Interprofessional Education and Healthcare

01/21/25 between professions in delivering DEFINITION OF TERMS patient-centered care. INTERPROFESSIONAL EDUCATION ​ When students from two or more INTERPROFESSIONAL TEAM-BASED professions le...

01/21/25 between professions in delivering DEFINITION OF TERMS patient-centered care. INTERPROFESSIONAL EDUCATION ​ When students from two or more INTERPROFESSIONAL TEAM-BASED professions learn about, from and CARE with each other to enable effective ​ Care delivered by intentionally collaboration and improve health created, usually relatively small work outcomes groups in health care, who are ​ The process by which a group of recognized by others as well as by students or workers from the themselves as having a collective health-related occupations with identity and shared responsibility for different backgrounds a patient or group of patients, e.g., ​ Learn together during certain rapid response team, palliative care periods of their education, with team, primary care team, operating interaction as the important goal, to room team. collaborate in providing promotive, preventive, curative, rehabilitative, PROFESSIONAL COMPETENCIES IN and other health-related services HEALTH CARE ​ Integrated enactment of COLLABORATIVE PRACTICE knowledge,skills, and ​ Occurs when multiple health workers values/attitudes that define the from different professional domains of work of a particular back-grounds provide health profession applied in specific comprehensive services by working care contexts with patients, their families, carers and communities to deliver the INTERPROFESSIONAL COMPETENCIES highest quality of care across IN HEALTH CARE settings ​ Integrated enactment of knowledge, skills, and values/attitudes that INTERPROFESSIONAL COLLABORATIVE define working together across the PRACTICE professions, with other health care ​ When multiple health workers from workers, and with patients, along different professional back-grounds with families and communities, as provide comprehensive services by appropriate to improve health working with patients, their families, outcomes in specific care contexts. carers and communities to deliver the highest quality of care across INTERPROFESSIONAL COMPETENCY settings DOMAIN ​ A generally identified cluster of more INTERPROFESSIONAL TEAMWORK specific interprofessional ​ The levels of cooperation, competencies that are conceptually coordination and collaboration linked, and serve as theoretical characterizing the relationships constructs HEALTH AND EDUCATION SYSTEM competencies. IPE has been ​ Consist of all the organizations, promoted by a number of people and actions whose primary international health organisations, as intent is to promote,restore or part of a redesign of healthcare maintain health and facilitate systems to promote interprofessional learning,respectively. They include teamwork,to enhance the quality of efforts to influence the determinants patient care,and improve health of health, direct health-improving outcomes activities, and learning opportunities ​ A means of improving at any stage of a health worker's patient-centered and career community-/population-oriented care. Interprofessional education HOW TO DESIGN COLLABORATIVE and health professions education,in CARE PLAN general, in a dynamic relationship COLLABORATIVE CARE PLANNING with health care systems are more ​ Individual health care providers responsive to the health needs of share their unique clinical the populations they are designed to perspective. Then team members serve. identify which providers will implement each aspect of the care GOAL OF IPE plan. Then the team members follow ​ To prepare all health professions through with the team students for deliberatively working recommendations communicating together with the common goal of and working together as needed building a safer and better patient-centered and INTERPROFESSIONALITY community/population oriented ​ The process by which professionals health care system reflect on and develop ways of practicing that provides an integrated and cohesive answer to the needs of the client/family/population. It involves continuous interaction and knowledge sharing between professionals, organized to solve or explore a variety of education and care issues all while seeking to INTERPROFESSIONAL COLLABORATIVE optimize the patient's participation PRACTICE ​ When multiple health workers from INTERPROFESSIONAL EDUCATION different professional backgrounds ​ A critical approach for preparing provide comprehensive services by students to enter the health working with patients, their families, workforce,where teamwork and careers and communities to deliver collaboration are important  the highest quality of care across TYPES OF COMPETENCE FROM AN setting INTERPROFESSIONAL PERSPECTIVE ​ Common ○​ It may be more helpful to think in terms of competencies that are common or overlapping more than one health profession but not necessarily all health INTERPROFESSIONAL EDUCATION AND professions. This can be the COLLABORATION source of interprofessional ​ This strategy was developed to tensions, such as in the address inappropriate supply, mix, debate about overlapping and distribution of the health care competencies between workforce who will provide holistic primary care physicians and care to patients with complex health nurse practitioners. The needs. IPEC has also shown to overlap may be a strategy to improve job satisfaction among extend the reach of a health health workers resulting in better profession whose quality and safety of healthcare practitioners are inaccessible delivery, and overall public for various reasons. satisfaction. ​ Complementary ​ A workforce that is ready for IPC ○​ Competencies enhance the therefore emerges from IPE qualities of other professions training in providing care. Thus,while experiences.Interprofessionality is in this example dentists and the field of interprofessional practice pediatricians identify useful and interprofessional education overlap in their roles consistent with their scope of practice,dentists and pediatricians mostly have complementary expertise. ​ Collaborative ○​ Competencies are those that each profession needs to work together with others, such as other specialties INTERPROFESSIONAL COMPETENCIES within a profession, between ​ It is no longer enough for health professions, with patients workers to be professional. In the and families, with current global climate, health non-professionals and workers also need to be volunteers, within and interprofessional (WHO, 2010,p.36) between organizations, within communities, and at a  broader policy level. ​ (Regulated professions) Interprofessional ​ Non regulated professions (common collaborative competencies health workers, managers) are the focus of this report. ​ IPE is well received among participants who develop communication skills, further their abilities to critically reflect and learn to appreciate the challenges and benefits of working in teams IPE INTERNATIONALLY 2008 ​ 42 countries were represented in this study with 396 respondents from different fields. For most of the respondents, IPE was compulsory, with students usually assessed in groups BENEFITS ______1/27/25 ​ Educational benefits INTERPROFESSIONAL EDUCATION ○​ Students have real world WHO Framework 2010 experience and insight ○​ Staff from range of INTERPROFESSIONAL EDUCATION profession provide input into ​ occurs when students from two or programme development more professions learn about from ○​ Students learn about work of and with each other to enable other practitioners effective collaborative ​ Health policy benefits ○​ Improved workplace practice WHO FRAMEWORK FOR ACTION ON and productivity INTERPROFESSIONAL EDUCATION AND ○​ Improved px outcomes COLLABORATIVE PRACTICE ○​ Raised staff moral ​ Provide strategies and ideas that will ○​ Improved px safety help health policymakers implement ○​ Better access to healthcare elements of interprofessional education and collaborative practice IPE AND COLLABORATIVE PRACTICE that will be the most beneficial in ​ It is one of the most promising their jurisdictions solutions and one of the strategies presented in 2006 that was IPE - A “necessary step” for making the pronounced as “innovative future healthcare workforce to be prepared approaches to teaching in the to local health needs and is one who is a industrialized and developing “collaborative practice-ready health countries” worker”  ​ A strategy that will play an important collaborative practice within role in mitigating the global health institutions workforce crisis 2.​ HEALTH WORKERS ​ Accrdg. to WHO a.​ who provides services and ○​ We are currently facing a workk together to ensure severe global health patieints and the community workforce crisis with, critical receive the best treatment shortages imbalanced skill possible mix, uneven geographical 3.​ EDUCATORS distribution of health a.​ provide necessary training to professionals leaving millions heath workers and without access to health understand the importance of services bringing students from range of disciplines to learn about , IPE AND CP FOR IMPROVED HEALTH from and with one another OUTCOMES 4.​ INDIVIDUALS AND COMMUNITIES ​ WHO affirmed after 50 years of (MOST IMPORTANT) enquiry and sufficient evidence, that a.​ rely and require IPE enables EFFECTIVE health-services and trusting COLLABORATIVE PRACTICE their healthcare workers are which in turn OPTIMIZES HEALTH working together to provide SERVICE, STRENGTHENING them the best services possible COLLABORATION VS COLLABORATIVE PRACTICE KEY MECHANISMS FOR SHAPING IPE ​ COLLABORATION AND CP ○​ formed by coordination and IPE cooperation ​ Shaped by mechanisms that can be ○​ (Does merely working classifies into thkse driven by together equate to ○​ 1. Staffresponsible for collaborative practice?) developing ,delivering, ​ COLLABORATIVE PRACTICE funding and managing ipe ○​ takes ocoperation one step ○​ 2. Interprofessional curricula further by engaging in EDUCATOR MECHANISM collaborative practice-ready ​ REQUIRES: health workforce, poised to ○​ Supportive institutional take on complex or emergent policies and managerial problem to solve them commitment together ○​ Good communication among PEOPLE participants 1.​ HEALTH LEADERS AND POLICY ○​ Enthusiasm formwork being MAKERS done a.​ strive to ensure there are no barriers to implementing  ○​ A shared vision and mechanisms and actions can understanding of benefits of help shape their experience introducing new curriculum ○​ A champion who is COLLABORATIVE PRACTICE responsible for coordinating ​ "Works best when it is organized education activities and around the NEEDS OF THE identifying barriers to POPULATION being served, taking progress into consideration the way local CURRICULUM MECHANISMS health care is delivered ​ IPE is more effective accrdg to research when: INSTITUTIONAL SUPPORTS ○​ Principles of adult learning ​ Shape the way a team work are used cooperatively, creating SYNERGY ○​ Learning methods reflect real instead of fragmentation world practice experiences of ​ There is a need for clear governance students models, structured protocols, and ○​ Interactions occurs bet shared operating procedures students ​ Well constructed learning outcomes WORKING CULTURE assumes students need to know ​ CP is effective when there are ○​ 1. What ot do eg. Knowledge opportunities for shared decision ○​ 2. How to apply their making and routine team meetings. knowledge ​ Enables health workers to decide on ○​ 3. When to apply their skills common goals and patient within an appropriate ethical management plans, balance framework using that individual and shared tasks,and knowledge eg. Attitudes and negotiate shared resources behaviors ENVIRONMENT 01/28/25 ​ Space design, facilities and the built EXAMPLES OF INTERPROFESSIONAL environment can significantly LEARNING DOMAINS enhance or detract from 1.​ TEAMWORK collaborative practice in an 2.​ ROLES AND RESPONSIBILITIES interprofessional clinic 3.​ COMMUNICATION ​ Sometimes the community and 4.​ LEARNING AND CRITICAL patients, and even the health care REFLECTION team have inputs and 5.​ RELATIONSHIP WITH , AND recommendations for the effective RECOGNIZING THE NEEDS OF space design THE PATIENT ​ Physical space should not reflect a 6.​ ETHICAL PRACTICE hierarchy of positions ​ ONCE health workers are ready to practice collaboratively, additional HEALTH AND EDUCATION SYSTEMS ○​ Tension and conflict among ​ These systems must coordinate their caregivers efforts in order to ensure the future ○​ Staff turnover health workforce consists of ○​ Hospital admissions appropriately qualified staff, ○​ Clinical error rates positioned in the right place and right ○​ Mortality rates time. ​ IN COMMUNITY MENTAL HEALTH ​ PICture eme SETTINGS: ○​ Increase patient and carer HEALTH SERVICE DELIVERY satisfaction ​ The way in which health and ○​ promote greater acceptance education services are financed, of treatment funded and commissioned can ○​ Reduce duration of treatment influence the success of IPE and CP ○​ Reduce cost of care ○​ Reduce incidence of suicide PATIENT SAFETY ○​ Increase treatment for ​ REGULATION THAT TOO RIGID psychiatric disorders ○​ Processes may become ○​ Reduce outpatient visits fragmented and result in ​ TERMINALLY ILL AND escalation of costs and CHRONICALLY ILL PATIENTS: additional strain on the health ○​ More satisfied with their care system ○​ Report fewer clinic visits ​ REGULATION THAT IS ○​ Present with fever symptoms REASONABLY FLEXIBLE ○​ Report improved overall ○​ Increase in opportunities to health embed IPE ​ HEALTH SYSTEM BENEFITTED ​ Accreditation requirements for health AND HAS REDUCED THE COST centers and registration criteria for OF: students can also transform ○​ Setting up and implementing education and practice primary health-care teams for elderly patients with chronic COLLABORATIVE PRACTICE illnesses ADVANTAGES ○​ Redundant medical testing ​ IT CAN IMPROVE: and associated costs ○​ Access to and coordination ○​ Implementing total parenteral of health services nutrition teams within the ○​ Appropriate use of specialist hospital setting clinical resources ​ MAXIMIZES THE STRENGTHS ○​ Health outcomes for people AND SKILLS OF EACH with chronic diseases CONTRIBUTING HEALTH ○​ Patient care and safety WORKERS ​ IT CAN DECREASE:: ○​ Enhances efficiency of teams ○​ Total patient complications through reduced services ○​ Length of hospital stay duplication, more frequent  and appropriate referral 2/3/25 patterns, greater continuity INTERPROFESSIONAL and coordination of care and COLLABORATION collaborative decision making 1.​ The essence of collaboration with patients 2.​ Elements of interprofessional ​ Assists in recruitment and retention collaborative practice of health workers 3.​ Benefits of collab ○​ Will mitigate health workforce 4.​ Potential barriers to collab migration 5.​ Getting into colab 6.​ Checklist for assessing readiness for CHALLENGES FOR LONG-TERM collaboration PLANNING OF INTERPROFESSIONAL 7.​ Members of an interprofessional COLLABORATION: team ​ It is often sidelined by urgent crises such as (1) epidemics of HIV/AIDS Concepts relevant to collaboration and /or tuberculosis,(2) spiralling Collaborative interaction health-care costs,(3) natural ​ Exhibit a blending of professional disasters, (4) ageing populations, cultures and are achieved through and (5) other global health issues sharing skills and knowledge to (pandemic) improve the quality of patient care IPC HIV/AIDS, TUBERCULOSIS AND ​ The provision of comprehensive MALARIA health services to px by multiple ​ Detection, treatment, and prevention healthcare providers in various fields of these diseases require the working collaboratively to deliver collaboration of every type of worker quality care within and across the within the health system setting ​ AIMS of IPC in terms of WHO HEALTH ACTION IN CRISIS 1.​.Improve how px experience ​ During humanitarian crisis and care in terms of quality, conflict, a well-planned emergency efficiency, and overall px response is essential satisfaction 2.​ To improve the health of HEALTH SECURITY populations ​ Epidemics and pandemics place 3.​ Reduce the per capita cost of sudden and intense demands on the healthcare health systems INTERPROFESSIONAL IPE and CP are NOT PANACEAS for every COLLABORATIVE PRACTICE challenge in the health system ​ Process which includes communication and decision making enabling a synergistic influence of group knowledge and skills Interorganizational collaboration in the IMPORTANT CHARACTERISTICS THTAT business domain DETERMINE TEAM EFFECTIVENESS ​ Organization bet organization, between one another , between ROLES→COMMUNICATION- AUTONOMY- countries, and between professions RESOURCES -GOAL ( high quality care)--> ESSENCE OF COLLABORATION ​ Members seeing the importance of ​ Mutually beneficial each member roles ​ Well defined relationship to achieve ​ Open communication (open criticism common goals to better plan) ​ Commitment to a definition to mutual ​ The existence of autonomy relationship and goals ​ Equality of resources ​ A jointly developed structure and shared responsibility Essential ingredients for team success ​ Mutual authority and accountability 1.​ Role clarity for success 2.​ Trust and confidence ​ And sharing of resources and 3.​ The ability to overcome adversity rewards 4.​ The ability to overcome personal ​ No mean tasks differences 5.​ Collective leadership IPC AND PRACTICE Interprofessional collaboration BENEFITS OF COLLABORATION ​ A partnership bet a team of health ​ Provides a means for organization, providers bas a client in a institution or profession to achieve participatory collaborative and more than they can on their own coordinated approach to shared ​ Sharing of costs spread risks and decision making around health and reduce supply chain uncertainty social issues while forming strategic economic alliances that also serve as a fertile Interprofessional collaborative practice ground for innovation and learning ​ A process which includes ​ Potentially reduces self sufficiency in communication and decision making environment demanding great , enabling a synergistic influence of flexibility and innovation group knowledge and skills ​ In healthcare it is generally believe ls that collaborative efforts yield better Elements of collaborative practice health care and outcomes for the ​ Responsibility populations that are serves ​ Accountability ○​ Leads to ​ Coordination ​ Improved efficiency ​ Communication ​ Improves skill mix ​ Cooperation ​ Greater level of ​ Assertiveness responsiveness ​ Autonomy, and ​ More holistic services ​ Mutual trust and respect  ​ Innovation and 3.​ Ipc can lead to the loss of creativity uniqueness of a profession or professional identity "Shared decision making is a hallmark of collaborative care" ___020425__ COMPETENCIES: GETTING INTO COLLABORATION 1.​ Basic knowledge of each others ​ If everyone is moving forward roles and responsibilities together, then success takes care of 2.​ An attitude of mutual understanding itself. -Henry Ford respect and patient centeredness ​ Like other things that are valued but 3.​ Well developed communication and difficult to attain, working team work skills collaborations are perhaps as much an art as they are a science. BENEFITS OF COLLABORATION ​ The process of building a culture of 1.​ Benefits to px: collaborative collaboration is not exactly practice can improve access to and methodical, is somewhat organic, coordination of health services , and requires a great deal of practice improve health outcomes for people and nurturing. with chronic diseases and enhance px care nas safety POINTS RELEVANT TO FORGING 2.​ Benefits to healthcare providers COLLABORATIONS and payers: collaborative practice can decrease the total number of ​ Know when to collaborate and when patient complications, length of not to hospital stays , tension and conflict ​ Know what the collaborating among caregivers, staff turnover, professions or organizations stand to hospital admissions, and gain from the alliance and what the re-admission, clinical error rates, costs are to get there mortality rates, and medico legal ​ Be aware of the factors that drive the risk. strength of the collaboration 3.​ Benefits to society: collaborative ​ Become familiar with the factors that practice can reduce the cost of care, lead to successful collaborations as well as improve the overall health ​ Recognize the intangible elements of the population ​ Identify barriers to the collaboration that you desire to build, and find Potential barriers to Collaboration ways to remove the barriers 1.​ The own unique history, culture, ​ Create organizational learning attitudes, customs, nad belief of objectives and goals to facilitate each profession knowledge creation 2.​ Boundary disputes, status issues, ​ Commit to collaboration for the long language barriers, customer service haul. orientation, and reporting structures ​ Know when it is time to stop a are all potential challenges collaboration. CHECKLIST FOR ASSESSING 1.​ PRIMARY CARE PHYSICIAN READINESS FOR COLLABORATION ○​ AKA Family Practice Physician ○​ Provides general medical care ○​ Provides detailed histories of positive responses to the health questionnaire ○​ Contributes to decisions relating to preoperative risk assessment and evaluation of severity and stability of medical diagnoses ○​ Offers insights related to long-term prognosis treatment compliance and mutual treatment goals THE PATIENT & HIS SOCIAL SUPPORT ○​ Can serve as a coordinator ​ The patient is both the central focus of care and provide referrals and an integral member of the team. to appropriate specialists In many cases, the family and caregivers will also be part of the 2.​ PHYSICIAN-MEDICAL team. SPECIALITIES ​ The community may also play an ○​ Neurology important role in the team, as when ○​ Dermatology public health approaches to disease ○​ Radiation oncology prevention and health promotion are ○​ Medical oncology considered as part of the context of ○​ Hematology oncology care. ○​ Psychiatry ○​ Pain medicine DENTAL TEAM MEMBERS ○​ Infectious disease Depending on the context of care and ○​ Emergency physicians patient population, the oral healthcare team may include some or all of the following: 3.​ PHYSICIAN-SURGICAL ​ General or primary care dentist, SPECIALITIES dental assistant, and dental ○​ In addition to working with hygienist Oral and Maxillofacial ​ Midlevel provider, dental therapist, surgeons, dentists may expanded duty hygienist interact with specialists in: ​ Dental laboratory technician ​ Otolaryngology ​ Denturists ​ Plastic surgery ​ Dental specialists ​ Transplant medicine ​ Cardiac surgery 4.​ PHYSICIAN ASSISTANT OR ○​ A licensed practical nurse ASSOCIATE (LPN) has been trained to ○​ Licensed to practice provide home health or medicine under the direct nursing care under the supervision of a physician, supervision of an RN or a and his or her role overlaps medical doctor. significantly with that of the ○​ Along with nurses, they physician provide direct patient care, ○​ Involved in primary care such as oral cleansing. medicine, as well as in the ○​ Provides regular reminders medical and surgical and support services, specialties reinforces exercise and good ○​ Their responsibilities depend nutrition regimens, and may on the setting in which they provide daily oral home care. work, their level of 6.​ NURSE'S AIDE experience and training, and ○​ AKA Nursing Assistant regional laws ○​ Works directly with patients, ○​ Similarly to a physician, the providing assistance with PA conducts histories and activities of daily living (ADL), physical assessments, including oral home care, provides detailed medical eating, drinking,dressing, information, orders and toileting, and bathing interprets diagnostic tests, 7.​ ADVANCED PRACTICE NURSE, and diagnoses and treats INCLUDING NURSE illnesses,including PRACTITIONER prescribing medications ○​ Has completed advanced ○​ Physician assistants (usually training beyond the RN and medical, not surgical, PAs) is trained for expanded frequently provide direct practice capabilities, patient care in such facilities including independent as nursing homes or group practice,depending on homes training and jurisdiction. 5.​ REGISTERED NURSE 8.​ CERTIFIED REGISTERED NURSE ○​ Responsible for the daily ANESTHETIST OR ANESTHETIST care tasks and administration ○​ Has completed advanced of medications training beyond the RN with ○​ Trained to closely assess a focus on administration of patient needs and detect anesthesia, sedation, and small, yet significant, control of pain and anxiety changes in function and ○​ Provide work in collaboration status, which can be critical with surgeons, for any necessary treatment anesthesiologists, dentists, modifications podiatrists, and other qualified health professionals  ○​ May be the primary providers anticoagulants or of anesthesia care in rural chemotherapy agents settings when acute side ○​ Often provide general effects are noted anesthesia in an operating ○​ In an outpatient setting: room or outpatient treatment ​ provides patients with setting for patients unable to access to prescription tolerate dental care in a and over-the-counter routine clinic setting. (OTC) medications 9.​ PHARMACIST ​ administers some ○​ Ahealth professional who immunizations, dispenses medications ​ performs health prescribed by other health screenings, professionals and provides ​ monitors drug health screening, health combinations and education, and valuable interactions, health information on drug ​ and educates patients interactions and and other health contraindications professionals about ○​ Some also provide direct drug side effects and patient care, as well as frequency of compounding drugs as administration prescribed by the dentist ○​ Can be an excellent resource when commercial drugs are to the dental team, not available or when custom suggesting strategies for formulations will better suit improving patient compliance the patient's needs in taking the medications and ○​ In an inpatient setting: enhancing drug efficacy ​ may administer daily ○​ may be contacted to obtain a medications and list of an individual patient's titrate to appropriate medications doses; 10.​ SOCIAL WORKER ​ provide expertise on ○​ AKA Case Worker, Case drug combinations, Manager interactions and ○​ Can provide essential efficacy; emotional and social support ​ identify patient to the patient/client, allergies to caregiver, and family medications; ○​ Often called to assist in ​ and make identifying strategies for recommendations improving the situation of an regarding individual that is no longer discontinuation or able to effectively provide for alteration of his own daily needs  ○​ Their role typically involves for individuals with special locating, activating, and challenges or distractions, facilitating the provision of specifically those who may medical care, social services, have cognitive impairment or transportation, home care, mental illness, or exhibit and assisted living or nursing unhealthy behaviors or home care as needed self-destructive habits ○​ They are skilled in identifying ○​ collaborative efforts with oral funding sources, including health professionals can aid private insurance, public in facilitating care assistance, religious groups, 12.​SPEECH & LANGUAGE and nonprofit charitable PATHOLOGIST organizations. Thus helping ○​ Can provide evaluation and patients meet basic rehabilitation for the patient needs,identify resources to who has suffered a stroke or pay for oral and general received head trauma, or for healthcare, and improve the the patient with head and patient's quality of life neck cancer who has ○​ Their work also includes undergone surgical and/or coordination of care for radiation therapy patients who require ○​ Working with a speech and healthcare coverage and language pathologist may access to treatment. This assist the patient in achieving may involve working with a improved, mitigated, or legal guardian to aid in: corrected communication ​ facilitating healthcare function decisions on the 13.​PHYSICAL THERAPIST patient's behalf, ○​ Provides therapy, stretching ​ contacting family and exercises to address members to obtain muscle associated informed consent, temporomandibular ​ responding to family disorders, as well as trismus members who and miscrostomia disagree with ○​ Although the dentist and recommendations, other healthcare providers ​ and helping patients have some strategies to with understanding address these issues, the recommendations physical therapist has 11.​MENTAL HEALTHCARE specific training and PROFESSIONAL expertise that will be ○​ Routinely works to develop essential for the optimal and strategies and plans to comprehensive management enhance patient well-being, of such problems cooperation, and compliance  14.​DIETITIAN ​ The bold leadership of the dental ○​ Assists and advises patients profession through effective about healthy diets and collaboration with medicine, public dietary alternatives, health, and other disciplines, along especially individuals with with high level advocacy, will metabolic diseases, such as facilitate the development of relevant diabetes or workforce models reduce service hypercholesterolemia, and fragmentation and increase access those with to quality services through hypertension,vitamin collaborative, person-centered care deficiencies, or food allergies ​ The provision of this primary health ○​ Have expertise in care services in the dental office determining nutrient/caloric should focus on activities that recommendations for directly impact oral health like: patients undergoing head -​ Smoking cessation and neck cancer treatment or -​ Screening of osteoporosis who suffer from protracted -​ Identification of undiagnosed forms of stomatitis. diabetes -​ Obstructive sleep apnea CONDITIONS BEST MANAGED BY AN -​ Hypertension INTERPROFESSIONAL TEAM THAT -​ Nutrition and obesity INCLUDES DENTISTRY management ​ Focused on screening and primitive care _____021025 Driving Force Behind CP Dentistry and it's role in IPE and CP ​ The dental profession should be part Dentists: part of the wider health care of the political dialogue at national system and is naturally affected by new and global level and recognized as a demands, determinants, expectations and central driving force behind the circumstances. These highlights the needs development of competencies for of the dental profession to keep pace with CP and the implementation of any the changing system. CP model ROLES OF DENTISTS BENEFITS OF CP WITH REGARDS TO Leader DENTISTRY ​ Dentists are front-line medical 1. Improved access to oral healthcare professionals in the prevention, early a.​ If collaborating professionals are detection and tx of oral and systemic working in separate sites in diseases underserved communities ​ They should be leaders internally b.​ Collaborating with providers that are (auxilaries) and externally (other at the same location professions) 2. Reduced costs and increased productivity  ​ We assume that the use of complications of diabetes lower-cost labor that is adequately (CVD and kidney diseases) trained to provide particular services ​ Other studies also noted the ff: should result in significant cost -​ Adults who lost their teeth savings without jeopardizing the have a lower intake of fresh quality of care fruits and vegetables, and ​ Dental auxiliaries were added to poor nutritional habits are increase productivity rate, dental once proven risk factors of assistants, hygienists, techno, NCDs denturists -​ For children, dental health has an even broader 3. Better quality of services implications for children: ​ CP, when implemented correctly, Poor OH results in decreased academic increases trust and accountability performance and can adversely affect among providers, facilitates behavioral and social development continuity of care resulting in better clinical outcomes for patients and COMMUNICATION OR REFERRALS TO improves overall health system OTHER HEALTH PROFESSIONALS performance ​ In some situations, it may not be feasible for dental tx to proceed, IPCP AND DENTISTRY because ket information is lacking or ​ Optimal oral health is a function of a because there are barriers to care variety of factors that cannot be overcome without -​ Need and demand teamwork and the participation of all -​ Technological progress team members -​ Socio-economic dynamics ​ A consultation involves referring a px -​ Satisfactory service delivery to another clinician for an opinion ​ Poor oral health in itself is a health and/or tx for a specific problem or concern, causing a significant communicating with the patient's disease burden and suffering, current healthcare providers to particularly among children, obtain specific information about the adolescents and older people. patient's condition ​ Oral health also has a broader impact as it has been linked to the DETERMINANTS IF YOU NEED increased risk in cardiovascular CONSULTATION disease, diabetes and other chronic 1.​ Is a consultation needed and with conditions whom? ​ Diabetic patients 2.​ How could this help the px? -​ That have periodontitis have 3.​ When will the consultation be 6x higher the risk of requested/timing? worsening glycemic control 4.​ What focus questions will be asked? and development of macro- and microvascular Collaboration may be needed at various times during the course of patient care, including in relation to initial patient ​ Simplification or modification of evaluation, treatment planning, and active patients with reduced QOL treatment, and during maintenance care DURING TREATMENT PLANNING ​ During the course of treatment During patient evaluation planning, the dentist may consult ​ At the time of examination and with other members of the assessment, the dentist screens the healthcare team. patient for signs and symptoms of ​ Through the course of active dental systemic conditions that may affect treatment, the dentist may oral health or dental treatment, as collaborate with other members of well as conditions that could have an the healthcare team to provide an effect on systemic health and the evaluation of the patient's response management of medical conditions to treatment. ​ During treatment, the dentist may Common reasons for requesting an also need to consult with other evaluation or consultation with healthcare team members for non-dental care providers include the ff: patients requiring additional medical 1. Screening for and optimal management care. of systemic conditions ​ High blood pressure DURING MAINTENANCE CARE 2. Systemic conditions contributing to an ​ During the maintenance phase of oral health problem dental treatment, the dentist will ​ PTSD, anxiety causes dry mouth collaborate with other healthcare 3. Oral manifestations of systemic providers to: conditions ○​ help minimize the risk for ​ Sometimes a dentist will be the first recurrent or relapse of oral healthcare professional to recognize diseases signs and symptoms of certain ○​ minimize the side effects and conditions or diseases complications of treatment ​ IIt will be important to have information about the diagnosis IPC IN A HOSPITAL before beginning dental treatment, ​ Most integrated example of IP because such information may collaboration in oral healthcare significantly alter the patient's dental occurs in the hospital dentistry prognosis and the development of practice setting an appropriate treatment plan ​ Dental professionals in a hospital 4. Oral health problems associated with setting integrate their practice within medical treatment the larger scope of collaborative ​ Mouth pain and ulceration during care in several ways cancer chemotherapy ​ Hospital dentists have ready access 5. Quality of life and life expectancy to the use of operating rooms and concerns general anesthesia experts for those ​ Cancer patients, taste disorders  patients unable to tolerate care in a ​ Three major reasons that the dentist routine outpatient clinic setting. may be consulted or asked to ​ They can rapidly consult with other collaborate: specialists or emergency services ○​ 1.Oral disease is contributing for patients with medical complexity to or has the potential to and special healthcare needs contribute to a general health ​ Blood products can be ordered, problem or compromise its coordinated, and administered treatment. relative to the timing of invasive ○​ 2. During examination, dental dental procedures. issues are detected that raise ​ Advanced imaging modalities are concerns to a healthcare accessible for diagnosis and provider who is not a dentist. treatment planning. ○​ 3.Specific referrals are made ​ Dental professionals in a hospital to the dental team for setting provide medically necessary assessment, diagnosis, and dental care and constitute a treatment. significant element in collaborative care. 1. ORAL DISEASES CONTRIBUTING TO A GENERAL HEALTH PROBLEM ​ The link between oral health and systemic health has been described in great detail in the literature. ​ There may be referrals of a patient to assess whether an oral health problem is contributing to a patient's general health problem. 2. DENTAL ISSUES THAT ARISE DURING EXAMINATION BY A NON-DENTAL DENTISTRY AS PART OF THE MEDICAL HEALTHCARE PROVIDER TEAM ​ Patients may seek care from another ​ A dentist may work with other healthcare provider, such as the healthcare providers is part of a emergency physician or primary collaborative healthcare team that medical provider, for dental has been assembled to treat complaints, because they have patients with complex problems. limited access to dental care. ​ In these settings, all patients are ​ Dental problems may also be assessed and managed by all team detected during the course of members, often with coordinated evaluation for non dental appointments and regular team problems-for example, during an meetings, to discuss diagnosis, annual health maintenance treatment planning, and outcomes examination. Common oral conditions that non-dental monitoring and continued providers will recognize and refer to the assessment of oral health. dental team: ​ Collaborative efforts with staff in ​ Caries these facilities can improve the oral ​ Signs and symptoms of periodontal health status of these patients disease, through preventive education in daily ​ fractured or missing teeth, oral hygiene strategies and ​ broken or defective restorations, and monitoring for signs and symptoms ​ limited chewing function or inability of pain and infection. to chew properly D. Evaluation for Possible Oral Source of 3. SPECIFIC REFERRAL TO THE DENTAL Infection TEAM ​ Most often occur in a hospital There are many contexts in which referrals setting, and as a result of the are routinely made to the dental team: severity and urgency of the patient's A. Pre-Procedural Oral Evaluation condition, the oral health ​ Providing dental evaluation and professional may be consulted clearance is a routine practice in regarding a possible source of areas such as transplant medicine, infection in the oral cavity head and neck oncology,and cardiac ​ Process will require ongoing surgery to ensure provision of any dialogue between the necessary treatment that could dentist,infectious disease specialist, minimize the risk of infection and and pharmacist to determine an oral complications before such optimal antibiotic therapy procedures E. Oral Evaluation in an Emergency B. Clear & Timely Communication & Medicine Setting Collaboration ​ Patients may present to a hospital ​ Clear and timely communication and emergency department (ED)with a collaboration between all of the chief concern related to the teeth, medical specialties involved is periodontium, jaws, or other oral essential in situations in which the structures or tissues potential for morbidity and mortality ​ Common concerns include pain, is high infection, dentoalveolar trauma,and ​ Any decisions to modify medical bleeding therapy must be shared and ​ Procedures that are commonly approved by the team. carried out by the dental team in hospital emergency setting: C. Oral Health Status in Supportive Care ○​ Identification of an oral Facilities source of infection and ​ Patients who reside in assisted management with living, nursing homes or group home intravenous or oral antibiotic facilities require a special degree of therapy  ○​ Incision and drainage of an ​ Medical oncology oral abscess ​ Speech and language pathology ○​ Splinting or stabilization of ​ Social work traumatized teeth ○​ Pulpal management of A. Initial Recognition of Oral Cancer fractured teeth ​ Visits to the dental office provide ○​ Achieving hemostasis in a excellent opportunity for the conduct patient with oral bleeding of thorough head and neck cancer ​ If the Emergency Department has a screening. dental component, some urgent care B. Referral for Definitive Diagnosis & dental treatment, such as pulp Treatment of Oral Cancer extirpation, simple extraction, or a ​ The dental team should arrange for provisional restoration can be done appropriate referrals when head & on site by the dentist. neck cancer is suspected. ​ The written referral should describe CONDITIONS BEST MANAGED BY AN the appearance & location of the INTERPROFESSIONAL TEAM THAT lesion, the length of time the patient INCLUDES DENTISTRY has been aware of it, & any other 1.Head and Neck Cancer symptoms. ​ The dental team plays an essential ​ The results of any tests or treatment role in recognizing, diagnosing, performed by the dental team should treating, and managing follow-up for also be included. patients with oral cancer and is ​ The dental professional should notify solely responsible for managing and the PCP of the cancer diagnosis and treating any dental problems for the any specialist referrals that have patient throughout this process. been and are being made. 2.Cleft Palate/Craniofacial Anomalies ​ The referring dentist should follow 3. Temporomandibular Joint up with the specialist to confirm the Disorders/Orofacial pain diagnosis and proposed plan of 4.Obstructive Sleep Apnea care. 5. Head and Neck Trauma (Gunshot, ​ **Tumor Board Typically include: Explosion, Motor Vehicle ○​ medical oncologist Accident) ○​ radiation oncologist, 6.Combined Treatment in an Operating ○​ surgical specialist Room Setting ​ For head & neck cases ○​ May include: Example of Specialties Involved--Tumor ○​ Oral & maxillofacial Surgeon Board ○​ ENT Surgeon ​ Oral and maxillofacial surgery C. Planning Dental Treatment after ​ Otolaryngology Diagnosis of Head & Neck Cancer ​ General dentistry ​ Once the diagnosis of head and ​ Maxillofacial prosthodontics neck cancer has been made, the ​ Radiology dental team, in collaboration with the ​ Radiation oncology other health professionals, will need  to treat the cancer and provide ​ If there are teeth for RCT or if there long-term rehabilitative and is a question of the caries involving preventive care for the patient. the pulp, extraction should strongly ​ The presence of untreated oral be considered to minimize the risk of disease can increase the risk of continued or recurrent pulpal adverse effects from cancer therapy. infection. ​ As part of the dental treatment E. Supportive Dental Care During Cancer planning process, even the patient Therapy without dental disease must be ​ Maintaining oral hygiene & informed of the transient and monitoring for adverse effects are residual adverse effects of cancer two of the more important tasks to therapies on both the hard and soft be implemented during cancer oral tissues. therapy. ​ After a comprehensive assessment ​ Many patients will be uncomfortable of the patient's oral condition has performing their usual oral hygiene been made, treatment planning for regimens, thus dentists should offer pre and post cancer therapy can be alternatives. addressed. ​ Symptomatic care is continued as ​ "The potential adverse effects of necessary. In the absence of each type of cancer therapy must be infection, mucositis usually resolves taken into account in planning dental within 2 to 4 weeks after completion care.” of cancer therapy. Healing of oral D. Coordinating Dental Care in Patients tissue after radiation treatment may Before Cancer Therapy take as long as 6 weeks. ​ Any urgent dental treatment should ​ Periodic oral examinations to be provided without delaying the evaluate the condition of the mucosa onset of therapy for the cancer. are needed. ​ It is critical that any invasive dental F. Coordinating Dental Care After Cancer treatment be performed as soon as Therapy possible, because the oral cavity ​ After cancer therapy, the dentist must be given time to heal after continues to serve in an essential, dental treatment and before initiation often central, role. of chemotherapy or radiation ○​ Helping the patient to therapy. maintain optimal oral health ​ An essential goal of dental treatment ○​ Managing any oral before any cancer therapy is to complications or problems eliminate oral sources of bacteria that arise and dental infection, such as ○​ Alerting other members of periodontal disease, pericoronitis, the healthcare team to any and periapical pathosis. medical complications or ​ Extract teeth with significant recurrence of the cancer periodontal disease involvement. ○​ Providing (or supporting the ​ Carious teeth need to be restored or provision of long term removed.  prosthodontic reconstruction and oral rehabilitation G. Prosthetic Rehabilitation ​ Replacement of teeth may be indicated for patients who have received therapy for head and neck cancer. ​ Prosthetic devices made to be used to restore function & improved esthetics may include medically necessary maxillofacial prosthetics ​ In planning prosthetic rehabilitation, the overall oral condition must first be evaluated, & the prosthesis should be specifically designed & maintained to minimize mucosal trauma & irritation while optimizing speech, chewing, & swallowing functions. H. Long-Term Follow-Up: Maintenance & Surveillance ​ Scheduling regular dental appointments with the dental team is extremely important for patients who have been diagnosed and treated for head and neck cancer. ​ The reasons include maintaining oral health, preventing oral disease, and monitoring for complications or recurrence of the cancer.