Building Health Workforce Capacity Through Community-Based Health Professional Education Workshop Summary (2015) / Chapter Skim
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3 Factors for Spreading/Scaling Up Innovations in Community-Based Health Professional Education to Practice
3 Factors for Spreading/Scaling Up Innovations in Community-Based Health Professional Education to Practice
Pages 53-76
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From page 53... ...
In setting the stage for more in-depth discussions on spreading and scaling up models of community-based health professional education, Forum member and workshop planning committee co-chair Warren Newton from the American Board of Family Medicine first noted that different disciplines 53
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From page 54... ...
Of the 1,000 persons who get ill, 750 will have a symptom, 250 will see a physician, 9 will go into the hospital, and 1 will go into a tertiary care center. The question White raised is why so much of health professional education is located in tertiary care settings, which is the smallest box seen in the lower-right corner of Figure 3-1.
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From page 55... ...
Fifty years after the original report, health professions education is still heavily weighted toward university hospitals. Newton then asked the workshop participants -- who represent multiple professions and educational associations from around the world -- how to move the health professional educational system out of the lower-right boxes of Figure 3-1 into the larger boxes, where students will work with patients in the community and professional settings in which the vast majority of the population experiences health care.
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From page 56... ...
introduction of tools and models for the education of health professionals, and changes in licensure/accreditation processes, more educators may adopt innovations. This adoption, described in the workshop as the spread and scale-up of health professional educational innovations, was the focus of the remaining presentations at the workshop.
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From page 57... ...
Talib then introduced the two panelists in her session: Scott Hinkle, from the National Board for Certified Counselors, and Ruth Wageman, from ReThink Health. Mental Health Facilitator Program Scott Hinkle, National Board for Certified Counselors Scott Hinkle, from the National Board for Certified Counselors (NBCC)
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From page 58... ...
New Curricula Educator's Edition of the MHF program The Educator's Edition of the MHF program is a new addition to the program that was first piloted in a school district in North Carolina and is being brought to the state of
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From page 59... ...
A Syracuse University counseling professor is serving as an outside evaluator doing an outcomes study for the MHF program in Malawi and Mexico. The Educator's Edition evaluation for the state of Montana took place in summer of 2014.
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From page 60... ...
NBCC partnered with the university to bring the MHF program into the human services bachelor's degree program, which has 10,000 enrollees. These students are being trained in mental health facilitation with the hope of creating a large cohort of facilitators that could serve their local communities now and in the future.
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From page 61... ...
Some groups, working with members of the ReThink Health team, use a computer simulation of a regional health system to test the impact and implications of policies or interventions they could consider implementing. Developers of the model drew from a host of different studies and scenarios when designing the program in an effort to cover the full array of potential outcomes that could result from a given intervention, among them IHI's Triple Aim (population health, cost of care, quality of care)
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From page 62... ...
ReThink Health's Computer Simulation ReThink Health uses computer simulation to help groups to explore a range of ideas to transform their health system. For example, a stewardship group might have a set amount of money to invest in transforming their system but very different views about which initiatives would best 1 The Institute for Healthcare Improvement (IHI)
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From page 63... ...
> Care Adequacy of Behaviors Routine Physician Control Mental Primary Care & Self-Care Use of Specialists Illness Capacity (Ability to work & for Routine Care support family) Support Patient |
From page 64... ...
Some groups that ReThink Health has worked with have tested hundreds of different scenarios, learning from their simulations how different strategies for health system change produce different strengths and weaknesses over time, said Wageman. For example, one possible challenge that Wageman identified in these theoretical scenarios is that the community runs out of money before producing any significant health improvement outcomes because of the long time lags between project initiation and demonstration of an effect, and because of the need to sustain expensive initiatives for long periods.
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From page 65... ...
(healthier behaviors, pathways to advantage) SOURCE: ReThink Health, n.d., as presented by Wageman on May 1, 2014.
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From page 66... ...
There is a sense of urgency, and leaders are committed to finding solutions together, she said. TECHNOLOGY AND INNOVATIONS IN COMMUNITY-BASED HPE Forum and workshop planning committee member Gillian Barclay started the session by challenging the notion of technology as the driver for better care, improved population health outcomes, and better value for care.
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From page 67... ...
He began his work in Camden by opening a practice that provided full-spectrum family health services to a largely H ispanic Medicaid population. After recognizing the need for a new way for hospital providers and community residents to collaborate, he founded the Camden Coalition of Healthcare Providers and has served as its executive director since 2003.
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From page 68... ...
Engagement, he said, would not be looked at using conventional health professional educational tools and jargon but would include such unconventional elements as motivational interviewing, harm reduction, change management, community organizing, and coalition building. From Brenner's perspective, these methods also help to break down hierarchies, owing to their facilitative framework.
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From page 69... ...
Once identified, these patients are registered in the program coordinated by the care management team that assists the patient in navigating the complex health care system. The teams include registered nurses, licensed practical nurses, and health coaches, as well as social work support and/or case workers.
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From page 70... ...
. Camden Coalition Workforce Health coaches Brenner describes the workforce at the coalition as "homegrown," just like his data system.
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From page 71... ...
What he and many others have discovered is that you cannot fix health care without reaching outside of your local community. Telemedicine in Rural Alaska Sarah Freeman, Alaska Native Tribal Health Consortium Sarah Freeman is the Telehealth Program Development Director for the Alaska Federal Health Care Access Network (AFHCAN)
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From page 72... ...
, and the trip is disruptive to patients' lives. The Alaska Tribal Health System is a voluntary association serving FIGURE 3-4 The Alaska Native Health Care System referral pattern.
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From page 73... ...
Freeman stated that the Alaska Tribal Health System also has behavioral health aides and dental health aides that work with community members. These individuals are typically stationed in the Alaska Tribal Health System hubs of their spoke-and-hub model.
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From page 74... ...
Training the Health Workforce Freeman stated that training community health aides on how to use store-and-forward equipment is essential for the system to function properly. The equipment was designed to be very user-friendly; for example, it has a touch screen that is color coded for simplicity.
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From page 75... ...
Challenges One of the challenges that Freeman noted is working with multiple health organizations to provide consistent care across the state. The consortium works with more than 30 different tribal health organizations, and Freeman believes the collaboration between these sites has been improving significantly over the 8.5 years she has been with Alaska Native Tribal Health Consortium.
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From page 76... ...
Anchorage: Alaska Native Tribal Health Consortium. Freeman, S
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