Foster, Elissa, PhD

Hirschmann, Krista M, PhD

Ray, Daniel, MD

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksDepartment of MedicineWhen We’re All Together, the Patient Knows It:Creating an Interdisciplinary Learning Communityin Palliative MedicineKrista M. Hirschmann PhDLehigh Valley Health Network, Krista.Hirschmann@lvhn.orgDaniel Ray MDLehigh Valley Health Network, Daniel.Ray@lvhn.orgElissa Foster PhDLehigh Valley Health Network, Elissa.Foster@lvhn.orgFollow this and additional works at: http://scholarlyworks.lvhn.org/medicinePart of the Medical Sciences CommonsThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtHirschmann, K., Ray, D., & Foster, E. (2011). When we're all together, the patient knows it: Creating an interdisciplinary learningcommunity in palliative medicine. Poster presentation.Lehigh Valley Health Network, Allentown, Pennsylvania“When we’re all together, the patient knows it:”Creating an Interdisciplinary Learning Community in Palliative MedicineKrista M. Hirschmann, PhD; Daniel Ray, MD; Elissa Foster, PhDThe Palliative Medicine Scholars (PalMS) program was initiated to:•	 	Foster	the	culture	of	palliative	medicine	across	the	Lehigh	Valley	Health	Network•	 	Develop	faculty	for	an	anticipated	Palliative	Medicine	Fellowship•	 	Reinforce	OACIS	(Optimizing	Advanced	Complex	Illness	Support),	an	interdisciplinary	team-based	program	that	facilitates	communication,	self-management,	and	patient-centered	care	for	those	with	complex	illness.Context Acknowledgements: 	We	would	like	to	thank	The	Kenneth	B.	Schwartz	Center,	which	supported	a	.25	FTE	for	a	facilitator	and	lunch	for	the	participants	during	our	inaugural	year	and	the	Abram	Samuels	Fund.Sessions	meet	twice	a	month,	are	90	minutes	long,	and	are	delivered	over	lunch.	Planning	occurs	approximately	1-2	months	in	advance	through	team	meetings	facilitated	by	a	medical	educator	using	a	planning	session	guide.	Our	curriculum	materials	are	housed	in	a	web-based	repository	accessible	to	group	members.	To	stay	green,	presenters	distribute	only	one	double-sided	handout	summarizing	key	points	of	their	content	and	learning	activities.	ConclusionsIn	the	first	36	months,	PaIMS	has	grown	to	include	130	people	on	our	session	sign-in	sheet	and	275	people	on	our	email	distribution	list.		Sample	topics	include:•		Patient-Centered	Interviewing/Pain	Assessment		•		Overview	of	Pain	Medications	•	Psychosocial	Issues	with	Suffering		•		Ethical	Principles		•		Resources	&	Processes		•		Nutrition	•		Breaking	Bad	News		•		Coping	Strategies		•	Nonpain	Symptom	Assessment	&	Management		•		Neuropathic	Pain		•		Communicating	about	Advance	Directives			•		Vent	Withdrawal		•		Still	Suffering	.	.	.	Honoring	Cultural	&	Spiritual	Practices	•		Hospice	Referral		•		Death	Pronouncement	&	Organ	Donation			•		Visceral	Pain		•		Assessing	Functional	Capacity		•		Radiation	Therapy:	Treatment	&	Impact	•		Community	Resources	for	Caregivers		•			Facilitating	a	Family	Meeting		•			Pediatric	Milestones	for	Understanding	Death			•			Assessing	Functional	Capacity	(Hospital)		•		Understanding	Palliative	Chemotherapy:	Benefits	and	Burdens		•		Complementary	Medicine		•		Functional	Capacity	(Home	Care)	•		Physiology	of	Stress		•		Labyrinth	Walk			•		The	SPEED	of	Trust		•		Sexuality	and	Chronic	Illness“There was one cancer patient we had that went poorly and one that went well . . . . The difference between that patient and the first was that I had people to talk to and knew everyone (through PalMS).” “It (PalMS) created a community for us.  Every single person who works on a patient connects with each other . . . .” “I don’t think I had a thorough understanding of what everybody did.  It (PalMS) increased my appreciation and ability to support them.”“We all get trained in how to do, but PalMS has made us comfortable with how to be. We witness each others’ stories.  We’re an audience for each other and it’s supporting and it’s validating.”“PalMS starts with real issues and real people.  Those involved are willing to work on and build to the ideal.”“All members are encouraged to participate and are respected for the unique qualities and skills they have to offer.  The movement gains more momentum and has a greater influence on cultural change at [the Network].”“PalMS itself is a great example for ‘leading within’ to energize, tap creativity, and mobilize collaboration to develop a process that brings people together to learn from each other, solve problems and build relationships to improve patient care and the feeling of connectedness and ownership of staff.”  Participant Voices 1		By	using	a	collaborative	educational	forum	and	engaging	people	through	their	personal	experiences	and	professional	expertise,	we	have	strengthened	the	palliative	medicine	culture	and	community	of	our	hospital	network.2		Participants’	feedback	and	active	participation	indicates	that	we	have	created	a	successful	and	sustainable	interdisciplinary	learning	community.		3		PalMS	reduces	cross-disciplinary	tensions	by	emphasizing	common	professional	values	and	demystifying	the	roles	of	other	providers.	4		The	PalMS	culture	of	personal	connection	in	a	safe	and	facilitated	environment	carries	over	to	the	floors	and	bedside	where	participants	feel	more	comfortable	and	trusting	of	other	members	of	the	team.ResultsPalMS	is	open	to	anyone	with	a	personal	or	professional	interest	in	palliative	care.	Attendees	include:Who Participants	collaboratively	designed	a	curriculum	grounded	in	five	core	competencies:Process The	following	core	theories	informed	our	facilitation	of	PaIMS	as	a	learning	community.	These	theories	include:Theoretical GroundingCore CompetenciesM edica lC ontentC om m unicationsk illsP ersona law areness E th icsS ystem s adm in istra tiveissues re la ted toP a llia tive m ed ic ineTheoreticalGroundingRelationship-centerednessA ssum es that it is throughhea lthy and d iversere la tionsh ips that work isaccom plishedAdultlearningE ncourages that contentm ust be m ean ing fu l topartic ipants ’ experiencesand ind iv idua l learn ingagendas as clin ica lp rovidersAppreciativeinquiryE ncourages partic ipants toseek out what we do we ll andtry to grow it, rather thandwe lling on prob lem sw ith in the systemSystemsthinkingP rom pts partic ipants to m ain ta ina sense of open boundariesw h ile seek ing resources w ith inour network to createownersh ip andsusta inab ilityPaIMSCommunityQuality ExpertsAdministratorsPhysiciansNursesRespiratoryTherapistsPhysicalTherapy,OccupationalTherapyPastoral CarePharmacistsCase ManagersDietitians

When We’re All Together, the Patient Knows It: Creating an Interdisciplinary Learning Community in Palliative Medicine

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When We’re All Together, the Patient Knows It: Creating an Interdisciplinary Learning Community in Palliative Medicine

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