HealthMarch 12, 2018

How to use an educational EHR in interprofessional education

Interprofessional EducationEducational electronic health records (EHRs) like Lippincott DocuCare are not only great for ensuring nursing students get real-life documentation training in a safe and managed environment, but they provide vast benefits to interprofessional education (IPE), as well.

The World Health Organization defines IPE as students from two or more professions learning about, from, and with each other to enable effective collaboration and improve health outcomes. IPE offers a chance for students to learn, collaborate and communicate effectively, thereby making them better practitioners and patient caregivers. They gain a mutual respect for each other's skills, and learn to work better as teams in on-the-job patient scenarios. The more collaboration and practice in effective communication nursing students have in nursing school, the more success they will have in clinical practice and, ultimately, help improve patient outcomes.

The interprofessional communication skills gained are key to providing quality team-based care to patients, as well. And with a good IPE program, team members use technologies such as electronic messaging, telephone, video-conferencing and other mediums to communicate effectively. EHRs are becoming more popular as primary forms of communication between IPE teams and vital components of interprofessional collaboration in health care.

Interprofessional collaboration is key to increasingly complex patient care

The National League of Nursing (NLN) in December 2015 published a vision statement for Interprofessional Education and Practice, calling on nursing schools to change from the traditional and still-predominant model of having separate professional programs to creating collaborative IPE and practice initiatives. This is because the on-the-job demands of nurses and health practitioners to offer patient-centered, comprehensive and coordinated care have skyrocketed. As a result, there has also been a spike in the demand for advancements in the way IPE is approached, in order to ensure nurses are adequately prepared for their expanding roles.

This means there is also increasing demand on nursing instructors to find effective ways to provide IPE opportunities that integrate effective technologies to their students.

“The greater focus on preparation for collaborative, patient-centered care from nursing stakeholders signals the obligation that nursing educators have to refocus as well," the NLN notes.

But implementing and running IPE programs in nursing schools definitely has its challenges. If an institution is used to being structured strictly by discipline, has siloed decision-making processes in place and is very reluctant to change, instituting IPE can be frustrating. Nursing school administrators and instructors need to be willing to try new thing, adopt new technologies, and break out of archaic approaches to medicine.

“Continued support from the institution through the allocation of resources and participation from faculty, practitioners, hospital executives, and others is crucial to your success," the NLN adds.

So how can nursing schools address some of these challenges in bringing more IPE programs to their nursing students? Introducing EHRs to your IPE program.

It's not your old IPE model anymore

The old IPE model of a group of students standing around a model “patient" exhibiting symptoms A, B, or C, are no longer valid. Now, with technology like electronic health record software at their disposal, nursing students from multiple disciplines can care for these virtual patients collaboratively and in a safe, monitored environment.

EHRs, in their simplest form, are a digital version of a patient's paper chart. They"re easy to find, search, and update, and provide tools like reminders, alarms, and automated processes that improve clinical accuracy. U.S. healthcare organizations have been transitioning from paper-based medical records to electronic health records for over a quarter of a century. They allow organizations to minimize the high rate of medical errors occurring throughout the healthcare industry and act as a tool for increasing patient safety and decreasing the overall cost of healthcare.

When it comes to integrating EHRs into your nursing education program, there are vast benefits for both students and instructors - they help close skills gaps when nurses get on the job, they help nursing students become proficient in documentation before they get to a clinical setting, they become comfortable with technology, and it helps them hone their communication, concise writing and general computer skills, among other things.

And when it comes to the benefits for instructors of using EHRs in your IEP program is, one big bonus is that there is far less paperwork and files to worry about as you teach. All of the patient records and other necessary documentation your nursing students may need to diagnose and treat the virtual patient are all housed in the EHR. Plus, EHRs like Lippincott DocuCare offer nursing instructors the opportunity to customize the patient scenarios. But the key benefits to using an EHR in your interprofessional education center on improving communication, increasing proficiency and comfort with using technology to document and chart, and utilizing the technology to communicate with, and learn from, other professionals - regardless of their location - on patient care.

How these schools used EHRs to boost interprofessional collaboration

Here's how one specific school - the Indiana University School of Medicine - uses simulated health records in its IPE program. 

Residents work with graduate-level peers in the school's nursing and social work programs to collectively create comprehensive care plans for geriatric patients. The plans are formed through their chosen EHR, which includes details from real-life records. Each month, 15 trainees from a geriatric rotation are e-mailed a geriatric case for review that includes a case file and patient summary. They communicate through the EHR system and through a team card, on which team members contribute to shared notes. The trainees meet once a month for a face-to-face session to discuss the case.

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“The big take-home for our students, of all the things that we cultured from our qualitative data, was the opportunity to learn about other professions, to interact with other professions, to see other professions” viewpoints and to see how other professions were caring and documenting their care of geriatric patients," said Debra Litzelman MA, MD, professor of medicine at Indiana University (IU) School of Medicine and director of Education and Workforce Development at the IU Center for Global Health.

Meanwhile, at the UC San Diego School of Medicine's Southwestern Medical Center, a pilot study was conducted to determine how effective utilizing an EHR environment to care for virtual geriatric patients was in achieving IPE competencies. The research looked at:

  • Communication - writing skills, professionalism
  • Interprofessional roles: understanding the scope of their professional roles
  • Teamwork: integrating information from other professionals into treatment plans and documentation

The virtual patient in the exercise was an elderly man admitted for an acute stroke who was experiencing an inpatient fall on day 3 of his hospitalization. Identical patients were created for each IP team to document within a single assigned chart. Students were responsible for logging into their EHR, checking their inbox for staff messages and appropriately responding, reviewing documentation entered by other team members, and charting based on clinical information available.

The results backed up the idea that there are vast benefits to institutions curriculums that focus specifically on teaching IPE geriatric practice within the EHR.

How to integrate an EHR into your own IPE

Consider this when thinking about how to integrate an EHR into your IPE program and increase interprofessional collaboration ...

Lippincott DocuCare includes more than 200 assignable, true-to-life patient scenarios covering a wide range of diagnoses and demographics -from medical-surgical to mental health to maternal-pediatric and beyond- appropriate for all levels of nursing. Numerous evidence-based patient records developed jointly with the NLN provide a seamless clinical learning experience across vSim for Nursing and Laerdal Medical simulation scenarios. Or, as an instructor, you can create your own scenarios.

Some of these DocuCare scenarios include:

  • Christopher Parrish - Nutrition (Fundamentals)
  • Jared Griffin - Asepsis and Infection control (Fundamentals)
  • Millie Larsen - Fall Risk and Functional Assessment (Gerontology)
  • Henry Williams - Discharge to Pulmonary Rehabilitation (Gerontology)
  • Skyler Hansen - Diabetes: Hypoglycemia (Medical-Surgical)
  • Vincent Brody - COPD: Spontaneous Pneumothorax (Medical-Surgical)
  • Andrew Davis - Alcohol Withdrawal (Psychiatric - Mental Health Nursing)
  • David Carter - Schizophrenia (Psychiatric - Mental Health Nursing)

In addition, DocuCare includes screens specifically created so that occupational therapists, respiratory therapists, and providers can chart in the program as well; so DocuCare can be used in interprofessional simulation in those specialties.

And there are IPE opportunities for nearly every patient situation. Instructors can pick a virtual case patient, have students from across disciplines discuss their concerns and learn from each other. And in your nursing school's sim lab, students can work together to provide care to the patient, or take turns, using direct observation with an oral or written debrief on the plan of care.

By utilizing DocuCare within your IPE program, students can focus on interprofessional collaboration within the EHR, to practice providing the best patient care.

In addition, the NLN offers a toolkit - A Guide to Effective Interprofessional Education and Collaborative Practice Experiences in Nursing Education - which includes a guide to infusing a culture of interprofessional collaboration and patient-centeredness into your institution, eight detailed guides for IPE activities suitable for a variety of nursing environments, strategies for evaluating a program's impact and implementing evidence-based teaching practices, and more.

There are a few critical factors for a successful IPE program, according to the NLN:

  1. IPE infrastructure to engage students
  2. Commitment of time and effort from leaders, faculty, staff, practitioners and students.
  3. Financial models and reliable funding sources to cover IPE costs
  4. Program revision process with reliable evaluation tools to measure the program's effectiveness
  5. Faculty development to ensure the IPE programming is delivered effectively; many clinicians were not educated in, nor did they practice in, an interprofessional, team-based environment
  6. Centralized group for coordinating IPE programming
  7. Diverse array of authentic IPE programs that utilize different learning formats
  8. Ongoing coaching for participants after training to provide feedback.

The NLN toolkit offers specific ways to address those challenges.

Want to learn more about how you can effectively integrate Lippincott DocuCare into your IPE program? Check out more product information by clicking the link below and a rep will get in touch with you.

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