborate electronically on team-based assignments. Over the past summer, JCIPE, the Jefferson Health Mentors Program (JHMP), faculty from Jefferson Medical College and the School of Health Professions, Academic & Instructional Support & Resources (AISR) and Jeff Information Technology (IT) assembled a working group and developed yet another innovative tool to better integrate technology into our IPE efforts – the product was a new iBook, entitled “Assessing Patient Safety.

Outpatient Mineralocorticoid Receptor Antagonist Prescription Rate for Heart Failure

Aims for Improvement: Improve MRA prescription rate in the outpatient cardiology clinic by 25

From the Editors

Welcome to the Spring 2014 edition of the Jefferson Center for Interprofessional Education (JCIPE) newsletter. In this edition of our newsletter, you will have a chance to read about two new innovations in technology designed to enhance interprofessional education and collaborative practice. We believe that integrating technology into IPE will be central to aligning health care education reforms with changes in healthcare delivery. This Spring also marks the graduation of our 6th cohort of JHMP students at TJU. Now, over 4,100 students have completed this longitudinal IPE curriculum; feedback from graduates has been highly positive, detailing the impact of IPE experiences in better preparing them for teamwork as well as providing them with an unexpected advantage in employment opportunities, where competency as an effective team player is highly valued by employers

Spud 1.0: generalising and automating the user interfaces of scientific computer models

The interfaces by which users specify the scenarios to be simulated by scientific computer models are frequently primitive, under-documented and ad-hoc text files which make using the model in question difficult and error-prone and significantly increase the development cost of the model. In this paper, we present a model-independent system, Spud, which formalises the specification of model input formats in terms of formal grammars. This is combined with an automated graphical user interface which guides users to create valid model inputs based on the grammar provided, and a generic options reading module, libspud, which minimises the development cost of adding model options. <br><br> Together, this provides a user friendly, well documented, self validating user interface which is applicable to a wide range of scientific models and which minimises the developer input required to maintain and extend the model interface

Using a Resident-Led Process Improvement Committee to Change Pain Medication Prescribing Habits: Early Results

The aims of this project were to: Streamline the ordering of IV and PO pain meds Encourage the appropriate ordering of Ofirmev

Creating a Medical Home for Trans Older Adults: Challenges, education, and best practices

Background: LGBT individuals face multiple disparities and challenges navigating the healthcare system. Most attention on such issues has focused on LGBT youth, leaving older adults as an especially vulnerable population. LGBT older adults are more likely than their heterosexual counterparts to experience poverty, worse mental and physical health, and mistreatment under current care models. Trans older adults represent a particularly underserved group and often have specialized care needs, including hormone therapy and behavioral healthcare. Geriatricians can help improve access to care with increased sensitivity toward and knowledge of LGBTspecific issues. With the unique challenges faced by LGBT older adults in mind, Jefferson Geriatrics, an outpatient practice devoted to the care of older adults, launched an initiative to create more LGBT-inclusive and trans-friendly primary care services in the Philadelphia region. Objectives: After engaging with our poster, participants will: 1) Understand needs and challenges facing LGBT older adults, focusing on trans older adults 2) Identify best practices for providing trans-competent primary care 3) Explore concerns and challenges facing health care providers and staff in caring for a trans older adult population Methods: An online survey was administered to healthcare providers and staff in a geriatric primary care practice to assess knowledge and attitudes related to LGBT individuals. Providers underwent cultural competency training pertaining to the care of the LGBT aging community. They also participated in medical competency training in areas such as HIV management and hormone therapy for trans individuals. Finally, a survey was conducted within an LGBT aging community to help gain an understanding of attitudes, perceptions and needs of older LGBT adults. Conclusions/Impact: There remains much opportunity to improve upon the care of LGBT older adults, in particular trans older adults. In our poster, we describe a model for practice transformation to create a medical home for trans older adults.https://jdc.jefferson.edu/sexandgenderhealth/1005/thumbnail.jp

From the Editors

This fall has seen a flurry of activity at the Jefferson Center for InterProfessional Education (JCIPE). In September, Lauren Collins, MD, Associate Director of JCIPE, was selected as one of five recipients of the prestigious Macy Faculty Scholars (MFS) program, a two-year career development award supported by the Josiah Macy Jr. Foundation. She now joins a national network of other MFS recipients in helping to re-envision training of health professions students and delivery of collaborative care. Elizabeth Speakman, EdD, RN, ANEF, FNAP, JCIPE Co-Director, completed her three-year Robert Wood Johnson Executive Nurse Fellowship and was recently selected to attend the Institute of Medicine Future of Nursing: Campaign for Action Summit 2015. In addition, Nethra Ankam, MD, from the Department of Rehabilitation Medicine and Sidney Kimmel Medical College, and Tracey Vause Earland, MS, OTR/L, from the Department of Occupational Therapy of the College of Health Professions, both longtime faculty champions of IPE at Jefferson, have recently been appointed to serve as the new Co-Directors of the Jefferson Health Mentors Program (JHMP), overseeing dynamic changes in one of our flagship activities