Association of a Multisite Interprofessional Education Initiative With Quality of Primary Care

Edwards, Samuel T.; Hooker, Elizabeth R.; Brienza, Rebecca; O’Brien, Bridget; Kim, Hyunjee; Gilman, Stuart C.; Harada, Nancy D.; Gelberg, Lillian; Shull, Sarah; Niederhausen, Meike; King, Samuel; Hulen, Elizabeth; Singh, Mamta; Tuepker, Anaïs

doi:10.1001/jamanetworkopen.2019.15943

Cited by 26 publications

(14 citation statements)

References 41 publications

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“…A final 39 studies were included in the meta-analysis 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 after 11 studies were excluded because of inadequate data (eTable in the Supplement ). 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 Figure 1 depicts the inclusion process of the systematic review and meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

Assessment of Interprofessional Collaborative Practices and Outcomes in Adults With Diabetes and Hypertension in Primary Care

et al. 2021

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IMPORTANCE Interprofessional collaborative practice (ICP), the collaboration of health workers from different professional backgrounds with patients, families, caregivers, and communities, is central to optimal primary care. However, limited evidence exists regarding its association with patient outcomes. OBJECTIVE To examine the association of ICP with hemoglobin A 1C (HbA 1c), systolic blood pressure (SBP), and diastolic blood pressure (DBP) levels among adults receiving primary care.

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Section: Resultsmentioning

confidence: 99%

Assessment of Interprofessional Collaborative Practices and Outcomes in Adults With Diabetes and Hypertension in Primary Care

et al. 2021

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“…10 Similarly, diabetes control of patients managed by interprofessional teams of trainees improved at 5 VA primary care sites. 6 In a walk-in clinic, patients of trainees and supervising attendings had similar patient satisfaction, symptom resolution, and functional status improvement. 11 In contrast, one study showed that trainees deliver poorer quality of preventive care compared to faculty.…”

Section: Discussionmentioning

confidence: 98%

“…Our findings contribute to the limited literature on the impact of IP training programs on patient health care utilization. 6 , 9 The few studies assessing the effect on patient care outcomes of general ambulatory training programs have shown mixed findings. Patient satisfaction was not adversely affected and diabetes control benefited from management by trainees.…”

Section: Discussionmentioning

confidence: 99%

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Integrating Interprofessional Trainees into a Complex Care Program for Veterans Experiencing Homelessness: Effects on Health Services Utilization

et al. 2021

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PURPOSE High-quality, comprehensive care of vulnerable populations requires interprofessional ambulatory care teams skilled in addressing complex social, medical, and psychological needs. Training health professionals in interprofessional settings is crucial for building a competent future workforce. The impacts on care utilization of adding continuity trainees to ambulatory teams serving vulnerable populations have not been described. We aim to understand how the addition of interprofessional trainees to an ambulatory clinic caring for Veterans experiencing homelessness impacts medical and mental health services utilization. METHODS Trainees from five professions were incorporated into an interprofessional ambulatory clinic for Veterans experiencing homelessness starting in July 2016. We performed clinic-level interrupted time series (ITS) analyses of pre- and post-intervention utilization measures among patients enrolled in this training continuity clinic, compared to three similar VA homeless clinics without training programs from October 2015 to September 2018. RESULTS Our sample consisted of 37,671 patient- months. There was no significant difference between the intervention and comparison groups’ post-intervention slopes for numbers of primary care visits (difference in slopes =−0.16 visits/100 patients/month; 95% CI −0.40, 0.08; p=0.19), emergency department visits (difference in slopes = 0.08 visits/100 patients/month; 95% CI −0.16, 0.32; p=0.50), mental health visits (difference in slopes = −1.37 visits/month; 95% CI −2.95, 0.20; p= 0.09), and psychiatric hospitalizations (−0.005 admissions/100 patients/month; 95% CI −0.02, 0.01; p= 0.62). We found a clinically insignificant change in medical hospitalizations. CONCLUSIONS Adding continuity trainees from five health professions to an interprofessional ambulatory clinic caring for Veterans experiencing homelessness did not adversely impact inpatient and outpatient care utilization. An organized team-based care approach is beneficial for vulnerable patients and provides a meaningful educational experience for interprofessional trainees by building health professionals’ capabilities to care for vulnerable populations.

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“…Less formal experiential education strategies, particularly those incorporating interprofessional consultation, improve quality of care ( 29 ) and enhance knowledge ( 16 ). If implemented effectively, experiential interprofessional education strategies may help improve management of chronic pain specifically ( 26 ).…”

Section: Three Different Approaches/protocolsmentioning

confidence: 99%

Practical Opportunities for Biopsychosocial Education Through Strategic Interprofessional Experiences in Integrated Primary Care

et al. 2021

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Even with the expansion of primary care teams to include behavioral health and other providers from a range of disciplines, providers are regularly challenged to deliver care that adequately addresses the complex array of biopsychosocial factors underlying the patient's presenting concern. The limits of expertise, the ever-changing shifts in evidence-based practices, and the difficulties of interprofessional teamwork contribute to the challenge. In this article, we discuss the opportunity to leverage the interprofessional team-based care activities within integrated primary care settings as interactive educational opportunities to build competencies in biopsychosocial care among primary care team members. We argue that this approach to learning while providing direct patient care not only facilitates new provider knowledge and skills, but also provides a venue to enhance team processes that are key to delivering integrated biopsychosocial care to patients. We provide three case examples of how to utilize strategic planning within specific team-based care activities common in integrated primary care settings—shared medical appointments, conjoint appointments, and team huddles—to facilitate educational objectives.

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Association of a Multisite Interprofessional Education Initiative With Quality of Primary Care

Cited by 26 publications

References 41 publications

Assessment of Interprofessional Collaborative Practices and Outcomes in Adults With Diabetes and Hypertension in Primary Care

Assessment of Interprofessional Collaborative Practices and Outcomes in Adults With Diabetes and Hypertension in Primary Care

Integrating Interprofessional Trainees into a Complex Care Program for Veterans Experiencing Homelessness: Effects on Health Services Utilization

Practical Opportunities for Biopsychosocial Education Through Strategic Interprofessional Experiences in Integrated Primary Care

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