Effectiveness of a faculty development program on interprofessional education: a randomized controlled trial.
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Humans↗
Biomedical subjects
Lynne Sinclair
Publications and source records attributed to Lynne Sinclair.
Interprofessional education: the student perspective.
The Toronto Rehabilitation Institute (Toronto Rehab) is a current leader in the movement of interprofessional education (IPE) initiatives in Ontario, Canada. Nine students from seven different health care disciplines, including medicine, nursing, occupational therapy, pharmacy, physiotherapy, social work, and speech language pathology participated in the second IPE clinical placement in the winter of 2005 on Toronto Rehab's Stroke inpatient unit. In an effort to increase interprofessional collaboration, improve communication skills, foster respect and enhance knowledge of the different roles each discipline plays on the health care team, these students met together over a five week period and participated in interprofessional group sessions led by different health care professional leaders from the unit. This paper discusses the students' perspectives on this IPE experience and the corresponding benefits and challenges. All participants in the study recognized the importance of interprofessional teamwork in patient care and agreed that all health care education should include opportunities enabling them to develop the skills, behaviours and attitudes needed for interprofessional collaboration.
Education, Medical↗
Evaluating organizational readiness for change: a preliminary mixed-model assessment of an interprofessional rehabilitation hospital.
We conducted a Functional Organizational Readiness for Change Evaluation (FORCE) to assess the characteristics of readiness for change across two programs (N=216 employees) in an interprofessional rehabilitation hospital that was about to undergo strategic changes as part of a planned physical merger within the next two years. The study used a mixed-method approach: a quantitative survey, previously validated in a drug rehabilitation setting, followed by key informant interviews to further enlighten survey findings. Statistical analyses identified correlations between demographic variables (age, education and experience) and readiness for change, as well as the prevalence of specific organizational characteristics (motivation for change, access to resources, staff attributes, organizational climate, and exposure/ use of training opportunities) that facilitate or impede change. Findings were intended to better inform the tactics for successful implementation of upcoming initiatives. Much like assessing a patient prior to initiating a treatment, FORCE can serve as a management tool to direct the planning and implementation of changes intended to improve hospital performance.
Attitude of Health Personnel↗
Exploration of patient safety phenomena in rehabilitation and complex continuing care.
Patient safety has been relatively unexplored in rehabilitation and complex continuing care (CCC) settings. From the perspectives of staff members, this qualitative study aimed to explore patient safety phenomena that exist within rehabilitation/CCC and to identify the characteristics of the current workplace culture that act as enablers of or barriers to patient safety. Sixty-six staff members in a large, multisite, academic rehabilitation/CCC health centre volunteered to participate in one of six interprofessional focus groups, designed to model patient care teams that exist within the clinical programs; one focus group was also conducted with support services staff. Thematic analysis revealed that rehabilitation/CCC settings present with distinct patient safety issues due to the unique and increasingly complex populations that are served, and the place of rehabilitation/CCC along the continuum of care. Enablers and barriers identified related to teamwork, culture, resources and organizational and individual responsibility. Results of this study have helped form the foundation for future patient safety initiatives within our settings, with clear emphasis on enhancing an open and just culture in which to discuss safety issues through development of improved leadership-staff relations, teamwork and communication and clearer processes and structures for accountability. The approach to addressing these issues must fit within our rehabilitation models of care.
Continuity of Patient Care↗
Discharge criteria from perioperative physical therapy.
OBJECTIVES: To develop valid and reliable hospital discharge criteria and a scoring system that would be used to assess when a patient should be discharged from perioperative physical therapy (PT) care. DESIGN: We developed the postoperative physiotherapy discharge scoring tool (POP-DST), a tool composed of objective criteria and a scoring system that would be used to determine when a patient should be discharged from perioperative PT. It is a composite score of the following five subcategories: mobility; breath sounds; secretion clearance; oxygen saturation; and respiratory rate. The score for the POP-DST ranges from 6 to 15, with a score of > 13 indicating readiness for discharge. We examined the content validity of the the POP-DST using focus groups and a mailed survey. To determine interrater reliability, two therapists, who were blinded to each other's scores, assessed postsurgical patients. Validity was examined by comparing the decision to discharge based on the score on the POP-DST to the decision to discharge according to the therapist's judgment. In addition, subjects who were discharged from PT were followed-up 7 to 10 days later to determine whether they had developed any subsequent respiratory problems. PATIENTS: One hundred four surgical patients were assessed to determine the reliability and validity of the POP-DST. For the ability of the test to detect postoperative complications following discharge from PT, 204 surgical patients were followed-up after discharge from PT. RESULTS: Interrater reliability was moderately high (intraclass correlation coefficient = 0.76; r = 0.77). There was strong agreement between the decision to discharge the patient from PT based on the tool criteria compared to the therapist's judgment (kappa range, 0.91 to 0.96). The ability of the POP-DST to predict those patients who would not develop complications postoperatively was 94%. CONCLUSION: The results indicate that the POP-DST would facilitate clinical decision making related to PT discharge planning in postsurgical populations. The instrument demonstrated strong content validity and predictive validity, as well as high levels of interobserver agreement. This tool should be considered as a work in progress until it is more fully validated.
Decision Making↗