interspecialty learning: breaking the barriers between primary and secondary care saif ahmad, prit...
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Interspecialty Learning: Breaking the Barriers between Primary and Secondary Care
Saif Ahmad, Prit Chahal, Jane Little
Introduction
• An effective primary-secondary care interface is of growing significance to professionals and patients
• An understanding of commissioning and NHS management is important for doctors
Aims
• Evaluate a novel interspecialty learning exercise designed to educate GP and medical trainees on NHS management and commissioning
What was done
• 74 GP and medical trainees attended
• “NHS Management Structures and Service Re-Design”
• Whole day (not on hospital site)
The Intervention
• 6 mixed, randomly allocated groups
• Asked to re-design a service– E.g. Heart failure, diabetes
• Internet, consultants and expert patients
The Intervention
• Each group then pitched their business case to a commissioning panel– Dragons’ Den
Questionnaires
• Pre- and post event (100% compliance)
• Assessed– 1) Perceived knowledge and skills– 2) Attitudes
Multiple variables pre- and post
A B C D E0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5Pre
Post
A- Combined teaching helpful
Understanding ofB- Patient centred approach to service designC- Evidence based approachD- Primary-secondary care interfaceE- NHS management structures
Likert score
Comments
• “Revolutionary way of learning”.
• “An excellent approach to teaching a relatively unfamiliar, drab subject”
• “...helped me to understand how both primary and secondary care can be integrated for the interest of the patient”.
Comments
• “Secondary care physicians seemed to blame problems on inappropriate GP referrals ie its all the GPs fault. Felt that day was focused on sorting out inadequacies in primary care. It was quite demoralising spending time working out ideas for them to be completely ripped apart”
Potential Partners
• Medics with A&E doctors
• Surgeons with anaesthetists
• GPs with anyone
• List is endless....
Ken Currie, Three Oncologists Scottish National Portrait Gallery © KEN CURRIE
Conclusion
• Interspecialty learning may modify trainees’ knowledge, skills and attitudes
• Regular exercises are likely to reinforce these benefits
• Potentially improve collaboration and patient care
References
• 1. Lingard, L., et al., The rules of the game: interprofessional collaboration on the intensive care unit team. Crit Care, 2004. 8(6): p. R403-8.
• 2. Pollard, L.C., et al., Perceived barriers to integrated care in rheumatoid arthritis: views of recipients and providers of care in an inner-city setting. BMC Musculoskelet Disord, 2011. 12: p. 19.
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