If you spend any time with the National Center for Interprofessional Practice and Education team, you will hear the word. And you might wonder what it means. What exactly is the “Nexus?” It means working toward a future where health care practice and health professions education operate in a meaningful system, learning and working together in teams with students, patients, families and communities to make a positive impact on the Triple Aim of improving the patient experience of care, improving the health of populations and reducing the per capita cost of health care. These teams will be the norm, not the exception.

An excellent example of an evolving “Nexus” is the National Center Innovations Incubator Network member in Grand Rapids, Michigan. The West Michigan Interprofessional Education Initiative (WMIPEI) is a unique inter-institutional regional interprofessional education consortium of Grand Valley State University, Grand Rapids Medical Education Partners, Michigan State University, Ferris State University and the region’s major health care systems and practices. WMIPEI is partnering with Cherry Street Health Services—the largest Federally Qualified Health Center (FQHC) system in Michigan—to examine how giving students real-life and meaningful experiences on a health care team might produce better prepared graduates tomorrow while addressing operational challenges of  today.

“Change won’t wait,” says Jean Nagelkerk, PhD, vice provost for health at Grand Valley State University. “Our partners at Cherry Street are expecting about 6000 new insured lives as a result of the state’s Medicaid expansion, and we’re moving quickly in Michigan toward bundled payment systems. So we’re testing a new model that we believe will improve access, cost and quality of care simultaneously.” Teams of medical, physican assistant and pharmacy students—along with Cherry Street’s professional nursing, medical and dietetic staff–will provide interprofessional diabetes care with a defined panel of patients while measuring productivity, costs and outcomes using the National Center Data Repository.

Chris Shea, chief executive officer of Cherry Street Health Services, explains, “Since we are developing a system of health care that integrates the physical and behavioral aspects of care, we are encouraged to coach students in an interprofessional education model that embraces this transformative delivery system.” The interprofessional team of students will be working collaboratively with Cherry Street health professionals to care for patients by engaging in daily huddles, planning care as a team, and presenting case conferences.  The student IPE team will also be working collaboratively with high risk patients to conduct medicine reconciliations and make recommendations for their care, engage in returning phone calls for health problems, conduct diabetic group classes, and create collaborative care plans with select patients.  This IPE clinical experience is a unique opportunity for students to share their clinical expertise in planning care using a team approach to enhance the care of patients.

The team is aiming to improve patient and staff satisfaction, increase productivity and access to care, improve clinical indicators such as HbA1c and cholesterol levels, and decrease the average annual cost for care of diabetic patients. Nagelkerk reflects on how this is different from the status quo, “We’re testing a new model—not only of team-based care, but training students as a integral part of that team. It means that we can support practicing health professionals to learn new team-based skills while preparing students to meet the workforce needs of the not-so-distant future.”

The real potential for this new model lies in its scalability. If successful, Cherry Street will expand the model to its entire 25-clinic FQHC network, and National Center will disseminate the information to facilitate national adoption. Nagelkerk emphasized the potential for large-scale impact “In five years, I think we’ll see teams of students placed in clinical settings routinely, working collaboratively in planning and providing care for clients.  They will add value and enhance the productivity of the clinical setting and assist clients with reaching their goals and improving health outcomes.”  Everyone – patients, health professionals, and students – benefits by learning together.