The Rise of Interprofessional Care: SD Leads the Nation in a Team Approach to Medicine
By Peter Carrels
Interprofessional care occurs when multiple health workers from different professional backgrounds provide comprehensive health services by working with patients, their families, caregivers, and communities to deliver the highest quality of care across settings. -----World Health Organization
Interprofessional education occurs when learners of two or more health and/or social care professions engage in learning with, from, and about each other to improve collaboration and the delivery of care. -----Institute of Medicine of the National Academies
Dr. Wendell Hoffman was an early, active and visible South
Dakota advocate for interprofessional training and practice in healthcare.
According to Hoffman, an infectious disease specialist at Sanford Health and a highly regarded advocate for improved patient care, many physicians learn by pragmatic necessity the value of interprofessionalism as they provide care to their patients.
“The first person most physicians talk to each morning is a nurse,” explains Hoffman. “That’s basic interprofessional practice.”
But Hoffman worried that unless a concerted effort was undertaken by educational institutions, healthcare systems and others the advantages of expanding and increasing interprofessional relationships, consultation, and practice would not be better realized. He especially encouraged interprofessional education, so healthcare professionals could hit the ground running once they finished school and started work in the real world where patient outcomes aren’t hypothetical.
The Interprofessional Movement in South Dakota
That is exactly the type of effort –focused, measured and determined- characterizing the newly invigorated campaign to propel the interprofessional movement in South Dakota.
The campaign got a big boost and elevated levels of responsibility and opportunity last June when the University of South Dakota, representing South Dakota’s Interprofessional Practice and Education Collaborative (SD-IPEC), signed a Memorandum of Agreement (MOA) with the National Center for Interprofessional Practice and Education. SD-IPEC is the statewide group working to advance interprofessionalism in South Dakota.
Dr. Carla Dieter, chair of the Nursing Department in the School of Health Sciences at the University of South Dakota, also serves as chair of SD-IPEC.
“We are now part of a national effort to contribute to the measurement of the interprofessional education and practice through affiliation with the National Center,” says Dieter. “By working with the national center we can tap into resources that will help propel our work forward on a broader scale as well as contribute to the National Center's Data Repository. It is exciting to be part of this important national effort.”
Leading a National Effort
South Dakota is one of only 11 states to have formalized a relationship with the national organization, and South Dakota’s level of statewide organization is a rarity among states. Out of the 11 member states, only South Dakota’s and Arizona’s initiatives involve multiple educational institutions, and South Dakota is the only member state involving practice partners in their membership.
It is not hyperbole to observe that South Dakota’s initiative to advance interprofessional education and practice rates as among the most aggressive and resourceful in the nation. Carla Dieter and her colleagues in SD-IPEC are leading a singularly unique effort that has elevated the state to national prominence.
One of SD-IPEC’s objectives is to further and appropriately broaden those participating in the effort. The group recognizes that the state’s rural composition and its diverse and far-flung constituencies demands greater engagement and participation. That means communities, community organizations, and local and state governmental representation in SD-IPEC is imperative. Whereas some states are pursuing interprofessional health care emphasizing specifically parochial locales, South Dakota is doing just the opposite. It truly is a statewide effort.
The National Center for Interprofessional Practice and Education
The National Center and its Nexus Innovations Network are housed at the University of Minnesota, in Minneapolis. The Center was founded in 2012 to provide leadership, resources and evidence to advance interprofessional healthcare across the country, and it functions as a unique public-private partnership with funding from the Health Resources Services Administration (HRSA), the University of Minnesota, and the three private foundations: Josiah Macy Jr. Foundation, Robert Wood Johnson Foundation, and the Gordon and Betty Moore Foundation.
Barbara Brandt, PhD, director of the National Center has been keenly interested and involved in South Dakota’s interprofessional initiatives, and she is delighted with the state’s direction and progress. “South Dakota,” said Brandt, “provides us a unique opportunity to see the potential of a unified, statewide collaborative of higher education and health system partners working towards the shared goal of improved population health.”
The Need for Interprofessionalism
The need for interprofessional education and practice in healthcare is convincingly and poignantly described by Dr. Dieter.
“Current research shows that ineffective communication among healthcare professionals is a leading cause of medical errors,” she says. ”This requires a response in how we educate healthcare students. By providing opportunities for students to learn together, they not only understand each other’s roles, but recognize the expertise of each team member and the value of their contribution.”
“The ultimate goal is to educate students interprofessionally so that it becomes so ingrained in their nature to work together that when they enter practice it will translate into sound interprofessional practices and produce positive patient outcomes,” says Dr. Dieter.
The History of Interprofessionalism in South Dakota
The history of the interprofessional movement in South Dakota does not date back far. As Dr. Wendell Hoffman was urging greater interprofessional progress in the state leadership at the University of South Dakota’s School of Health Sciences recognized the need to begin organizing to accomplish that movement.
In 2012 Carla Dieter organized her colleagues in the USD School of Health Sciences into a
group they called IPE (Interprofessional Education) Champions, a collective that included Dr. Michael Lawler, dean of the School of Health Sciences, Dr. Bruce Vogt, director of USD’s Area Heath Education Center (AHEC), and leadership from the departments of nursing, physical therapy, medical laboratory science, physician assistant studies, addiction studies, dental hygiene, occupational therapy, and social work.
The group discussed matters of interdisciplinary education and how student education could be improved by collaboration between departments, and the use of interprofessional concepts and curriculum. Their deliberations led to a 2013 statewide gathering titled an Interprofessional Education Summit that was held in Chamberlain, South Dakota.
The so-called “Summit” was attended by approximately 125 leaders and representatives from academic institutions, healthcare systems, government, regulatory bodies and community-based organizations from across South Dakota. This meeting was especially meaningful for several reasons. For the first time educators, practitioners and others involved in healthcare and public health were able to learn what was happening in a broad scale across the state in matters related to interprofessional education and practice. It was also an opportunity for participants to discuss their visions about interprofessional education and practice, and to discover shared perceptions and objectives.
Barbara Brandt of the National Center gave the Summit’s keynote address, and she and Carla Dieter developed a close working relationship.
Establishment of the SD-IPEC
The Summit also led to the establishment of South Dakota’s Interprofessional Practice and Education Collaborative (SD-IPEC), and that group’s mission is straight-forward and ambitious: Organize and implement IPE efforts throughout South Dakota. This is the group Dieter was selected to lead. It is a dedicated and ever-evolving team comprised of health educators and leaders from institutions across the state.
Key members of the group include the University of South Dakota, Augustana University, Dakota State University, South Dakota State University, Avera Health, and Sanford Health. The group organized committees investigating various outcomes of interprofessionalism, and an advisory council has been formed to serve as a sounding board for the core team and also to allow team members access relevant expertise and to provide important connections to those in influential positions in South Dakota.
The Future of the Interprofessional Movement
Next steps for the interprofessional effort in South Dakota are conducting projects that include interprofessional teams and specific objectives. These projects are pursued under the title “Nexus Innovations Network Projects”. The National Center approves Nexus projects and through these projects seeks to test new ideas and drive sustainable national change in healthcare and health professions education. A handful of projects are already planned or underway.
It’s tempting to dismiss interprofessionalism as a trendy idea or some dreamy, ivory-tower-type healthcare application. But if you do so you’d be wrong. Interprofessional healthcare is serious and sincere business. It’s the next progressive step in an evolving approach to healthcare. Interprofessional might be a clumsy word, but through its training and practice it is intended to streamline and improve the delivery of healthcare services. At its root is the genuine intention to better serve patients.
Current research shows that ineffective communication among healthcare professionals is a leading cause of medical errors. This requires a response in how we educate healthcare students. By providing opportunities for students to learn together, they not only understand each other’s roles, but recognize the expertise of each team member and the value of their contribution. The ultimate goal is to educate students interprofessionally so that it becomes so ingrained in their nature to work together that when they enter practice it will translate into sound interprofessional practices and produce positive patient outcomes.