Center of Excellence in Primary Care Education (CoEPCE) - Boise VA Medical Center
Formal training, workplace learning and reflection drive the Boise Center of Excellence’s team-based primary care curricula. This interprofessional curriculum supports several disciplines, particularly nurse practitioner, internal medicine and pharmacy residents, and psychology interns and post-doctoral fellows. To deepen trainees’ understanding of interdependent roles and optimize preparation for practice in a transforming healthcare system, the Center also fosters multidisciplinary, continuous quality improvement (CQI) projects.
PACT Interprofessional Care Update "ICU" - is a weekly case conference that:
- Provides a forum to optimize care for the highest need patients from trainees’ panels (e.g., high clinic/ER utilizers, those facing multiple co-morbidities, chronic pain, and/or psychosocial impediments)
- Combines resources and expertise from trainees and supervisors across disciplines (NP, MD, RN case manager, PsyD/PhD, PharmD, SW, etc.) on a specific patient case to improve patient-centered care outcomes
Referral patterns of patients from Silver Team addressed during PACT ICU reflect how the Center is embracing more multidisciplinary perspectives. In particular, involvement of pharmacy, psychology and social work in providing care has increased, compared with control teams, especially for "warm handoffs."
Curriculum of Inquiry - begins with a seminar series that addresses systems issues and incentives, guidelines for framing a good question and evidence-based practice. Criteria for project development and presentation include:
- Designing research, quality improvement and/or advocacy projects that are data-driven
- Selecting projects that spark interdisciplinary interest, since groups must include at least three learners and two disciplines
- Outlining group findings monthly at "works in progress" meetings
- Describing final projects in a series of medicine grand rounds
To cite an example project, a study of the literature and accrediting bodies of NPs, Internal Medicine, Clinical Pharmacy and Clinical Psychology has yielded a cross-sectional matrix of differences and similarities between disciplines’ competencies, amount of schooling, work experience, and state licensing. This breakdown, summarized in Venn diagrams, has helped facilitate dialogue and increase understanding across medical disciplines at the Boise VA and when presented at other venues.