Katherine Stevenson

To develop and evaluate a classroom-based curriculum designed to promote interprofessional competencies by having undergraduate students from various health professions work together on system-based problems using quality improvement (QI) methods and tools to improve patient-centered care.
DESIGN:
Students from 4 health care programs (nursing, nutrition, pharmacy, and physical therapy) participated in an interprofessional QI activity. In groups of 6 or 7, students completed pre-intervention and post-intervention reflection tools on attitudes relating to interprofessio nal teams, and a tool designed to evaluate group process.
ASSESSMENT:
One hundred thirty-four students (76.6%) completed both self-reflection instruments, and 132 (74.2%) completed the post-course group evaluation instrument. Although already high prior to the activity, students' mean post-intervention reflection scores increased for 12 of 16 items. Post-intervention group evaluation scores reflected a high level of satisfaction with the experience.
CONCLUSION:
Use of a quality-based case study and QI methodology were an effective approach to enhancing interprofessional experiences among students.
KEYWORDS:
interprofessional education; quality improvement

The Saskatchewan Ministry of Health has committed to a multi-million dollar investment toward the implementation of Lean methodology across the province's healthcare system. Originating as a production line discipline (the Toyota Production System), Lean has evolved to encompass process improvements including inventory management, waste reduction and quality improvement techniques. With an initial focus on leadership, strategic alignment, training and the creation of a supportive infrastructure (Lean promotion offices), the goal in Saskatchewan is a whole health system transformation that produces "better health, better value, better care, and better teams." Given the scope and scale of the initiative and the commitment of resources, it is vital that a comprehensive, longitudinal evaluation plan be implemented to support ongoing decision-making and program design. The nature of the initiative also offers a unique opportunity to contribute to health quality improvement science by advancing our understanding of the implementation and evaluation of complex, large-scale healthcare interventions. The purpose of this article is to summarize the background to Lean in Saskatchewan and the proposed evaluation methods.

Current models of health care quality improvement do not explicitly describe the role of health professions education. The authors propose the Exemplary Care and Learning Site (ECLS) model as an approach to achieving continual improvement in care and learning in the clinical setting. From 2008-2012, an iterative, interactive process was used to develop the ECLS model and its core elements-patients and families informing process changes; trainees engaging both in care and the improvement of care; leaders knowing, valuing, and practicing improvement; data transforming into useful information; and health professionals competently engaging both in care improvement and teaching about care improvement. In 2012-2013, a three-part feasibility test of the model, including a site self-assessment, an independent review of each site's ratings, and implementation case stories, was conducted at six clinical teaching sites (in the United States and Sweden). Site leaders reported the ECLS model...

The overall goal of interprofessional education and
collaborative practice is to provide health system users
with improved health outcomes. Interprofessional
collaboration (IPC) occurs when learners/practitioners,
patients/clients/families and communities develop
and maintain interprofessional working relationships
that enable optimal health outcomes. Interprofessional
education (IP
E), which is the process of preparing
people for collaborative practice, and IPC itself, are
more and more frequently incorporated into health
professional education and models of practice. For this
reason, a clear understanding of the characteristics
of the ideal collaborative practitioner is required to
inform curriculum and professional development for
interprofessional education, and enlighten professional
practice for interprofessional collaboration.
In the fall of 2008, the Canadian Interprofessional Health
Collaborative (CIHC), with funding from Health Canada,
established a working group whose mandate was to:
review the literature related to competencies,
review existing competency frameworks for
IP
E and IPC and other competency frameworks
for health providers (assuming that existing
competency frameworks could provide a
starting point for analysis and debate and
encourage shared thinking around the
key foundations for an interprofessional
competency framework), and
develop a Canada-wide competency
framework for interprofessional collaboration.