Connecting the Dots:Advancing a Culture of Interprofessionalism

Jan A Odiaga DNP, APN, CPNP-PCJoanne M Miller PhD, APN, GPN-BCChris Bruti, MD, MPH Mary Jo Guglielmo, MPHGabriella Cs-Szabo, PhD Theresa Gierlowski, MPM

The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award

No. UE5HP25067. The National Center is also funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty

Moore Foundation, The John A. Hartford Foundation and the University of Minnesota. © 2015 Regents of the University of Minnesota, All Rights Reserved.

This activity has been planned and implemented by the National Center for InterprofessionalPractice and Education.

In support of improving patient care, the National Center for Interprofessional Practice and Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses

Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physicians: The National Center for Interprofessional Practice and Education designates this live activity for a maximum of 1.5 AMA PRA Category 1 Credits™.

Physician Assistants: The American Academy of Physician Assistants (AAPA) accepts credit from organizations accredited by the ACCME.

Nurses: Participants will be awarded up to 1.5 contact hours of credit for attendance at this workshop.

Nurse Practitioners: The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts credit from organizations accredited by the ACCME and ANCC.

Pharmacists: This activity is approved for 1.5 contact hours (.15 CEU) UAN: 0593-0000-17-016-H04-P

The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award

No. UE5HP25067. The National Center is also funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty

Moore Foundation, The John A. Hartford Foundation and the University of Minnesota. © 2015 Regents of the University of Minnesota, All Rights Reserved.

Disclosures

The National Center for Interprofessional Practice and Education has a conflict of interest policy that requires disclosure of financial interests or affiliations of organizations with a direct interest in the subject matter of the presentation.

Jan Odiaga, Joanne Miller, Mary Jo Guglielmo, Gabriella Cs-Szabo and Christopher Bruti

do not have a vested interest in or affiliation with any corporate organization offering financial support or grant monies for this interprofessional continuing education activity, or any affiliation with an organization whose philosophy could potentially bias his/her presentation.

The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award

No. UE5HP25067. The National Center is also funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty

Moore Foundation, The John A. Hartford Foundation and the University of Minnesota. © 2015 Regents of the University of Minnesota, All Rights Reserved.

Interprofessional continuing education credit will be awarded to participants that paid the continuing education credit fee while registering for the Summit.

All workshop participants are asked to scan their barcode (from nametag) upon entrance to session and complete the evaluation distributed at the end of the workshop. Those who registered to receive continuing education credit will also receive a certificate of completion following the Summit.

Connecting the Dots:Advancing a Culture of Interprofessionalism

1. Describe Kotter’s Accelerated Model for Change Management

2. Define the “Big Opportunity for Change” within your institution

3. Apply the functional elements within Kotter’s model to your institution

Objectives

ICEBREAKER

• Pick a package of M&M’s from the table

• OPEN: Who ever has the most red M&Ms starts the conversation, move around the table clockwise

• Introduce yourself, where you are from, what is your role in IPE

Who is John P. Kotter?

• Professor of Leadership Emeritus, Harvard Business School

• Well known in the business world

• Authored multiple books on successful system transformations

Our Iceberg is Melting :Changing and Succeeding under Any Conditions

• TeamSTEPPS®

• 8 Steps to change

CREATE

BUILD

FORM

ENLIST

ENABLE

GENERATE

SUSTAIN

INSTITUTE

Reaching the tipping point is a slow steady means of transformationDoes it work in today’s world?Why not?

Accelerate: Building Strategic Agility for a Faster-Moving World

Why Accelerate Change?

Change is constantToday's environment is competitive and demanding You have to compete to winOrganizations need to be flexible and ready to respond

• Connects to the hierarchy throughout structure to remove barriers

• Pulls in people from the hierarchy (volunteer army) to react

• Focuses on continual assessment

Change is based on a Dual Operating Systems

Hierarchal Structure

• Formal organizational structure

• Change is rigid and structural

• Change driven by a small, powerful core group

• Change designed to function within the culture of the hierarchy

Strategy Accelerator Network

Kotter’s 2006 Our Iceberg is Melting Kotter’s 2014 Accelerate

The Big Opportunity for Change

.

Kotter’s Accelerated Model of Change:The Accelerator Network

CREATE

ENABLE

FORMSUSTAIN

BUILDINSTITUTE

GENERATE ENLIST

Action is focused around the Big OpportunityMotivated volunteers from the hierarchy are recruited to the network to realize the vision.

Differences between the Dual Operating Systems

Activity #1

Define a “Big Opportunity for Change” for your university or institution

1. What is your interprofessional initiative, “Big Opportunity”?

2. How will it link to your institution’s strategic plan, mission and vision?

3. Is it something you “have to do” or “want to do”?4. Will it change outcomes?

• Using your worksheet write down your ideas and thoughts• Share results and compare ideas with your table• Group discussion

Activity #2

• Using your worksheet, complete accelerators CREATE and BUILD

• Share your results and compare ideas with your table

• Group discussion

Accelerators = Action

CREATE: Sense of Urgency to avoid complacency. Must be reinforced at all levels of the Hierarchy

• Rush developed a new strategic mission and vision plan

• Credentialing bodies added IPE as standards for competency based education

• Grass roots movements from the students and faculty

• Interprofessional education (IPE) chosen as a quality improvement program for accreditation through the Higher Learning Commission (HLC)

Accelerators = Action

BUILD: Guiding Coalition is central to the network and consists of volunteers representing all levels, departments and skills in the hierarchy. All members are equal.

• All 4 colleges committed to IPE and assigned representatives to develop an IPE curriculum

• Rush leadership supported IPE

• Rush marketing promoted IPE course and events

• Faculty participated in IPE training

• Using your worksheet, complete accelerators FORM, ENLIST, and ENABLE

• Share your results and compare ideas with your table

• Group discussion

Activity #3

Accelerators = Action

FORM: Strategies, Vision and Initiatives The vision statement is created and is focused on capitalizing on the identified big opportunity. It appeals to people's emotions and sets out strategic initiatives to achieve that vision.

• Human Resources and Services Administration (HRSA) grant provided start-up resources

• Rush initiated a unified calendar

• Wednesday afternoons identified as IPE time

• IPE incorporated into Rush’s strategic mission and plan

• IPE course implemented for first year students

• IPE course recognized on student transcripts

Accelerators = Action

ENLIST: a Volunteer Army It's the Guiding Coalition's responsibility to communicate the vision and the strategy in such a way that employees buy into the message, commit to it, and feel motivated to volunteer to be a part of the change.

• Program directors volunteered their students for the pilot IPE course

• University faculty participated in IPE workshops to incorporate IPE into their courses/curriculum

• Student Affairs and Colleges offered IPE-themed student programs

Accelerators = Action

ENABLE: Action and remove barriers qualified and skilled members of the network volunteer to deal with identified barriers and implement solutions within the hierarchy.

• University Curriculum Committee (UCC) approved required student competencies for Interprofessional Collaborative Practice (IPCP)

• UCC approved first year IPE course

• Unified university calendar implemented

• Students pre-enrolled in IPE pass/no pass course

• IPE course became part of the Higher Learning Commission (HLC) Quality Initiative

• Using your worksheet, complete accelerators GENERATE, SUSTAIN, and INSTITUTE

• Share your results and compare ideas with your table

• Group discussion

Activity #4

Accelerators = Action

GENERATE: Celebrate short-term wins The Guiding Coalition must celebrate and communicate visible and significant short term wins in order to generate motivation and confirm that decisions and actions are benefiting the organization.

• HLC showcased Rush’s IPE initiative on their website

• Evaluation of student experiences shared with hierarchal leadership

• Evaluations shared with all colleges, program directors and facilitators

• Thank you lunches for faculty volunteers, staff, and leadership

Accelerators = Action

SUSTAIN: The sense of urgency around the “Big Opportunity” develop new projects, themes and volunteers in order to invigorate people and the process.

• Student enrollment doubled from year 1 to year 2

• Faculty involvement increased

• IPE course modified in response to student feedback

• Health Mentor community assessments incorporated in response to Leadership suggestion

• Collaboration expanded with Roosevelt University College of Pharmacy

Accelerators = Action

INSTITUTE : Transforming educational culture to IPE Change needs to be assimilated into the organization and normalized in the culture of the hierarchy linking made between the change and organizational success.

• Course is mandatory for the College of Health Sciences and Rush Medical College

• All incoming first year students experience IPE as part of strategic plan

• Wednesday afternoons designated as “IPE time”

• Website advertises interprofessional experiences for students

Lessons Learned

• Effective COMMUNICATION is key! “Everybody needs to know everything”

• Good RELATIONSHIPS are vital to culture change• Start small and build, but START!• 2 steps forward, 1 step back is a WIN!• Assess, evaluate, and ADJUST every step of the

way• Embed the “BIG OPPORTUNITY” into

organizational goals and curriculum

References

• Kotter, John P. Accelerate: Building Strategic Agility for a Faster-Moving World. Harvard Business Review Press, 2014

• Kotter, John P. A Sense of Urgency. Harvard Business Press, 2008.

• Kotter, John P., and Holger Rathgeber. Our Iceberg Is Melting. St. Martin's Press, 2006.