The president of the Josiah Macy Jr. Foundation describes a recently announced initiative, cofunded with the Robert Wood Johnson, John A. Hartford, and Gordon and Betty Moore Foundations, to get the health professions to learn together, then practice, as a real team.
A growing body of evidence shows that health care delivered by well-functioning teams leads to better patient outcomes, greater efficiencies, and even professional satisfaction. But learning how to work as a team isn’t necessarily intuitive; it has to be taught. Fortunately, efforts are growing to make it possible for medical students, nursing students, and other health professions students to learn side-by-side, so that when they begin practice, they have the skills to work collaboratively and as members of a team.
But these interprofessional education efforts, while encouraging, have not yet translated into enduring and widespread changes in health education or practice. Doctors, nurses, and others on the health care team may go to the same institution for training, but they rarely interact there in ways that enable them to see the value that each profession can bring to the team. We need to change that mindset. We need to move away from the system we’ve created in which each profession has its own culture and provide students with team-based experiences. That way, they will be prepared to work in the way that health care operates today.
As the only national foundation solely dedicated to improving health professions education, the Josiah Macy Jr. Foundation has spent several years seeking ways to ensure that health professions education is in synch with contemporary health care needs. While the United States takes pride in its high educational standards, over recent years many have come to believe that our excellent health professions education system is more focused on institutional needs and should be more responsive to the demands of the health care delivery system.
In the more than four years since I took over the helm of the Macy Foundation, interprofessional education has become a growing part of the work we support. In fact, it is now the largest single component of our grant portfolio. We have provided grants to about twenty universities and health systems in the United States, including the Institute for Healthcare Improvement, Geisinger Health System, the University of Washington, and others to promote team-based training and competency building among medical students, nursing students, and others.
We also have been working with professional organizations, government agencies, and foundations to help create a set of core competencies in interprofessional education and to outline an action plan to advance their adoption. This plan calls for, among other things, a national clearinghouse of resources on interprofessional education, which will include models of team-based or collaborative care.
This month, the Macy Foundation, along with some of the leading health and patient advocacy foundations in the United States—the Robert Wood Johnson Foundation, the John A. Hartford Foundation, and the Gordon and Betty Moore Foundation—collectively committed $8.6 million over the next five years to support a new, national Coordinating Center for Interprofessional Education and Collaborative Practice, initially funded by the U.S. Health Resources and Services Administration (HRSA). This center will be the “go to” body for coordinating and connecting efforts to foster interprofessional education and will help bring the field to an important new level.
We have been spearheading these efforts for a simple reason: we will never have the health system we want and need unless we pay a lot more attention to how we’re training people to enter it.
This requirement will be there regardless of how the U.S. Supreme Court rules on the Affordable Care Act of 2010 later this month. Meaningful reforms affecting how care is delivered, practiced, and paid for are already under way. Contemporary practice models that require greater collaboration, such as accountable care organizations and patient-centered medical homes, are being established. The U.S. medical education system will need to move quickly to create experiences and opportunities in interprofessional education, and to advance replicable models of education and practice that foster collaboration, communication, and team approaches to care delivery.
We see our efforts here at the Macy Foundation and those of our partners as leading us down that path. The public-private Coordinating Center for Interprofessional Education and Collaborative Practice is aimed at scaling up interprofessional education and helping bring it into the mainstream of health professions education. The center will use a number of strategies to achieve these goals, including
* Developing, managing, and evaluating programs
* Engaging leaders in education, practice, and policy
* Developing successful funding streams to ensure sustainability
* Contributing to the development and dissemination of metrics and evaluation of programs
* Disseminating lessons learned and replicable innovations
We hope that these actions help change the paradigm of health professions education and move interprofessional education from an extracurricular activity to a core part of the curriculum so it becomes more relevant for better clinical practice and better patient care.
To learn more about the Coordinating Center for Interprofessional Education and Collaborative Practice, read HRSA’s Funding Opportunity announcement: http://1.usa.gov/ipecriteria.
For information about the exciting work of some of the Macy Foundation’s grantees, watch these presentations from the foundation’s first Grantee Conference on Interprofessional Education, held in April 2012: http://macyfoundation.org/news/entry/ipe-conference-video