scholarly journals Interprofessional education in a student-led emergency department: A realist evaluation

2017 ◽  
Vol 31 (2) ◽  
pp. 199-206 ◽  
Author(s):  
Anne Ericson ◽  
Susanne Löfgren ◽  
Gunilla Bolinder ◽  
Scott Reeves ◽  
Simon Kitto ◽  
...  
Keyword(s):  
Emergency Department ◽  
Interprofessional Education ◽  
Realist Evaluation

scholarly journals A Structured Curriculum for Interprofessional Training of Emergency Medicine Interns

2019 ◽  
Vol 21 (1) ◽  
pp. 149-151 ◽  
Author(s):  
Ashley Rider ◽  
Tiffany Anaebere ◽  
Mariko Nomura ◽  
David Duong ◽  
Charlotte Wills
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Interprofessional Education ◽  
Hospital Setting ◽  
Scope Of Practice ◽  
Registered Nursing ◽  
Interprofessional Training ◽  
Before And After ◽  
Team Based Care ◽  
Improve Health

Interprofessional education (IPE) has been shown to improve health outcomes and patient satisfaction. IPE is now represented in the Accreditation Council for Graduate Medical Education’s emergency medicine (EM) milestones given the team-based nature of EM. The Highland Allied Health Rotation Program (H-AHRP) was developed by residents to enhance and standardize IPE for EM residents in a single hospital setting. H-AHRP was incorporated into the orientation month for interns starting in the summer of 2016. EM interns were paired with emergency department preceptors in registered nursing (RN), respiratory therapy (RT), pharmacy (PH), laboratory (LAB), and social work (SW) in either a four-hour shadowing experience (RN, RT, PH) or lecture-based overview (LAB, SW). We conducted a survey before and after the program. Overall, the EM interns reported an improved understanding of the scope of practice and day-to-day logistics after working with the preceptors. They found the program helpful to their future as physicians and would recommend it to other residencies. The H-AHRP program allows for the early incorporation of IPE into EM training, enhances interns’ understanding of both the scope and logistics of their colleagues, and is a well-received effort at improving team-based care.

Interprofessional Education of Emergency Department Team on Falls in Older Adults

2020 ◽  
Vol 68 (3) ◽  
Author(s):  
Emily DeDonato ◽  
Stephen E. Hall ◽  
Teresita M. Hogan ◽  
Lauren J. Gleason
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Interprofessional Education ◽  
Falls In Older Adults

scholarly journals LO81: The use of in situ simulation to improve emergency department staff comfort with the management of high acuity, low occurrence cases

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S36-S37 ◽  
Author(s):  
M. Bilic ◽  
K. Hassall ◽  
M. Hastings ◽  
C. Fraser ◽  
G. Rutledge ◽  
...  
Keyword(s):  
Emergency Department ◽  
Interprofessional Education ◽  
Low Frequency ◽  
High Volume ◽  
Simulation Design ◽  
Low Frequencies ◽  
In Situ Simulation ◽  
High Acuity ◽  
Quasi Experimental

Introduction: In the emergency department (ED), high-acuity presentations encountered at low frequencies are associated with reduced staff comfort. Previous studies have shown that simulation can improve provider confidence with practical skills and management of presentations in various fields of medicine. The present study examined the effect of in situ simulation on interprofessional provider comfort with the identification and management of high-acuity low-frequency events in the ED. It further assessed the feasibility of implementing weekly simulation as an interprofessional education initiative in a high-volume ED. Methods: This was a retrospective pre-test post-test quasi-experimental design. Weekly in situ simulation events were facilitated by an interdisciplinary team in a high-volume ED in Hamilton, Ontario that sees an average of 185 patients per day. To date, 34 simulation events were held between January 18, 2019 and November 22, 2019, and included neonatal, paediatric and obstetric emergencies, and adult codes. There was an average of 20 patients presenting to the ED during these events. Events included a debrief, and typically lasted 60 minutes in total. Participants included individuals from various disciplines working on shift at the time of the event. Questionnaires were administered via email following the event, in which participants were asked to rank their comfort with emergency codes before and after the simulation using two 5-point Likert scales. The data from 39 questionnaires was analyzed. T-tests were used to analyze differences in self-reported comfort scores. Results: Questionnaire responders included nurses (41%), respiratory therapists (26%), resident physicians (10%), paramedics (3%), attending physicians (3%), students of various disciplines (10%) and other (7%). 38% of participants reported increases in comfort following simulation when compared to prior. Using the 5-point scale, the average reported score for comfort pre-simulation was 3.59 (95% CI 3.30–3.88), and the average post-simulation score was 3.97 (95% CI 3.76–4.19, p = 0.03). Conclusion: Our results demonstrate that weekly interprofessional in situ simulation is feasible in a high-volume ED, and significantly improves self-reported provider comfort with the identification and management of high-acuity, low-frequency events. This warrants the implementation of this simulation design to improve staff confidence and has implications for its potential role in improving team dynamics and patient safety.

scholarly journals LO044: Stress-testing the resuscitation room: latent threats to patient safety identified during interprofessional in-situ simulation in the emergency department

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S45-S45
Author(s):  
G. Mastoras ◽  
C. Poulin ◽  
L. Norman ◽  
B. Weitzman ◽  
A. Pozgay ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Safety ◽  
Interprofessional Education ◽  
Healthcare Professionals ◽  
Tertiary Care ◽  
Healthcare Team ◽  
Monthly Basis ◽  
In Situ Simulation ◽  
Training Tool

Introduction: Emergency Department (ED) resuscitation is a complex, high-stakes procedure where positive outcomes depend upon effective interactions between the healthcare team, the patient, and the environment. To this end, resuscitation teams work in spaces designed to optimize workflows and ensure that necessary treatments and skillsets are available when required. However, systematic failures in this environment cannot always be adequately anticipated, exposing patients to opportunities for harm. As part of a new interprofessional education initiative, this prospective, observational study sought to characterize latent threats to patient safety (LST’s) identified during the delivery of in-situ, simulated resuscitations in two Canadian, tertiary care, academic Emergency Departments. Methods: In-situ simulation sessions were delivered on a monthly basis in the EDs of each hospital campus, during which a variety of simulated resuscitation scenarios were run with distinct teams of ED healthcare professionals. A research assistant was present throughout each session and documented LST’s identified by simulation facilitators and participants during the case and debriefing. Data were entered into a master table and grouped thematically for analysis. Results: After a pilot run-in, 10 in-situ simulation sessions were delivered, involving 27 cases and reaching 180 ED healthcare professionals (25 attending MD, 37 resident MD, 59 RN, 24 RT). 83 latent safety threats were identified through these sessions (mean 3.1 LSTs per case) of which 52 were determined to be “actionable”. Corrective mechanisms have been initiated in 72% of these cases (e.g., new education campaigns and in-servicing, equipment provisioning, equipment checklists). Conclusion: In-situ simulation, beyond its role as a training tool for developing Non-Technical and Crisis Resource Management skills, can be effectively used to identify systematic deficits and knowledge gaps that could expose critically ill patients to harm. Effective quality improvement and continuing education programs are essential to translate these findings into more resilient patient care.

Interprofessional Education in An Orthodontic Outreach Training Centre

2016 ◽  
Vol 5 (4) ◽  
pp. 63-69
Author(s):  
Richard Cure
Keyword(s):  
Primary Care ◽  
Patient Care ◽  
Interprofessional Education ◽  
Clinical Care ◽  
Realist Evaluation ◽  
Care Hospital ◽  
Integrated Education ◽  
Training Centre ◽  
Team Members ◽  
The Uk

Interprofessional education (IPE) describes those occasions when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes. In the UK, orthodontic treatment is now delivered by a highly skilled team. Historically, education and training for orthodontic team members has been delivered ‘uniprofessionally’ in secondary care hospital settings, despite 96% of dental care, including orthodontics, being delivered in primary care. This paper describes an evaluation of IPE in Leamington Spa Orthodontics (LSO), a University-approved, primary care outreach training centre, where all members of the orthodontic team deliver patient care and are educated together in an IPE environment. The study methodology is realist evaluation, which aims to describe and understand the educational environment and identify how stakeholders perceive their experiences. This study describes a quality assured, primary care model of integrated education and patient care, which enhances interprofessionality and offers an alternative strategy for the future for commissioning of education and clinical care.

scholarly journals Interprofessional Care of Emergency Department Doctors and Pharmacists: Crossing a Collaboration Chasm

2020 ◽  
Vol 11 (2) ◽  
pp. 12
Author(s):  
Jumana Al-Salloum ◽  
Dixon Thomas ◽  
Ghada AlAni ◽  
Baljinder Singh
Keyword(s):  
Emergency Department ◽  
Patient Care ◽  
Interprofessional Education ◽  
Administrative Support ◽  
Interprofessional Collaboration ◽  
Role Clarity ◽  
Patient Centeredness ◽  
The Public ◽  
Interprofessional Care ◽  
Article Type

Role clarity of emergency department doctors and pharmacists is essential to provide collaborative care. Evidence is available that interprofessional care of doctor-pharmacist collaboration improves patient care in emergency settings. Pharmacists need to improve their knowledge and skill in emergency practice to be more productive and sought after. Team dynamics, training, and administrative support are critical. Interprofessional collaboration should not be programmed to fail for the short-term convenience of any profession. With more considerable effort from different stakeholders, once a collaborative system is established that will sustain improved patient care and the public trust of healthcare. Crossing a collaboration chasm takes time and effort. Interprofessional education should be built-in essential competencies to be collaborative with role clarity, teamwork, better communication, and ultimately patient-centeredness.   Article Type: Commentary

scholarly journals 192 Primary care streaming in emergency departments- contexts and mechanisms associated with perceived effectiveness outcomes: a realist evaluation

2020 ◽  
Vol 37 (12) ◽  
pp. 837-838
Author(s):  
Michelle Edwards ◽  
Michelle Edwards ◽  
Alison Cooper ◽  
Freya Davies ◽  
Andrew Carson Stevens ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Nurse Practitioners ◽  
Emergency Departments ◽  
Patient Flow ◽  
Care Service ◽  
Psychological Theory ◽  
Realist Evaluation ◽  
Evaluation Methodology ◽  
Service Development

Aims/Objectives/BackgroundRecent policy has encouraged emergency departments (EDs) to deploy nurses to stream patients from the ED front door to GPs working in a separate GP service operating within or alongside an ED. We aim to describe mechanisms relating to effectiveness of streaming in different primary care service models identified in emergency departments. We explored whether patients were appropriately streamed to emergency care, primary care, other hospital services or community primary care services; patient flow (including effects on waiting times and length of stay in the emergency department); and safe streaming outcomes. We sought suggestions for quality improvements relating to streamingMethods/DesignA realist evaluation methodology was used to explore perceived streaming effectiveness. We visited 13 emergency departments (purposively selected across England & Wales; 8 streamed primary care patients to a primary care clinician) and carried out observations of triage/streaming and patient flow and interviews with key members of staff (consultants, GPs, nurses).Field notes from observations and audio-recorded interviews were transcribed verbatim and were analysed by creating context, mechanism and outcome configurations to refine and develop theories relating to streaming effectiveness.Results/ConclusionsWe identified five contexts (nurses’ knowledge and experience, streaming guidance, teamwork and communication, operational management and strategic management) that facilitated mechanisms that influenced the effectiveness of streaming (streaming to an appropriate service, patient flow, delivering safe care). We integrated a middle range psychological theory with our findings to recommend a focus for training nurses in streaming and service improvements. We recommend a collaborative approach to service development, guidance and training (including input from emergency department clinicians, primary care clinicians) and a range of training strategies that are suitable for less experienced junior nurses and more experienced senior nurses and nurse practitioners.

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