Building the future of health care: First USF Health IPE Day focuses on value of team care

To work together effectively as practitioners in a 21st Century health system students must learn together.  And, equally important, the coordinated, team approach to patient care that today’s students aspire to must be modeled across clinical settings where they will practice after graduation.

That was the overarching message of USF Health’s inaugural Interprofessional Education Day held Nov. 16 in the USF Marshall Student Center.

The event brought together more than 250 graduate students, faculty and deans from all USF Health colleges, along with alumni and Tampa Bay community partners, to discuss the advantages and challenges of preparing students for a future that includes greater use of interprofessional health services.

The inaugural IPE day was attended by students, faculty and deans from all four USF Health colleges, along with alumni and community partners.

Interprofessional education, or IPE, is the essence of the USF Health brand. As the region’s only academic medical center, USF Health is uniquely positioned to organize, integrate and focus the capabilities of many health disciplines on behalf of the Tampa Bay community.

“This day highlights the power of USF Health – with its colleges of medicine, nursing, public health, and pharmacy, school of physical therapy and rehabilitation sciences, as well as athletic training and physician assistant programs – to take the lead in how interprofessional health education can be implemented,” said Victoria L. Rich, PhD, RN, FAAN, senior associate vice president of USF Health and dean of the USF College of Nursing.

Dr. Rich co-chaired IPE Day with Jay Wolfson, DrPH, JD, associate vice president of health law, policy and safety at USF Health and distinguished service professor of public health, medicine and pharmacy. They planned the inaugural event with a committee comprised of faculty members from all four health colleges and a student representative.

USF College of Nursing Dean Victoria L. Rich, PhD, welcomes speaker Chad Epps, MD, executive director of healthcare simulation at the University of Tennessee Health Sciences, to the Oval Theater stage.

“By sharing knowledge and training together, we create an environment ready for creativity and innovation,” USF System President Judy Genshaft said in her welcoming remarks. “In patient care, as we better understand each other, we provide more thoughtful care when we work as one team. Many times a patient’s life depends on it, as there is no single person or specialization that can ever address all the complexities of a patient’s needs… Truly the team-based approach embraced here at USF represents the future of health care.”

Charles J. Lockwood, MD, MHCM, senior vice president for USF Health and dean of the Morsani College of Medicine, has championed improved patient care and outcomes through stronger interdisciplinary collaboration. In his introduction, he painted a picture of the national health care challenges creating an impetus for IPE – including mounting pressure to reduce unprecedented health care costs.

The U.S. spends more on health care – nearly 18 percent of its GDP – than any other developed country, and with largely worse health outcomes, Dr. Lockwood said. This has led to a health care system transitioning from fee-for-service (care based on volume of services provided) to a focus on reducing cost while improving quality of care, known as value-based care.

From left: Kevin Sneed, PharmD, dean of the USF College of Pharmacy; Jay Wolfson, DrPH, IPE Day co-chair; Scott Newell, MAS, IPE Day speaker; Charles Lockwood, MD, USF Health senior vice president and dean of the Morsani College of Medicine; Victoria Rich, PhD, dean of the College of Nursing and IPE Day co-chair; Donna Petersen, ScD, dean of the College of Public Health; and Chad Epps, MD, IPE Day speaker.

“The only way we can provide that type of care is together. It can’t possibly be accomplished by the doctor alone, or the nurse alone, or the pharmacist alone,” Dr. Lockwood said. “In order to have that very efficient, tightly knit health care delivery system, we must train together, practice together, and do research together.”

Medical errors are the third leading cause of deaths in the U.S. after heart disease and cancer, according to a Johns Hopkins patient safety analysis. “Not only is there an economic imperative for IPE, but also a moral and ethical imperative to ensure we maximize patient safety,” he added.

The morning program featured two national speakers. Both emphasized the important role that simulation-based interprofessional activities can play in reducing medical errors by teaching health professionals at all levels how to think and act as a mutually supportive, problem-solving team.

IPE Day speaker Scott Newell, standing, interacts with Frederick Slone, MD, (blue shirt), who has a teaching appointment with the MCOM Department of Medical Education.

In the first presentation, Scott Newell, a commercial pilot and paramedic turned health-care simulation educator, drew parallels and distinctions between aviation and health care teams and explained how team training with simulation and crew (crisis) resource management techniques are critical to more effective communication, improved safety and quality outcomes.  All human beings, no matter how well trained and competent, make mistakes – but many medical errors result from a chain of events that can usually be averted at several points, preventing the medical error from causing severe patient harm, Newell said.

The second presentation by Chad Epps, MD, executive director of health care simulation at the University of Tennessee Health Science Center and past president of the Society for Simulation in Healthcare, provided examples of how other academic institutions across the country are structuring their simulation-enhanced IPE.   Dr. Epps said IPE is not students from different health disciplines sitting alongside each another in the same classroom and learning in parallel, but rather “students in two or more professions learning about each other’s professional roles, learning how to communicate with one another, and learning to provide mutual support to other members of the team.”

An interprofessional team looks over their mission during the collaborative escape room exercise. From left:  Amy Schwartz, faculty member, College of Pharmacy, Zemelia Miller, student, Physician Assistant Program; Anne Marie Buford, student, School of Physical Therapy; Chris Chrosniak, student, College of Nursing; Andrew Armstrong, student, College of Nursing; Anna Torrens Armstrong, faculty member, College of Public Health; and Kanisha Jenkins, student, Athletic Training Program.

At the morning session wrap-up, Dr. Lockwood challenged faculty to develop an IPE curriculum that takes full advantage of USF Health’s state-of-the-art simulation resources as well as clinical opportunities with primary teaching hospital Tampa General Hospital and other community partners.

A lunchtime panel discussion, moderated by Dr. Wolfson, featured the deans of all four USF Heath colleges and other key leaders, and the IPE Day guest speakers.

The afternoon culminated with a fun, interactive escape room exercise – a spy game designed to build camaraderie and teamwork within the 15 interdisciplinary student groups participating.

From left, top row: USF System President Judy Genshaft and Dr. Rich with the winning USF Health student team Michael Woolard, College of Nursing; Tyler Mauzy, School of Physical Therapy; Daniel Segarra, Morsani College of Medicine, Dr. Emily Hall, a faculty member for the Athletic Training Program; Matt Allman, College of Public Health; and Dr. Lockwood. Bottom row with the winning trophy: students German Herrera Alzate (left), Physician Assistant Program, and Jennifer Willms, School of Physical Therapy. Not pictured: Lucinda Shaw, adjunct faculty member, College of Nursing.

What They Said: 

We’ve known that poor communication and system errors are major causes of preventable death in 1999 and here we are in 2018, and we still haven’t made a whole lot of advancements…  We have a tremendous opportunity to impact patient safety and change the way we deliver health care.

Speaker Chad Epps, MD, referring to the Institute of Medicine’s landmark report “To Err is Human” published in 1999

Dr. Epps: IPE activities created with shared, linked outcomes and objectives can improve patient safety and care. Interprofessional faculty development also has to be a priority for IPE to work.

One difference between the airline industry and health care is that when a pilot screws up, the first place he ends up is a smoking hole in the ground… In health care we still tend to bury our mistakes… How many of you have filed an incident report and never found out what happened with it?

Speaker Scott Newell, MAS, NREMTP, CHSE, talking about the motivating factors for the safety culture in aviation driving crew members to speak up when they see a potential error

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Today’s IPE Day helps us think about how we can take our current IPE offerings to the next level. There is little doubt that if we use the energy and momentum generated at events like this, USF Health can become a model of IPE across the education continuum, and our patients and the community will be the better for it.

Bryan A. Bognar, MD, MPH, FACP, vice dean for educational affairs, USF Health, Morsani College of Medicine

The lunchtime panel discussion included deans and other key leaders from USF Health, and the two featured IPE Day speakers.

I am committed to working with the deans and their respective IPE experts to build the best interprofessional education experience possible for our students so they will graduate to become IPE champions in their future practice environment.

Haru Okuda, MD, FACEP, FSSH , USF Health’s first executive director of interprofessional education simulation programming and CAMLS executive director

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Part of the reason to engage the practice community is to push the environment toward IPE. We hear from our graduates who are well trained (in interprofessionalism) that when they get out in the workforce sometimes they are told “We don’t do that here.”

Donna Petersen, ScD, USF Health senior associate vice president and dean of the USF College of Public Health, on the gap between enthusiasm for interprofessional learning and interprofessional practice

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Today begins to define the culture of what USF Health will be moving forward. Every program will begin to define how they are part of massive health care-related changes… We’re asking for buy-in for IPE from everybody.

Kevin Sneed, PharmD, USF Health senior associate vice president and dean of the USF College of Pharmacy

Dr. Kevin Sneed comments during the panel discussion.

Research indicates that the effects of IPE for graduates do not not typically persist in the practice area. Partnering with employers and patients has the potential to address this “missing link,” with the goal of improving the quality and effectiveness of health care. We are committed to developing and sustaining these vital collaborative partnerships.

Laura Lee (Dolly) Swisher, PT, MDiv, PhD, FNAP, FAPTA, associate dean, USF Health Morsani College of Medicine, and director of the School of Physical Therapy & Rehabilitation Sciences

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It was great to see the diversity of health disciplines represented within USF Health… This day helped broaden our ability to collaborate, be problem solvers, lean on people’s strengths to do the best we could to succeed in our mission.

Michael Woolard, third-year nurse anesthesia student and member of the winning team for the IPE Day escape room exercise

Alyssa Radel, (center) an athletic training student in the MCOM, reacts to an IPE Day speaker.

Students pick up the dossiers and burner phones their teams need to begin the IPE Day escape room exercise, which involved a mission to rescue their “kidnapped” leader (played by Dr. Charles Lockwood) from an evil robot (played by USF Health’s Joe Ford). The “mission” promoted collaboration and problem solving while encouraging the students to have fun.

Team leader Rohit Iyer (far right), a second-year medical student, works on a clue with fellow team members.

For one of the escape room activities, teams were asked to create a “spy tool.” Here, one team uses an Apple watch and the team leader’s bow tie to make a “bow-tie spy cam.”

-Video by Torie M. Doll and photos by Eric Younghans and Freddie Coleman, USF Health Communications and Marketing.  Jessica Samaniego, USF College of Nursing, also contributed photos to this story.