Stories From The Nexus

This summary of the Northern Maine Interprofessional Collaborative Practice (IPCP) Summit, held April 14, 2015, was written by Doug Wood, PhD, DO, dean of the University of New England (UNE) College of Osteopathic Medicine, Dora Anne Mills, MD, MPH, vice president for Clinical Affairs, UNE, and Shelley Cohen Konrad, PhD, LCSW, director of the Center of Excellence in IPE, UNE. The authors are also the principal investigators for the UNE Josiah Macy Jr. Foundation grant, “From Campus Curriculum to Rural Community Health Centers: A Statewide Model of Osteopathic IPE.”

Whenever a group of us from the University of New England (UNE), located in southern Maine, drives five hours to Aroostook County, we are struck by the beauty and serenity of its rolling hill

s blanketed with potato fields that sink into a low, wide horizon. The pulse of potato farming is felt throughout the year and throughout this region, which forms the state’s northern border with Canada.

In mid-April, with the ground still covered in snow, a group of us from UNE drove north to convene the Northern Maine Interprofessional Collaborative Practice (IPCP) Summit. We, too, were farmers, working alongside our colleagues in Aroostook County, to plant and harvest ideas to improve team-based health care practice and education. 

The Northern Maine Summit hosted approximately 80 individuals and teams from three federally qualified health centers (FQHCs), four hospitals, independent dental and behavioral health practices and four regional higher education institutions. Based on a similar summit supported by the Josiah Macy Jr. Foundation and hosted by UNE in southern Maine in 2014, the Northern Maine Summit promised to reap its own variety of ideas with a rural flavor to nourish interprofessional practice.

We have learned that rural areas, and especially rural FQHCs, are fertile soil for interprofessional practice and education (IPE). With primary care, behavioral health, oral health and pharmacy often housed under one roof – and with rural culture commonly very conducive to tight collaborations and effective teamwork – interprofessional practice is often a suitable crop for this environment.

Our hope is that by planting the seeds of awareness of national and state IPE and IPCP efforts we can help improve the team-based care delivered in these underserved areas as well as address the chronic workforce shortages experienced in rural Maine.

During the afternoon of the summit, we discussed and discerned with our Aroostook colleagues next steps to continue growing IPE and IPCP in northern Maine. Since some UNE health professions students already complete some of their clinical clerkships in the county, two steps identified were:  1) To further train preceptors in interprofessional concepts; and 2) To collaboratively develop interprofessional learning opportunities for those existing students.

To make a sustainable impact, we also want to increase the number of students in rural clerkships to help address the area’s chronic workforce shortages. Implementing these clerkships is a focus of a major four-year Josiah Macy Jr. Foundation grant to UNE with the ultimate goals of: ensuring that all UNE health professions graduates are equipped with the necessary team-based skills to ensure high quality patient-centered care; and addressing health workforce shortages in rural Maine.

Moving forward, we plan on creating a learning collaborative modeled after the Institute for Healthcare Improvement’s Breakthrough Series, using distance technology, such as webinars and conference calls, to augment occasional on-site meetings that support rural clinical faculty development with this network of Aroostook County community health centers as well as with hospital and other affiliated practices.

What was our biggest lesson from the summit? It was that the culture of rural areas can teach us a lot about interprofessionalism.

For instance, one story we heard is that an especially dry growing season in 2012 meant farmers had to delay the potato harvest. Without much notice, local schools responded by delaying their annual October harvest break. As one school superintendent noted, “These farmers pay taxes that support our communities and they need the students to bring in their crop. It just makes sense for us to work together.”[i] 

Indeed, these types of interprofessional partnerships that support each other are a foundation for IPE. We believe the journey with our clinical partners in Aroostook County will truly be a learning collaborative for all of us, as we learn from, with and about each other.

Planning your own long-distance summit?

Putting on a summit in a rural area five hours from our campus was challenging, but we learned a few pearls that may help others interested in doing the same:

National and local partnerships are key to success. With support from the Josiah Macy Jr. Foundation, and the ability to “beam in” National Center senior advisor Frank Cerra, MD, for a keynote address, our national collaborators were important resources. Our partnership with UNE’s Maine Area Health Education Center (Maine AHEC), with its regional center at the Northern Maine Community College, resulted in financial support, a local hosting site and easy connections with local leadership.

Engaging students in the summit enhances the discussion. One medical student in attendance not only shared some helpful ideas, but she also explained to the audience that despite having trepidations about spending three months in Aroostook, now that she is toward the end of a clerkship there, she feels rooted and wants to return to live and work after completing her training.

Using some standardized curriculum, from resources such as TeamSTEPPS’ Primary Care module and facilitated learning materials from our colleagues at the University of Toronto, provides an easy way to create evidence-based multimedia and engaging presentations that also gives the audience some access to ongoing resources.

Establishing in-person university community relationships early on is essential to developing interprofessional practice and education aimed at health care transformation. These in-person collaborative meetings help us to recognize the individuality of communities, which can lead to more robust and sustainable clinical education and systems change.

Interested in learning more? Please contact the UNE team at ipec@une.edu.

http://bangordailynews.com/2012/09/14/news/aroostook/potato-harvest-break-adjusted-in-parts-of-aroostook-county-to-meet-farmers-needs/