Background
In 2016, Maine Medical Center (MMC) was awarded the ACGME Pursuing Excellence in Innovation grant for the purpose of redesigning the standard clinical learning environment to improve interprofessional care and education.
An inpatient adult medicine patient care unit was created as the starting point to integrate a redesigned interprofessional clinical learning and care environment. This care unit would go on to be known as the Interprofessional Partnership to Advance Care and Education (iPACE) Unit and would be innovative in applying systems engineering and design methods to enhance the quality and efficiency of both patient care and medical education.
Building on the successes of the initial iPACE pilot, MMC received a grant from the American Medical Association (AMA) for furthering the development of interprofessional education. This five year, “Reimagining Residency” grant aims to redesign residency though interprofessional care and education while also improving overall knowledge, skills and attitudes. This three-pronged approach is outlined by its goals below:
iPACE Across – We will be integrating the iPACE model in inpatient clinical learning settings by adapting the core principals of iPACE creatively in the context of different clinical care models.
iPACE Out – We will be introducing the core principals of iPACE into outpatient and rural settings, which provide care underserved patient populations. This will give us the opportunity to investigate the effects of interprofessional, team-based care on health care disparity outcomes.
iPACE Over – We will “imprint” interprofessional, team-based care as the shared mental model for medical students and learners from other disciplines by creating unique fourth year medical school rotations based on the iPACE core principals.
Preamble
The interprofessional team includes diverse professionals whose main objective is to provide excellent patient centered care while respectfully learning from, with, and about each other; innovating with one another; and owning their continuous improvement with passion and integrity.
Core Principles
- Patient-centered care that involves an interprofessional team that includes the patient and their family (one team)
- Intentional, structured, and collaborative team practice (one round)
- Full involvement of the care team in formulating and communicating patient-care plans (one plan that gives one message), with utilization of telecommunication technology as necessary.
- Purposeful learning by the interprofessional team
- Co-location of patient and care team to optimize teaming potential
- Promoting team members’ full scope of practice and well-being
- Commitment to and participation of the full team in rapid cycle improvement
Healthcare has previously been run on a normal standard of care model based on specialization and segregated work flows. Like most teaching hospitals in the US, the graduate medical education programs at MMC have never been truly integrated into how clinical care and education is approached. iPACE looks to not only merge the two, but to also improve communication and collaboration across different roles (doctors, nurses, and other health professionals) in the clinical learning environment.
Interprofessional collaboration (IPC) occurs when multiple fields of healthcare professionals work together through action and knowledge to provide the highest level of care possible for the patient and family. IPC provides a unique addition to medical education. Not only are residents and medical students given the opportunity to experience bedside learning, but when the entire team, including the patient, are collaborating and formulating a plan of care, a more complete picture of the medical experience is understood. Every iPACE team member is able to bring new information and perspectives to the group providing a rich clinical learning environment.
Some benefits include:
- Improved patient outcomes
- Improved patient experience
- Improved care team well-being
- Cost reduction
The Design Thinking (DT) framework, developed in the late 1990s, is the acceleration of innovation as it relates to solving complex problems and renewing an organizational environment. This model provides a standardized approach to iPACE implementation in the health care setting allowing for the generation of innovative solutions interdisciplinary teams may face. This is very general; it is carried out through a six step process and iteration loops. Do drop downs with examples below.
Understand
- collection of existing information to familiarize the group on the problem and become an expert on a specific topic
Observe
- identification of users’ needs through both qualitative and quantitative methods
Point of View
- generation of “micro-theory” about the problem and user’s needs utilizing the data and insights collected from the previous two steps
Ideate
- interprofessional team members generate potential solutions, structure them, and select one to move forward
Prototype
- detailed development of the solution selected in the ideate phase
Test
- testing of the prototyped solution with iterative modification of the prototype based on feedback from users and stakeholders
HPI Academy Design Thinking Process
