Welcome to the third issue of our new international magazine, Together: Stories of Collective Impact . This month we are pleased to continue to evolve the magazine, and are delighted to continue to receive submissions from around the world, e.g. a beautiful piece on elder care from Japan (p16). We also invited several pieces from our American colleagues, including from Case Western Reserve University and Arizona State University. Together aims to create a tangible space for us to connect, learn, share, celebrate, and champion how we work and learn together for a healthier world.
To all who are reading this magazine, thank you for continuing to share your stories, events, and cover art. And we look forward to your f uture submissions , feedback, and reactions
With gratitude,
Stella Ng
CACHE Director, on behalf of the CACHE Team
CACHE Editorial Team, Spring 2023
Eli Cadavid (Lead Editor)
Belinda Vilhena
Farah Friesen
Noor Yassein
Sofia Mirzazada
Stella Ng
Benji Nova (BenjiNova.com)
“The Light of Awareness” is a piece of art that embodies the essence of mindfulness and inner stillness. It features a flower character, which serves as a reminder of the beauty and grace that exists in nature, and an eye that symbolizes awareness. The eye represents the ability to observe one’s thoughts, emotions, and surroundings without judgment, and to tap into the deeper wisdom and intuition that lies within.
This piece is meant to serve as a visual representation of the concept of mindfulness, which has been increasingly recognized as an important practice in healthcare and education. By cultivating mindfulness, individuals can improve their ability to manage stress, cope with pain and illness, and enhance their overall well-being.
“The Light of Awareness” is a celebration of the potential for growth and healing that lies within each of us. It invites the viewer to pause and take a moment to connect with their inner selves and the world around them. It is a reminder that, even in the midst of chaos and uncertainty, we can always find a sense of peace and clarity by tuning in to the present moment.
As a cover piece for a magazine focused on collaborative healthcare and education, “The Light of Awareness” serves as a powerful representation of the importance of mindfulness in these fields. It encourages collaboration and teamwork by highlighting the shared goal of improving the well-being of individuals and communities. The eye serves as a reminder that, by cultivating awareness and compassion, we can become better healthcare providers, educators, and human beings.
Collaborative Change Leadership TM (CCL TM ) Certificate Program Receives
Ivan Silver Innovation Award!
CACHE Editorial Team
Congratulations to the Collaborative Change LeadershipTM (CCL) Certificate Program on being the 2021-2022 recipient of the Ivan Silver Innovation Award from the Continuing Professional Development office, Temerty Faculty of Medicine, University of Toronto.
This award recognizes the faculty: Mandy Lowe (Assistant Professor, Dept. of Occupational Science and Occupational Therapy), Maria Tassone (Assistant Professor, Dept. of Physical Therapy), Kathryn Parker (Associate Professor, Dept. of Pediatrics), Jill Shaver (Consultant, BJ Shaver Consulting), and Belinda Vilhena (Director, Operations and Business Development, CACHE – University of Toronto) for Collaborative Change LeadershipTM (CCL) Program: A Certificate Program for Leaders in Health and Health Education.
The Ivan Silver Innovation Award recognizes an innovative Continuing Professional Development (CPD) initiative developed and delivered by a University of Toronto faculty member or team that has demonstrated an impact on health professionals’ performance or improved health outcomes.
CCL is an exemplary CPD program that encompasses innovation in content and program delivery with demonstrated impact. Leadership in healthcare has been identified as a critical enabler and facilitator of the success of interprofessional collaboration (IPC) and patient-centred care within organizations. CCL brings together the fields of health delivery, interprofessional practice, and change leadership to offer a program to enhance leadership in challenging and uncertain times. Alumni are reaching out to share that they are engaging their teams and communities in compassionate and meaningful ways to co-create and sustain system change, achieving rapid, efficient, and unprecedented results.
Learn more about CCL: https://collaborativechangeleadership.ca/
Sylvia Langlois, PhD, MSc. OT Reg. (Associate Director, Curriculum & Faculty Relations, CACHE) and Paula Rowland, PhD (Research Advisor, CACHE) are recipients of the 2023 CAME Certificate of Merit.
The CAME Certificate of Merit Award promotes, recognizes, and rewards faculty committed to medical education in Canadian medical schools, and was be presented at the International Congress on Academic Medicine (ICAM).
Sylvia (Associate Professor) and Paula (Assistant Professor) are recognized for their exceptional contributions to health professions education research and practice through their appointments at the Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto.
Sylvia is passionate about relationship-centred work and building partnerships and engagement with those with experiential knowledge, students, and community organizations to foster student learning opportunities. She is keenly interested in student engagement and leadership in curriculum development and evaluation. Sylvia co-chairs the IPE Network of the Association of Faculties of Medicine of Canada (AFMC) and holds roles with InterprofessionalResearch.Global (IPRGlobal).
Paula focuses on broad mandates to reform the practice of health professionals within clinical workplaces. Her existing research has explored two substantive change efforts: patient engagement programs, and patient safety and quality improvement programs. In each of these domains, Paula explores questions about knowledge, power, and identity. Conceptually and theoretically, her work makes connections between sociology of the professions, sociology of work, and health professions education.
Congratulations Sylvia and Paula!
Denise Ponte joined the CACHE team as the Administrative Coordinator, Research & Innovation in September 2022, specifically working on CACHE’s project within the Team Primary Care: Training for Transformation initiative. Denise graduated from York University with a Honours Bachelor of Science in Kinesiology and Health Science, and has spent the last 10 years coordinating grant projects and events in the nonprofit sector.
Denise is an avid traveler and has traveled to more than 30 countries across Europe, the Middle East, and Asia. She is hoping her next adventure finds her in South America.
CACHE Editorial Team
Student-Led Environments to Deliver Virtual Autism Supports for Wait-times (SLED-VAST) is a new Student-Led Environment (SLE) and received the 2021/2022 Minister’s Award of Excellence from the Ministry of Colleges and Universities . Out of 540 nominations, there were 22 winners across 5 categories. SLED-VAST was 1 of 5 winners in the Future-Proofing Ontario’s Students category, which recognizes faculty and staff who have led the way in adapting programs that support new ways of learning.
SLEs are unique workplace-based learning opportunities where health professional learners, under the supervision and support of preceptors and facilitators, collaborate to create a discipline-specific or interprofessional learning environment; build their collaborative leadership competencies; and address a significant and identified gap in the workplace that would otherwise not be met and/or adds to existing service delivery. SLED-VAST facilitators include Gunjan Seth and Alifa Khan (family leaders through Holland Bloorview’s Family as Faculty program), Amanda Binns, PhD, SLP - CCC Reg. CASLPO, and Farah Friesen, MI (SLED-VAST Co-Leads).
SLED-VAST mobilizes education science to promote inquiry, empathy, and integration among health professions learners from a range of professions (e.g. occupational therapy, speech-language pathology, social work). It bridges the best evidence on how to train future health professionals with the latest evidence for how best to support autistic children from a neurodiversity affirming perspective, and moves these approaches into front-line supports.
In addition, SLED-VAST leverages technology to ensure that Northern Ontario communities are well served.
SLED-VAST fosters critical reflection, interprofessional collaboration, and knowledge of strengths-based, neurodiversity-affirming approaches to autism in a learning and practice environment informed by the transformative paradigm of education. By inspiring critical reflection – that is, questioning, challenging, and disrupting potentially harmful assumptions and norms in practice – SLED-VAST provides learners with a way to reimagine and enact more collaborative, compassionate ways of being and practicing, both for this specific initiative but also as a framework in their future learning and clinical practice.
The learners are integral to any SLE and the success of SLED-VAST is all thanks to the passionate interprofessional students who are volunteering their expertise and time to contribute to this initiative. The Minister’s Award was awarded to the whole SLED-VAST as a team, including the learners, facilitators, and Consortium, recognizing the value of collaboration. Often, there is only individual recognition when we know that working together is valuable and improves outcomes – whether it’s education, research or practice. The Award also means a lot as it recognizes a way of delivering education and clinically-relevant practice experiences for learners that is not yet the norm, yet perhaps is the way of the future.
Learn more about how SLED-VAST addresses workforce shortages and provides unique interprofessional learning experiences:
• Holland Bloorview: https://hollandbloorview.ca/stories-news-events/news/holland-bloorview-receives-twoawards-minister-colleges-and-universities
• Michener: https://michener.ca/initiative-to-launch-virtual-student-led-clinic-serving-autistic-children-receivesministers-award-of-excellence/
• UHN: https://www.uhn.ca/corporate/News/Pages/Initiative_to_launch_virtual_student_led_clinic_serving_ autistic_children_gets_high_marks.aspx
SLED-VAST is supported by the Ministry of Children, Community and Social Services through the Ontario Autism Program (OAP) Workforce Capacity Fund and developed in partnership with the SLED-VAST Consortium, including collaborators at George Jeffries Children’s Centre, Holland Bloorview Kids Rehabilitation Hospital, McMaster University, NOSM University, UHN’s The Institute for Education Research (TIER), Western University, and others.
For learners interested in volunteering with SLED-VAST, please contact SLED-VAST@utoronto.ca.
The Centre for Advancing Collaborative Healthcare & Education (CACHE) has established annual Awards of Merit for Excellence in Interprofessional Education in the following four categories:
• Ivy Oandasan Leadership Award
• Award of Merit for Outstanding Role Modeling of Interprofessional Collaboration for Patient-Centred Care to Learners
• Award of Merit for Excellence - Interprofessional Education Teaching (individual or team)
• Susan J. Wagner Student Leadership Award in Interprofessional Education
Awards are open to educators/preceptors affiliated with the University of Toronto who have had teaching or supervisory responsibilities directly with University of Toronto students. The student award is open to University of Toronto students in the Health Sciences who are graduating in the spring or fall of the award year (2023).
Submissions are due Friday, June 30, 2023. Please email sabrina.bartlett@uhn.ca if you have any questions.
Darlene
Hubley, MScCH, BScOT, OT Reg. (Ont.) (IPE Leader, Holland Bloorview Kids Rehabilitation Hospital)
I am an occupational therapist and the IPE Leader at Holland Bloorview Kids Rehabilitation Hospital. I have enjoyed a long standing relationship with the University of Toronto through the Department of Occupational Science and Occupational Therapy as a lecturer, through the Centre for Faculty Development as a member of the faculty development leaders network, and through CACHE as a member and now co-chair of the IPE Leaders Network . I am interested in designing and facilitating meaningful interprofessional education opportunities that foster compassionate and collaborative client and family-centred care.
I am passionate about bringing the stories of people with lived experience to education. I am hopeful that by connecting in an authentic way with children/youth with disability and their family members, learners and practitioners in health care provider roles will continue to view collaboration as essential to care and take action to do more together. For me, transformation happens when kindness motivates us to see people’s strengths and abilities, and allows us to work together to enable their autonomy, agency, and role within the community. I have seen how teaching and learning with youth leaders, and with family as faculty (both patient educators) enables students in the health professions to have generative conversations with children/youth with disability and family members and to have the confidence to truly partner with people (children/youth, family, colleagues, community partners etc.) to move forward together.
Participation in the CACHE IPE curriculum prepares learners for collaboration in the clinical environment. Students really enjoy meeting each other and learning about each other’s roles, especially when the roles can be explored within a clinical context. Service users articulate the value of collaborative care and express appreciation for participating in IPE as a way to impact health and social care systems. I also notice how collaborative projects spark creativity and innovation and am excited to see how student leadership is emerging as a catalyst for system change.
To highlight some of my scholarly work and projects I have noted the following points:
• I collaborated with Kathryn Parker, Maria Tassone, Mandy Lowe and Tracey Paulenko to co-create a theory of impact of IPE. Our work has been presented at local, national and international conferences.
• I am a member of our faculty team that provides faculty development for patient educators. We have a manuscript in review.
• Collaboration Across Borders (CAB VIII) is approaching and I will be involved in several oral presentations and networking events.
• I have been invited along with a group of TAHSN colleagues to present on student-led learning environments (SLEs) at the upcoming IPC Collaboration Showcase. I have been fortunate to be in a supporting role for emerging SLEs at Holland Bloorview.
Community Health through Indigenous Research Gregory Cajete, PhD (University of New Mexico)
Community health and well-being will be explored through the lens of Indigenous research paradigms based on Indigenous knowledge systems, community values, and building sustainable Indigenous communities. Special emphasis will be placed on Indigenous oriented community-based research and health education.
1. Describe the important themes and context of community-based research and education related to Indigenous Communities.
2. Explain the general considerations for health research and education through an Indigenous lens.
www.collaboratingacrossborders.com
Sharona Kanofsky, PA-C, CCPA, MScCH (Physician Assistant Program, Temerty Faculty of Medicine, University of Toronto); Karen Ng, RPh, PharmD, BScPhm, ACPR (Interfaculty Pain Curriculum, University of Toronto)
The expression “no pain, no gain” might be an outdated exercise motto, but over 1200 students from 8 health professions programs certainly gained from their participation in the University of Toronto (UofT) Centre for the Study of Pain’s Interfaculty Pain Curriculum (IPC), delivered in collaboration with CACHE on March 6-8, 2023.
As one of the first interprofessional learning activities at UofT, IPC started in 20011, marking this year the 22nd iteration of the curriculum. IPC strives to support our future health care providers in understanding pain science, and the complex interplay of the pain experience with one’s environment while applying the biopsychosocial principles of pain self-management. Students participating in IPC have long benefited from the dual focus of the multi-day curriculum: learning about pain and its management in clinical practice, while also learning and experiencing the impact of interprofessional teamwork in the delivery of patient-centred care. However, while these dual educational priorities have remained the same, many aspects of healthcare education and the landscape of pain management have changed in recent years.
In response to these shifting winds, several innovations were made in the delivery of this year’s IPC 2023 “Making Connections.” These include a new hybrid delivery of the 3-day curriculum; the engagement of patient partners within the working groups and as small group facilitators; the engagement of students in working groups during the planning stages; and a flipped classroom approach, prioritizing student engagement.
For most of its history, IPC was delivered fully in person, with students attending large lectures and small group sessions across St. George campus in downtown Toronto.
In 2021 and 2022, like most educational activities, IPC was delivered fully online, due to the pandemic. This year, we attempted to combine the best of both worlds – blending the convenience of online learning with the rich learning experience offered by in-person facilitated small-group learning. Teaching during the pandemic demonstrated to us that virtual learning can either improve or degrade the quality of educational experiences, depending on deliberate and informed choices made by educators. For example, some content can be delivered effectively using virtual asynchronous platforms, while deeper learning, such as applying knowledge, skills, and values to patient cases in small groups, is more effective and engaging in person. Meaningful learning can also happen online synchronously, by leveraging technology that prioritizes engagement and interaction among participants. We used all these options to deliver IPC.
As we learn more about the value of person-centred care, we are prioritizing and valuing the voice of the patient or client in healthcare and health systems decision-making. Based on this understanding, we have included patient partners in our curriculum planning and as small group facilitators in this year’s curriculum. We delivered this as a pilot this year, with approximately 10 student groups benefiting from a faculty facilitator paired with a patient partner facilitator.
In addition to patient and client voices, student voices are invaluable in developing educational content. This year, we have expanded our student representation in IPC by including student members on some of our working groups. We hope to get even more students involved in the co-development of next year’s IPC.
Lastly, and perhaps the most fun innovation, we focused on the flipped classroom educational approach. The flipped classroom acknowledges that primarily knowledge-based direct instruction can be delivered outside of class time, and that the best use of class time is to apply and deepen knowledge, practice skills, and develop attitudes and values, through more interactive activities, such as case discussions and games. To engage students from the start of the curriculum, we kicked off the three days of learning with some fun and friendly competition. During the two weeks leading to the start of the curriculum, we asked students to
complete a significant portion of the knowledgebased content as independent prework. To help them feel accountable to themselves and their teammates, we reminded students that they would be competing in a knowledge bowl game to help their teams gain points and win places on the podium and prizes. At the very start of the curriculum on Monday morning, teams of 11 students were placed in virtual breakout rooms. Following some introductions and icebreakers, teams worked together to find answers to questions based on the prework. This was followed by a fun and competitive Kahoot! game. Playing a fast-paced virtual game with over 1200 students was no small feat, requiring a significant technical lift, but thanks to the support of our IT team at Discovery Commons and the lively game show hosted by CACHE’s Sabrina Bartlett and Dean Lising, the game ran without a hitch.
The delivery of this robust curriculum would not have been possible without the dedication of our administrative duo Megan Valencia and Shelley O’Brien, IPC planning committee, 6 working groups, facilitators, patient partners, and student representatives. So far, we received mainly positive anecdotal feedback from facilitators and students. In the coming weeks, we plan to review survey feedback provided by students and facilitators and we look forward to discovering which of our innovations were successful and which can be updated for the next iteration of IPC 2024. When our health professions students learn about providing optimal care for patients experiencing pain, we all stand to gain.
Siobhan McKittrick, Reg. PT (Physical Therapist & Interprofessional Educator, Toronto Rehabilitation Institute)
February 13-17, 2023 marked UHN’s Teaching and Learning Week, while also coinciding with Heart Month and Valentine’s Day. This was the perfect time for Bickle’s newly established Practice Committee to host an interprofessional education showcase in their on-site auditorium. The Practice Committee was established only a few months ago with the intention of bringing representatives from health professions present in Bickle Centre, to engage staff in learning and best practice, and to have different health professions guiding the Centre’s staff education needs in a collaborative manner. A renewed focus on Code Blue Education was highlighted by the committee, and was the perfect topic to host over two afternoons in February.
The team of facilitators – which consisted of a range of health professions including educators, patient care coordinators, a physician, a social worker, a physiotherapist, a pharmacist, a nurse practitioner, an occupational therapist, a respiratory therapist, and two Wellness partners – put together an interactive format that allowed staff hands-on learning with different aspects of a code blue at different facilitator stations, but also had them take part in an overall code blue simulation led by a physician and nurse educator. There was a large emphasis on fun learning, which incorporated interactive games at various stations, and was embraced positively by the staff attending. The afternoons were well attended by a variety of professions and demonstrated the possibilities of interprofessional teaching and learning that could be embraced for many future topics – plans are already underway for the next interactive education showcase in Bickle Centre!
Greg Noack, Author, Speaker, Researcher (Rehab Therapist, Toronto Rehabilitation Institute)
Peter Kyriakides, Mentor, Speaker (Patient Partner, UHN)
Brothers Of Brain Injury (BOBI) is a talk of how two young men with brain injuries came into contact. One a Rehab Therapist, and the other a patient. It is a story of tragedy, hope, and triumph. The talk is given to patients of Toronto Rehab, students, and staff upon request. They share their stories of how they acquired their injury, their challenges and how they overcame them, and what they learned from each other. They have combined their unique stories to help uplift, empower, and educate patients, families, and staff on the impacts and possibilities of brain injury. BOBI showcases when patients and care professionals work together as teammates the best outcomes are achieved. Not only does BOBI highlight the importance of coordinating and treating patients as team members, it also shows the impact and educational benefit it brings to the wider community.
If you’re interested in attending, please contact: greg.noack@uhn.ca
Sara Morassaei, MSc (Program Manager, Practice-based Research and Innovation, Sunnybrook Health Sciences Centre)
Lisa Di Prospero, MRT(T), MSc (Director, Practice-based Research and Innovation, Sunnybrook Health Sciences Centre)
Every year at Sunnybrook Health Sciences Centre, the Practice-based Research and Innovation (PBRI) portfolio hosts the TAHSNp Innovation Fellowship Program with the support of clinical program and department leaders. The Fellowship was established to build leadership and quality improvement (QI) capacity in our point-of-care health professionals. After almost a decade since the start of the program, we are celebrating our most interprofessional cohort ever – the 2022-23 cohort includes Fellows from seven different health professions! Over six months, the Fellows met weekly in an interprofessional environment that includes didactic and practical learning, as well as the ever-so-important “round-table” sessions. This is our time to share, rejoice, rant, and support each other through the ups and downs of designing and implementing QI changes. We are not only tremendously proud of our diverse mix of Fellows for having the courage and commitment to lead innovative projects, but also for the exceptional and authentic support that they have provided to each other throughout their journeys.
“My co-fellows have been the ultimate source of support. Our cohort created a safe environment to promote sharing and learning. When I was stuck or unsure, my co-fellows provided feedback that I would have never thought of. I also felt comfortable to share my thoughts and ideas about others’ projects. That is what makes this fellowship cohort so great - we all get to implement our own individual passion projects, but also learn and support each other in a supportive, collaborative space.” [Kelly Bishop, Occupational Therapist, 2022-23 Fellow]
“The Fellowship program has made me feel more connected to health professionals outside of my program. It is empowering to learn of the work that others are doing across the hospital. Even if our clinical work does not directly intersect, we share many similar opportunities and challenges.” [Larissa Waldman, Genetic Counsellor, 2022-23 Fellow]
For more information on the Fellowship program, please see the paper below:
Smith, K. A., Morassaei, S., Ruco, A., Bola, R., Currie, K. L., Cooper, N., & Di Prospero, L. (2022). An evaluation of the impact for healthcare professionals after a leadership innovation fellowship program. J ournal of Medical Imaging and Radiation Sciences, 53(4S), S137–S144. https://www.jmirs.org/ article/S1939-8654(22)00355-1/fulltext
Elizabeth Williamson, RN, MN, CRN (C) (Advanced Practice Nurse at Sunnybrook Health Sciences Centre, St. John’s Rehab Program and Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto)
Jennifer Shaffer, PT, MSc (RS), BSc (PT), BSc (Professional Practice Leader, Physiotherapy, Sunnybrook Health Sciences Centre, St. John’s Rehab Program and Status-Only Lecturer, Dept. of Physical Therapy, Temerty Faculty of Medicine, University of Toronto)
Peter Broadhurst, MD, FRCPC (Physiatrist, Sunnybrook Health Sciences Centre and Assistant Professor, Dept. of Medicine, Temerty Faculty of Medicine, University of Toronto)
In February 2023, three of our clinical leaders collaborated to develop and facilitate a unique Interprofessional Education (IPE) Elective Learning Activity, entitled “The Nuts and Bolts of In-Patient Rehab.” This in-person session took place at the St. John’s Rehab (SJR) Program of Sunnybrook Health Sciences Centre. The three hour session was well attended by learners of various professions, which included medicine, nursing, chiropractic, and office administration.
During the session, the learners were engaged in activities which introduced them to the roles of various members of the interprofessional team. They were provided with an overview of rehabilitation and the SJR program, and were able to observe the interprofessional teams on the inpatient units. Following this, they had the opportunity to put these learnings into action, by rotating through various activity stations, which included testing of balance, cognition, fine motor and gross motor skills, as well as mobility aids.
Although each of these three clinical leaders have unique skills and diverse professional backgrounds, the commonality is their passion for the specialty of rehabilitation, and the importance of introducing learners and novice clinicians to a rehabilitation environment with a collaborative practice lens.
Overall, the evaluations were very positive, and the facilitators are looking forward to facilitating future sessions.
Any correspondence can be directed to Liz.Williamson@sunnybrook.ca
Paula Carere, NPPHC, BSCN, MEd. (Clinic Director, Waterloo Region Nurse Practitioner Led Clinic)
Evgenia Oreshkin, B.Sc.Phm., R.Ph. (Clinical Pharmacist,
Waterloo Region Nurse Practitioner Led Clinic)
The packed schedule at the Waterloo Region Nurse Practitioner Led Clinic (WRNPLC) means this interprofessional primary care team will be busy providing patient-centred primary care to people of all ages, stages and health conditions.
Reflecting their philosophy of “Partnering for Health,” the team consists of nurse practitioners (NP), registered practical nurses (RPN), social workers, and pharmacists working in collaboration and to full scope of practice, all supported by capable reception staff. Programs are flexible, based on changing client needs, and led by team members depending on their expertise. They include medication reviews, spirometry, IUS and Nexplanon insertion, and Cognitive Behavioural Therapy. The strength of the team truly stands out in their shared care for complex patients – those with multiple chronic conditions, mental health, financial, and social issues.
Bronwyn O’Neill, a 2nd year NP student from McMaster University, met the team during her rotation, and shared her thoughts: “Allied Health Professionals are integral to providing comprehensive primary healthcare. Members such as pharmacists, social workers complement the role of the NP for patients to have access to holistic, effective, and efficient healthcare. Once you understand the skills and knowledge of each team member, the team becomes stronger. I will prioritize employment that has access to a team of Allied Health Professionals.”
To increase interprofessional education, Bronwyn suggests more opportunities for students to build relationships and partnerships across disciplines.
Interprofessional collaboration occurs daily at the Waterloo Region NP Clinic, and patients’ feedback reveals the appreciation for this patient-centred interprofessional care.
Olivia Petric, BSc, MHSc, SLP (Sunnybrook Health Sciences Centre); Anthea Ching; Rizla Dias, BNSc., MN (Sunnybrook Health Sciences Centre); Annie Hoang, MEd, RD (Sunnybrook Health Sciences Centre); Colleen Miller, MHSc, RD (Sunnybrook Health Sciences Centre); Zubeen Dharshi, MSc.SLP, CCC-SLP (Sunnybrook Health Sciences Centre); Angela Cheung (Sunnybrook Health Sciences Centre); Melodie Santos (Sunnybrook Health Sciences Centre); Wendy Kingsburgh, MSW, RSW, MSc (Sunnybrook Health Sciences Centre); Rhoda Lordly, B. Comm, CRM, CPPS, MSc(HQ), RSO-1 (Sunnybrook Health Sciences Centre)
The correct meal tray arriving at a patient’s bedside is a complex process involving collaboration among many health professionals and staff. A recent patient safety concern prompted teams to evaluate current processes, which highlighted opportunities to improve coordination of the complex steps involved in manual customization of the meal tray. As patients advance from NPO (nothing by mouth) to oral nutrition, it is common practice at Sunnybrook Health Sciences Centre to begin with a few pureed items to confirm tolerance before full meals are ordered. Creating a new diet order for this common practice would enable a more streamlined and efficient process.
In January 2022, a collaborative process mapping exercise was facilitated by risk and patient safety, which included key stakeholders from the interprofessional team including clinical nutrition, foodservices, nursing, and speechlanguage pathology (S-LP). The team identified gaps within the current process, and a sampled process was created to reduce risk for patients on dysphagia diets.
A new diet order, “Pureed Snacks TID”, was created in May 2022, which provides a single pureed item and single fluid item three times daily. This creates a tray of limited items thereby enabling CN and SLP staff to provide safer and more efficient delivery of care through diet progression.
Since implementation, no further safety incidents have been raised. Additional populations have benefitted from this development, such as patients with decreased level of alertness who are unable to stay awake and alert for a full meal, and palliative care patients feeding for comfort and not able to tolerate full meals.
A new way of training core concepts for patient-centered, team-based healthcare delivery
Barret Michalec, PhD (Director, Center for Advancing Interprofessional Practice, Education and Research, Arizona State University)
Yvonne Price, MAMC (Associate Director, Learning Solutions, Center for Advancing Interprofessional Practice, Education and Research, Arizona State University)
Jody Thompson, MS (Center for Advancing Interprofessional Practice, Education & Research, Arizona State University)
I-TEAM By Design™ is the most recent training offered by the Center for Advancing Interprofessional Practice, Education and Research (CAIPER) at Arizona State University.
Developed for both health professionals and health professions students, this accredited course is designed to cultivate and optimize interprofessional skills related to empathy, connectivity, emotional intelligence, humility, and self/other awareness.
Dr. Barret Michalec, CAIPER Director and content author for the course, provided a quick overview:
“Health professionals and health profession students are often told “Be more empathic” and “Be more of a team player” – but what does that even MEAN? Well, I-TEAM By Design™ spells it out for you in ways that relate to your professional development as well as you as a person, because you are more than your professional role.
We do this by first dissecting the concepts and debates surrounding such hot topics as empathy, humility, emotions, mindfulness, and then outlining how and why these attributes and practices are ‘good’ for patientcentered, team-based healthcare delivery as well as your own personal well-being.”
This short course keeps learners actively involved (and entertained) through animated modules that include pause activities for reflection, gamified knowledge checks to reinforce key concepts, and opportunities to practice through “workouts” in the I-TEAM gym.
Easy to integrate in pre-existing courses, stackable credentials, or other offerings within clinical, professional, and academic settings, learners who complete the course are eligible to earn a digital badge and certificate of completion as well as 8 continuing education credits in 6 different health and social care professions.
Visit the CAIPER website to learn more about I-TEAM By Design™.
Yuka Okada, RN (Director of Care, Momji Health Care Society)
Appeared in Japanese in TORJA magazine, Feb. 2023 issue. Below is the first time the English translation has been printed.
When a group of nurses gather, they usually introduce themselves by the department they work in,
“I’m in neurosurgery.” “Oh wow!”
“I’m in an organ transplant unit.” “Cool!”
“I’m in an operating room.” “Super!”
“I work at a senior’s home.”
One hundred percent of the time, this statement is followed with awkward silence giving the impression that nursing for the elderly isn’t exciting, desirable, or important. But I’ve been in this field for over three decades and I enjoy every single day and find the work very fulfilling.
The reason for my contentment dates back to the very first day I started training as a personal support worker (PSW). I had been assigned an elderly woman who was 100 years old, blind, hearing impaired, unable to communicate, with restricted mobility and diminished cognition rendering her in need of total care, including feeding. Her multiple comorbidities made other staff somewhat reluctant to provide care for her.
As a fresh and naïve student, I was determined to follow everything exactly as it had been taught and written in textbooks, so I explained each food on her plate before bringing it to her mouth. It was a slow, laborious process and the other staff chastised me saying,
“If you do that, you’ll need all day to feed her!” Being a very diligent student since day one of my practicum, I continued to feed her spoonful by spoonful explaining what she would be eating. When she finished the last spoonful of dessert, I was so surprised and moved to hear this elderly woman clearly say, “Thank You” while looking directly at me. I thought this must be how Dr. Anne Sullivan felt when she was able to communicate with Helen Keller for the first time.
Thirty years later, that moment still has an incredible impact on me and is a source of fulfillment and optimism to continue my work supporting the health, wellness, and independence of seniors. Whether as a PSW, practicing nurse, or now a director of nursing, I remain happy and fulfilled in my work.
I also receive daily confirmation and inspiration from the seniors I serve. Although I am the one to be offering assistance, it is actually the seniors who provide support to me. Their ongoing expressions of gratitude and keen observations of life and living touch my soul every time. Our conversations are steeped with their rich lived experiences offering wisdom and encouragement far beyond my understanding. This has made me so very grateful for my life’s work in nursing.
To the untrained ear, some of the seniors’ comments could sound like complaints or sermons. What I hear is a person’s life story. It’s like watching mini-movies where the seniors are the main characters. I can picture them as the handsome men and beautiful women they were in their youth and I am fascinated to hear their stories about facing life challenges, enjoying fun moments, and even the times when they were a bit naughty.
I honestly never get bored of hearing their stories. I often imagine what kind of life and personality this person once had. What did they like to do? Were they good at gardening, cooking, maybe they liked travelling? I have discovered that most made significant contributions to their communities through their volunteer efforts and donations. My experiences constantly remind me that all people deserve to be treated with dignity and respect.
Losing one’s cognitive capacity is what everyone fears, but even those living with dementia have not lost their “hearts” - their emotions and the way they feel hasn’t changed much. It really is a magical experience when the person with dementia and I connect with one another through a shared feeling. We don’t need language to understand each other.
In the autumn, maple trees ripen into beautiful colours and sparkle when the sun shines on them; we value this and go to great effort to view and appreciate them in the Fall. I believe the same can be said about the aging of humans. As we near the end of our lives, our thoughts and experiences ripen into wisdom allowing our authentic selves to shine. We, the people who are engaged in supporting seniors, believe it is our mission to help seniors shine. Stated another way, I believe we serve seniors by observing the culmination of their past experiences while being the witness to their unique existence in this world here and now.
For all these reasons, I love my work and find my interactions with seniors irreplaceable. I consider myself extremely fortunate and am humbled to be involved in each senior’s life.
And I often relay my seminal story to new recruits because I find it helps ground them in understanding the philosophy of care our department strives to achieve collaboratively. It also gives the other nurses and PSWs tremendous purpose and meaning, knowing they are providing care that genuinely puts the person first over the task.
So at nurses’ gatherings, I smile proudly at the awkward silence.
Elizabeth McLaney, MEd, BScOT, OT Reg. (Ont), BAH (Psychology) (Associate Director of Workplace Learning, CACHE & Director of Interprofessional & Academic Education, Sunnybrook Health Sciences Centre); Lindsay Baker, BEd MEd (Associate Director, Curriculum Integration and Partnerships, CFD); Maria Mylopoulos, PhD (Scientist & Associate Director of Training Programs, Wilson Centre); Manpreet Saini, MSc (Education Coordinator, Curriculum and Programs, CFD)
Best Practices in Education Rounds (BPER) are monthly 1-hour virtual rounds co-hosted by the Centre for Faculty Development (CFD), The Wilson Centre, and the Centre for Advancing Collaborative Healthcare & Education (CACHE). BPER provides the opportunity to share innovative and emerging ideas with a wide audience of interested health professional teachers, educators, leaders, scholars, and patient/client and family partners. BPER is co-led collaboratively by a representative from each Centre (CFD: Lindsay Baker; Wilson Centre: Maria Mylopoulos; CACHE: Elizabeth McLaney).
This year, the leads have worked to strategically spotlight a number of topics emphasizing interprofessional elements. For example, in December 2022 , Dionne Sinclair, Vice-President, Clinical Operations & Chief Nursing Officer at the Center for Addictions and Mental Health (CAMH) presented on “Increasing Cultural Awareness for Health Care Leaders” which linked intercultural competence to team function. More recently, this February, BPER’s ‘Battle of the Papers’ had 5 scholars champion “the one paper of the past academic year they felt every health professional educator must read.” Two papers contained especially prominent interprofessional themes. ‘Nurses whisper.’ Identities in nurses’ patient safety narratives of nurse-trainee doctors’ interactions (Samuriwo et al. 2021) was championed by Paula Rowland, Research Advisor for CACHE. Kathryn Parker, Associate Director, Student-Led Environments at CACHE championed Making room for student autonomy’ – an ethnographic study of student participation in clinical work (Kjær, Strand, & Christensen 2022 ). On April 11, Maria Tassone, Health Systems & Policy Advisor for CACHE and Mandy Lowe, Strategic Advisor for CACHE, co-presented on Enabling Transformative Learning: Lessons from Leadership. Topics such as the ones articulated in this article foreground the importance of interprofessional, team-based, and leadership learning within the field of health professions education.
Learn more about BPER here and watch archived recordings here.
Sylvia Langlois, M.Sc. OT Reg. (Ont.) (Dept. of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto)
Carolyn Cracknell (Project Officer, Interprofessional Education and Practice, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne)
Joanne Bolton (Acting Centre Director, Centre of Collaborative Practice, University of Melbourne)
Elizabeth Malloy, PhD (Associate Dean Learning and Teaching, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne)
During the past three years, so many partnerships and collaborations have continued - and been developed - virtually. Although these have been effective, there is no substitute for meeting in person, and enjoying both the formal and informal camaraderie. In February, Sylvia Langlois traveled to Australia and had the opportunity to meet with Elizabeth Malloy, Joanne Bolton, and Carolyn Cracknell from the University of Melbourne (UoM).
Together they discussed Interprofessional Education (IPE) programs, shared challenges, and upcoming opportunities. UoM have only recently launched the Centre for Collaborative Practice, and Sylvia generously shared about CACHE, the drivers for success, and lessons learned as a longstanding Centre and leader in IPE.
Sylvia was excited to hear about their excellent work in Indigenous health in the context of IPE , and is looking forward to future learning and forging stronger connections.
Excitingly, our two Centres were recipients of a collaborative research grant via the Manchester-Melbourne-Toronto Research Fund. Together the project team aims to work with people with experiential knowledge to develop a critical pedagogy in collaborative practice that addresses stigma in the context of mental health (Project Lead: Stella Ng, UoT and Ashley McAllister, UoM).
Noor Yassein, BA(Hons) (Curriculum & Communications Assistant, CACHE)
Sabrina Bartlett, MEd, BEd, BSocSc (Manager, Curriculum & Education Innovation, CACHE)
Elizabeth McLaney, MEd, BScOT, BA (Associate Director of Workplace Learning, CACHE)
Siobhan Donaghy, MSc(RS), BSc(OT), OTReg(Ont) (Professional/Collaborative Practice Leader, St John’s Rehab)
Jennifer Shaffer, PT, MSc(RS), BSc(PT) (Professional Practice Leader, Physiotherapy, St John’s Rehab)
On Thursday, March 30, the 2023 cohort of the Senior Interprofessional Projects took to the (virtual) stage, to present their final ideas to our panel.
The Senior Interprofessional Projects are an annual elective for senior health sciences students at the University of Toronto. In small interprofessional groups, they work together to come up with solutions for a problem presented by the organization chosen for their cohort.
This year, Sunnybrook’s St. John’s Rehab (SJR) was the lead organization, supporting transitions from hospital outpatient stroke rehab back to the community. Over the last 3 months, students looked at creating a process which is patient-focused and supportive. The goal was to find out how best to support a smooth, patient friendly transition from the outpatient hospital setting to the community, ensuring that stroke patients and their caregivers are able to connect with the community-based resources and agencies recommended by their interprofessional care team.
There were three groups total, each presenting novel and fascinating ideas, with a winner chosen at the end of the night. However, as one member of our panel expressed fittingly, everyone wins when there is so much learning involved - and with the incredible presentations put forth, this certainly rang true.
Congratulations to all the students involved, and thank you to St. John’s Rehab for supporting this valuable experience. In particular, thank you to our SJR & Faculty Leads (pictured above), Elizabeth McLaney, Jennifer Shaffer, Siobhan Donaghy, and Karl Wong, for all your dedication and work in making the projects a success.
The next iteration is set to begin again Fall 2023 - keep an eye on our website for details.
Zubeen Dharshi, MSc.SLP, CCC-SLP, Reg.CASLPO (Interim Professional Practice Leader for Speech and Language Pathology, Sunnybrook Health Sciences Centre); Annie Hoang, MEd, RD (Professional and Education Leader for Clinical Nutrition, Sunnybrook Health Sciences Centre); Ann Robertson, RD (Director, Food Services – Aramark, Sunnybrook Health Sciences Centre); Melodie Santos (Manager, Patient Food Services - Aramark, Sunnybrook Health Sciences Centre); Angela Cheung (Sunnybrook Health Sciences Centre); Colleen Miller MHSc, RD (Liaison Dietitian, Sunnybrook Health Sciences Centre)
The International Dysphagia Diet Standardization Initiative (IDDSI) provides an evidence-based, global framework with terminology and descriptors for dysphagia diets. As Canadian food manufacturers are moving to sole use of IDDSI labelling on dysphagia products in 2023, it was time for Sunnybrook Health Sciences Centre to begin transitioning to this by adopting dual language terminology for all liquid consistencies. This change impacted all liquid diet order sets, electronic diet orders, and clinician diet order writing practices.
A collaborative approach to reduce risk and manage patient safety was developed to manage the change in terminology which had broad implications. Due to the number of staff involved across the organization in the provision of diets to patients, care was taken to develop several channels of communication to share changes and information broadly to minimize the chance of any adverse outcomes during the transition period.
An interprofessional interest group involving leadership from clinical nutrition, speech-language pathology, and food services was established to work through implementation steps. The group met to discuss the impact of this change on diet office practices, information sharing within teams, and a broader communication and education strategy that would be needed to support this rollout across all campuses.
The implementation of IDDSI language for liquids was launched in September 2022. Strong collaboration with all involved resulted in an effective and safe transition. Post-implementation reflection within the interest group suggests the rollout was successful, and no patient safety concerns were identified during transition or post implementation. ©The International Dysphagia Diet Standardisation Initiative 2019 @ https://iddsi.org/framework/ Licensed under the CreativeCommons Attribution Sharealike
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Volume 1.1 (Fall 2022)
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Tyler Reimschisel, MD, MHPE (Founding Associate Provost, Interprofessional and Interdisciplinary Education and Research, Case Western Reserve University, Cleveland OH)
In early February, the Office of Interprofessional and Interdisciplinary Education and Research at Case Western Reserve University (CWRU) hosted a retreat on interprofessional education and collaborative practice. Our invited guests were Stella Ng, PhD, and Maria Mylopoulos, PhD. We were honored to host these two health professions education and research leaders at CWRU, since the University of Toronto is recognized internationally for its leadership and expertise in this field.
On the morning of the retreat, Dr. Mylopoulos led over 20 of our faculty and staff in a workshop on the lifelong learning practices of adaptive expertise and productive failure, and how these fundamental concepts are applicable to interprofessional education and collaborative practice. At noontime, Dr. Ng gave the keynote address to several faculty and staff from the health professions and social work schools at our university. She discussed the history of CACHE and its current portfolios, reviewed the four waves of interprofessional education, and highlighted the importance of integrating adaptive expertise
and critical reflection into our interprofessional and interdisciplinary education. Then over lunch, Drs. Ng and Mylopoulos met with several senior leaders, including Dr. Ben Vinson, III, our Provost and Executive Vice President; the deans of the Frances Payne Bolton School of Nursing; the Jack, Joseph, and Morton Mandel School of Applied Social Science; the School of Dental Medicine; the School of Medicine; and leaders from my office. Stella and Maria discussed the history and organization of CACHE and facilitated a conversation about interprofessional education and collaborative practice opportunities at CWRU. This dialogue provided an exceptional starting point for the strategic planning meeting that followed later that afternoon.
The retreat strongly resonated with everyone at CWRU. Drs. Ng and Mylopoulos encouraged us to build on our teamwork curricula and the collaborations we have fostered with our community partners. In addition, they challenged us to “catch the fourth wave” of IPE that addresses hierarchical power within healthcare teams, and how it can undermine authentic interprofessional teamwork that improves the health and wellbeing of individuals, families, communities, and populations. From a personal perspective, I am integrating what I learned into the coaching that I provide to established teams in healthcare, higher education, and nonprofit organizations. Drs. Ng and Mylopoulos’s mastery of the education literature and passion for the field of interprofessional collaboration provided inspiration to our senior leaders, faculty, and staff.
Lily Winnebota, MA (Project Manager, Team Primary Care, CACHE) Denise Ponte, BSc (Administrative Coordinator, Research & Innovation, CACHE)
The Centre for Advancing Collaborative Healthcare and Education (CACHE) is thrilled to announce that they are a key partner on a federal grant that aims to accelerate transformative change in the way primary care practitioners train to work together.
Team Primary Care: Training for Transformation is an interprofessional initiative of the Foundation for Advancing Family Medicine funded by Employment and Social Development Canada. This initiative is co-led by the College of Family Physicians of Canada and the Canadian Health Workforce Network, in partnership with over 65 health professional and educational organizations across Canada. The overarching aim of this project is to promote, enhance, and transform curricula, education, and team-based models for primary care professionals. Ultimately, Team Primary Care will help support training for primary care practitioners to contribute to the provision of more comprehensive, team-based primary care.
This is where CACHE comes in. CACHE will support the initiative by enabling and embedding collaborative competencies and collaborative leadership into Team Primary Care, adapting and implementing existing and effective toolkits with primary care teams, and offering and evaluating customized professional development programs, coaching, and resources.
“Through our professional development programs and coaching, we will support Team Primary Care in adopting and continually evolving best practices for interprofessional and collaborative practice,” says Stella Ng, project co-lead and CACHE’s Director & Scientist. “We will partner with our EDIA leaders for an integrated approach to positive change” adds Lynne Sinclair, project co-lead and CACHE’s Senior Consultant, Partnerships & Innovation.
Close to five million Canadians do not have a regular primary care provider. Additionally, nearly one in six family doctors in Canada are nearing retirement, potentially resulting in millions of Canadians losing their access to primary care. As a result, many Canadians seek care in overcrowded hospital emergency rooms, walk-in clinics, or virtual care apps that — while all critical within our health system — do not enable continuity of care throughout every stage of a patient’s life. Many Indigenous communities and Canadians living in rural areas are also disconnected from essential services that are not culturally sensitive nor safe, and must travel hundreds of kilometers to access care.
As governments expand efforts to address a growing crisis in access to primary care, team-based primary care approaches are likely to emerge as a dominant model of organizing primary care. Although there are pockets of team-based comprehensive primary care teams operating successfully across the country, many primary care professionals have not been trained to work in these models. This project will address these challenges by training individual primary care practitioners, building up existing primary care teams, and initiating new ones to hit the ground running as collaborative team-based models of care are scaled up across Canada in the coming years.
As mentioned above, the CACHE team and its broader communities and networks will contribute to this project by bringing their expertise in supporting collaborative healthcare, interprofessional education, and related research and innovation. Co-led by Ng and Sinclair, a new group of project team members will join the well-established CACHE team to enable its Team Primary Care efforts. We are delighted to introduce these new project team members here:
Reprinted with permission from UHN News .
As Nurse Manager of the Emergency Department (ED) at Toronto Western Hospital, and a member of TeamUHN for more than 30 years, Janet Pilgrim’s career is full of rewarding moments. But one event stands out for her: in March 2020, Janet announced to her team that the General Internal Medicine unit she was then-managing would be the first COVID-19 unit in the hospital. “I remember the fear and anxiety in their faces,” says Janet. “This was an important moment in my career, and I relied on my leadership education and training to manage it.”
Professional development has been an important steppingstone in Janet’s journey at UHN. Her story is just one example of how education is an essential part of navigating new challenges on the job. “My leadership education made all the difference for me,” says Janet. But professional development has taken a backseat in the pandemic. And with virtual or hybrid work, spontaneous idea-sharing and creativity that happens between colleagues in hallways or over a lunch break, is missing.
In addition, the past three years have been devastating to health care workers, and the industry is now facing a massive staff shortage, adding more pressure to the system. To meet some of these challenges and support staff such as Janet and her team, UHN launched a Professional Development strategy in 2022. A partnership between Education, Collaborative Academic Practice, Medical Affairs and People & Culture, the strategy is a commitment to TeamUHN’s growth and development with the hope of bringing more equitable access to learning.
“This strategy is the first of its kind at UHN,” says Belinda Vilhena, Director of Operations and Business Development at the Centre for Advancing Collaborative Healthcare and Education (CACHE) and Conference Services/BMO Conference Centre. “We’re working to create a menu of professional development offerings like workshops, lunch and learns and shadowing opportunities for staff’s personal and professional growth. “And this needs to be delivered in a variety of ways – in-person, e-learning or virtual sessions. Ideally, all of these offerings will be housed in one accessible website or platform.” The Professional Development team knows UHN staff need education options and attainable learning tools regardless of their title, department or shift time. “The Professional Development division is in the early phase of building a pathway to education that’s more than conferences and courses,” says Belinda. “It can happen in rounds or team meetings where staff learn how to ask better questions and dig deeper.
“Learning happens when it’s integrated into practice.” Maria Tassone, Executive Director of Education at UHN, leads the Professional Development strategy and draws from her personal and team’s experience building the collective rapid-response education that happened at UHN early in the pandemic. “In 2020, we developed an online platform and supported over 20,000 learners and health care providers through COVIDLearning.ca, the Medical Lab Science Grad Onboarding, the Vaccination Support Program and the Ontario Workforce Reserve for Senior Support for PSWs,” says Maria. “We showed that rapid health professions education is possible, and we can build on what we learned in terms of high-quality education as a health care intervention.”
For Janet, a new approach to professional development is the right idea. And this learning needs to be flexible enough for staff to pick up training while holding onto their protected downtime, which has become a lifeline in the pandemic. There have been so many changes over the past few years in our work and education in general, but health care professionals such as Janet recognize that some things have stayed the same. “We have to accept that things need to be different now,” she says. “But UHN is still a place where you can develop your career and be the best you can be.”
Alan Bennett, BA (Communications Specialist, University of New England)
University of New England President James D. Herbert has, for the second time, testified before the U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP) in Washington, D.C., about the healthcare workforce shortage and methods to improve it.
Herbert spoke during a Congressional hearing titled “Examining Health Care Workforce Shortages: Where Do We Go From Here?” at the request of Subcommittee Chairman U.S. Sen. Bernie Sanders of Vermont.
According to the American Hospital Association, the United States will face a shortage of up to 124,000 physicians by 2033 and will need to hire 200,000 nurses per year to meet demand.
President Herbert proposed a series of specific strategies to address this predicted shortage, including fundamental changes to the prevailing educational model to allow for greater flexibility and promotion of Interprofessional Education (IPE) training opportunities to break down silos in healthcare training and practice.
UNE was an early adopter of and is a national leader in interprofessional education. Herbert informed the subcommittee that interprofessional collaborative practice has been shown to improve clinical outcomes, reduce medical errors, increase patient satisfaction, and decrease provider burnout.
“Successfully addressing America’s health care workforce crisis will require not merely acting on individual initiatives in isolation,” Herbert said. “Although strategic investment of resources will be required, much of the work we confront reflects cultural changes that will require strong leadership; a willingness to innovate; and coordinated partnership between academia, government, industry, and the nonprofit sector.”
Read the full story here.
Did you read our Fall 2022 & Winter 2023 issues?
Click HERE to read Together : Stories of Collective Impact, Volume 1.1 (Fall 2022)
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Linda Ramjohn (Patient Care Manager) Yasmin Moolani Merchant, MD Lisa Fu, MD
Erika Lee, MD Giovanna Pirroncello, RN Lorena Gallo, RN
Eric Westcott (Administrative Staff) Paschal Oduoza (Administrative Staff) Jackie Campbell, B.Sc.(Pharm.)
Nurse Sunnybrook’s Drug Safety Clinic (DSC) evaluates patients for drug allergies. Drug allergy labels are associated with longer hospitalizations and worse clinical outcomes, along with higher costs to the healthcare system. 1
Our interprofessional clinic aims to de-label drug allergy, through skin testing and/or challenge doses. For patients who cannot be delabelled, we find alternatives or recommend desensitization protocols. These strategies, implemented by our collaborative team, positively impact patient outcomes.
The DSC is one of the few Centres in Ontario that offer drug allergy testing, and has been in high demand for many years. Due to constraints imposed by the pandemic, by early 2022, the DSC faced a backlog of over 3000 patients. To address this backlog, our dynamic team reviewed all DSC operations, with the goal of reducing the number of patients waiting by 80% by June 1, 2023. To meet this goal, the team identified the need to increase our testing clinics from 2 to 5 days a week and secure additional clinic space. In order to successfully implement this plan, we recognized the need to increase staff. In collaboration with senior hospital leadership, we increased staffing from 1 to 3 allergists and 2 full time nurses replaced casual staff.
Through interprofessional weekly huddles, the team – physicians, nurses, pharmacist, administrative staff, and management – collaborated to map current operations to identify gaps, and to design future state workflow to increase efficiencies. Each team member takes an active role through the weekly huddles and follows up on action items to continue to improve the clinic workflow. We tested and implemented several PDSA cycles for most clinic processes. These measures were evaluated weekly, including the number of patients on the waitlist, those seen in consult or tested each week, and cancellation rates. Our results showed that these processes were not only effective in reducing the waitlist -- we are on track to exceed our goal.
1. Kaminsky, Lauren W. et al. Penicillin Allergy Label Is Associated With Worse Clinical Outcomes in Bacterial Pneumonia. The Journal of Allergy and Clinical Immunology: In Practice 2022 September;10(12): 3262 – 3269
Sam Polzin (Communications Associate, Holland Bloorview Kids Rehabilitation Hospital)
Ontario’s specialty pediatric hospitals are standardizing the type of feeding tube equipment they use for children and youth, making the administration of nutrition and medications safer. By the end of January 2023, member hospitals of the Children’s Health Coalition will all be using ENFit feeding tube connectors.
ENFit, a global patient-safety initiative, makes mealtime and medication administration by tube as safe as possible by reducing the risk of misconnection and leakage. ENFit feeding tube connectors are designed so they cannot inadvertently connect to other delivery systems, such as trach tubes, IV lines, and catheters. It also uses a twist-in connection rather than a friction-held legacy connector.
This design comes with enhanced cleaning practices to prevent the buildup or residue from feeds or liquid medications. The ENFit system also comes with specific medication accessories to ensure best dose accuracy of medications.
Ontario’s pediatric specialty hospitals are working together with community agencies and children’s treatment centres to implement this change. The initiative relied on extensive collaboration across a variety of disciplines including nursing, pharmacy, dietitians, patient safety, practice and operations leads, materials management and purchasing. Clients and families were also consulted.
The Children’s Health Coalition encourages all healthcare institutions that use feeding tube connectors to adopt the ENFit system, to ensure kids remain as safe and healthy as they can while in care.
For information on preparing and administering medications using ENFit, visit https://stayconnected.org/
Noor Yassein, BAH (Curriculum & Communications Assistant, CACHE)
This May, Collaborative Advocacy and Partnered Education (CAPE) Learning will be hosting PSW Awareness Month 2023! This month is meant to spread awareness and show gratitude for PSWs and their exceptional work, as well as advocating with them in the issues they may face while doing so.
Currently, there are four weekly themes planned: Awareness, Interprofessional Inclusion, Education, & Recognition.
Join us each week as we hear from PSWs and their clients, engage in quizzes and scavenger hunts to win prizes, and learn through informative posts. We have a Twitter account (@CapeLearning ) where most of this will take place, as well as through the University Health Network (UHN)’s Instagram.
Additionally, during this month, the Centre for Advancing Collaborative Healthcare & Education (CACHE) will be hosting our third Exploring Health Teams event. This iteration of the event will feature PSWs and nurses, just in time for PSW Awareness Month & Nursing Week! It’s aimed at high school and university students, to learn more about different careers in healthcare. Find out more at www.exploringhealthteams.ca .
We are looking forward to celebrating PSWs and nurses with you this May! If you have any questions, or if your organization would like to participate officially in PSW Awareness Month, please reach out to noor.yassein@uhn.ca .
Exploring Health Teams website: www.exploringhealthteams.ca
CAPE Learning website: www.capelearning.ca
CAPE Learning twitter: https://twitter.com/CapeLearning
Academic Freedom and Social Media within Academic Settings: A Collective Responsibility?
May 9, 2023 | 12:00pm - 1:00pm EDT
Presenters: Archana Sridhar & Pier Bryden
This presentation will address social media expression and activities of faculty members. The session will review data about academics’ social media usage, explain the legal landscape in this new area, explore the differences between academic freedom and free speech, and use case studies to illustrate risks and tips to support faculty colleagues engaging in social media.
When online flare-ups occur - for example, in situations involving public health debates, political issues, or equity, diversity, and inclusion topics - university and hospital administrators are sometimes asked to navigate complex policies and novel situations. The presenters will encourage participants to engage in discussions to promote community understanding in advance of online challenges that may arise. Ideally, after this session, participants will feel more prepared to engage in social media activities for professional purposes, and more empowered to do so in ways that foster safety and well-being.
Register to attend via: https://centreforfacdev.ca/workshop-catalogue/383-academic-freedom-and-socialmedia-within-academic-settings-a-collective-responsibility/
Best Practices in Education Rounds (BPER) is a partnered program between the Centre for Faculty Development (CFD), The Wilson Centre, and CACHE. Collaborating between our Centres allows us to leverage our expertise and networks to provide more impactful, relevant offerings.
BPER provides the opportunity to share innovative and emerging ideas with a wide audience of interested health professional teachers, educators, leaders, and scholars. BPER aims to reach a diverse audience, including patient/client and family partners and a range of professional/health worker backgrounds.
Building interprofessional collaborative personcentered practice and care.
CIHC MEMBERSHIP OFFERS YOU:
• Access to monthly speaker series
• Participation in communities of practice & discussion groups
• Connection with members, regionally, nationally, & globally
• Access to resources on interprofessional education & practice activities
• A reduced registration fee at Collaborating Across Borders (May 16-18, 2023)
JOIN CIHC TODAY https://www.cihc-cpis.com/
May 15-18, 2023 | Virtual Conference | REGISTRATION IS OPEN!
Collaborating Across Borders (CAB) is the premier North American conference focused on interprofessional education and collaborative healthcare. The CAB Conference was first launched in 2007 as a venue where educators, clinicians, researchers, policy makers, patients/family partners and students from both sides of the Canada-US border could engage in rich productive dialogue. The conference has expanded to a global audience in the last 15 years.
The eighth Collaborating Across Borders (CAB VIII) conference will be held virtually from May 15 – 18, 2023. CABVIII is hosted by the University of Toronto’s Centre for Advancing Collaborative Healthcare and Education (CACHE) in collaboration with the Canadian Interprofessional Health Collaborative (CIHC) and the American Interprofessional Health Collaborative (AIHC). The theme of the conference is Hope and Trust in Health and Social Care. CAB VIII continues the tradition of focusing on advances in interprofessional practice and education, research and innovation, and policy, systems and leadership with a newly added francophone stream.
Apply to Become A CAB VIII Watch Party Host!
We’ve heard that virtual conferences can lack true social interaction, it can feel like any other day and be difficult to fully engage with other conference attendees and speakers. To bring conversation, discussion and interaction back into the online conference world, CAB VIII welcomes you to be a CAB Watch Party Host!
At a CAB VIII watch party, you come together with fellow attendees, be it colleagues from your group, your university, your city or your whole country, to join and listen to the CAB VIII Keynote speaker Gregory Cajete together on Tuesday May 16, 2023, 3:00-4:00pm EDT. Watch parties can be as small as two or three people in your living room or as big as fifty to onehundred people filling a whole lecture theater. You’ll follow the keynote together, discuss the presentation/ key messages, brainstorm over new ideas and create new connections and collaborations.
Click HERE to become a CAB VIII Host!
Tweet With Us! Tag @CAB_VIII_2023 \ @IPEUofT \ @CIHC_ca And by hash tagging #CAB2023 \ #CABVIII
Register Now: https://events.myconferencesuite.com/CAB-VIII/page/Registration Program and Speaker information now available on the website.
For more information about the conference contact: Conference Services, University Health Network, conferences@uhn.ca
Interprofessional Collaboration (IPC) Showcase 2023
May 17, 2023 | 4:30pm - 7:00pm EDT
Hybrid Event | Register Now
The Interprofessional Collaboration (IPC) Showcase celebrates excellence in team-based learning, collaborative care, interprofessional research and quality improvement, and leadership across our healthcare system. Offered jointly by Sunnybrook Health Sciences Centre and the University of Toronto, Centre for Advancing Collaborative Healthcare & Education (CACHE), this hybrid forum will provide a variety of speakers, presentations, and opportunities to connect. The IPC Showcase brings together people in diverse professions and roles to network with like-minded colleagues, share ideas, and create new opportunities for collaboration. This year we are pleased to extend the IPC Showcase to a broader audience by including it within the program for the Collaborating Across Borders VIII Conference
What’s New?
• Focused stories and examples will be shared highlighting best practices in workplace-based interprofessional learning from across the Toronto Academic Health Sciences Network and beyond
• Small group discussions will support exchange of best practices from participating people and organizations
• Large group sharing will uncover enablers and themes
• Opportunities for networking
Register Now
• We are pleased to offer this event at no charge.
• You do not have to be registered for the Collaborating Across Borders (CAB) Conference to attend, though all CAB registrants are warmly invited to attend the IPC Showcase.
• Select in person seats will be available at a downtown Toronto location. When you visit the registration link you will have the opportunity to indicate your interest in attending in person.
• Zoom attendance is unlimited.
• If you have any questions regarding the IPC Showcase please contact: Fatima.Mimoso@uhn.ca
Tuesday June 6, 2023
9:00am - 12:00pm EDT
Online and in-person at the BMO Education & Conference Centre
We The Brian D. Hodges Symposium celebrates Dr. Brian D. Hodges’ continuing contributions to health professions education research. Dr. Hodges, Director of the Wilson Centre from 2003-2011, is currently the Executive Vice-President of Education and Chief Medical Officer at the University Health Network, a Scientist at The Wilson Centre, and President, Royal College of Physicians and Surgeons of Canada.
By bringing together the community of health professions education researchers, educators, scholars and students, we aim to motivate attendees to think beyond the boundaries of their current work and look for points of intersection with the research of others. The symposium provides a rare opportunity for in-depth discussion of the theory and practice of education. Attendees will enjoy invited presentations from global leaders in health professions education and the next generation of education scientists and scholars.
Featured Panel:
• Dr. Lakshmi Krishnan from Georgetown (https://www.lakshmi-krishnan.com/ )
• Dr. Jacob Steere-Williams from College of Charleston (https://history.cofc.edu/about/faculty-and-staff/ steerewilliams-jacob.php)
• Dr. Edward Shorter from the University of Toronto (https://www.history.utoronto.ca/people/directories/allfaculty/edward-shorter; https://edwardshorterauthor.com/ )
• Dr. Joanna Krongold from the University of Toronto and a joint Postdoctoral Fellow between the Anne Tanenbaum Centre for Jewish Studies and the Office of Inclusion at the Faculty of Medicine (https://www. jewishstudies.utoronto.ca/news/new-fellowship-established-explore-antisemitism-healthcare; https://www. jewishstudies.utoronto.ca/people/directories/postdoctoral-fellows/joanna-krongold)
Should you have any questions please contact Cheryl.ku@uhn.ca
Visit the website for updated information about the event: http://thewilsoncentre.ca/hodges-symposium-2023
Wednesday June 7, 2023 | 12:00pm– 1:00pm | Virtual Livestream
Join Dr. Stella Ng as she dives into the topic of preparing healthcare professionals to navigate the complex social landscape in healthcare. In this talk, she will discuss the challenges that come with teaching social determinants of health and cultural competence, and why these approaches have received critique. Dr. Ng will then introduce an alternative approach called critical pedagogy, which shifts the focus beyond the self and towards questioning assumptions and societal power dynamics. By incorporating critical pedagogy principles, healthcare learners can develop the critical reflective capabilities necessary to thrive in their social roles as healthcare professionals. Discover how personal experiences and relationships can play a pivotal role in shaping these capabilities, and learn how critical pedagogy and critical reflection can transform healthcare for the better!
Register HERE.
AMEE Annual Conference
AMEE Glasgow 2023 - Inclusive Learning Environments to Transform the Future
August 26 - 30, 2023 | Glasgow, Scotland & Online Registration Open!
We are excited to welcome you back to Glasgow for our 51st Annual Conference. We hope that you can join us and many friends and colleagues to learn, share and network together in Scotland’s largest city. If you are unable to join us in Glasgow you can follow and join the virtual content, in what will be a truly hybrid Conference.
AMEE brings together renowned experts and junior researchers from around the globe who are working at the cutting edge of the field of health professions education research. Whether you join us in-person or remotely you’ll have unparalleled access to the latest ideas, methods and techniques being used in teaching, assessment and research, and will benefit from hearing about the experiences of people who have used them in many different contexts around the world.
Registration for in-person attendance is now open - See all registration details HERE .
If you have any questions about our upcoming conference, or any other aspect of AMEE, please get in touch by emailing conferences@amee.org
September 18-19, and 28-29, 2023 | Virtual Summit
Now accepting submissions for this year’s Call for Abstracts . Deadline to submit an abstract is May 19, 2023.
Nexus Summit 2023 marks eight years of the interprofessional practice and education community gathering, learning about, from and with each other, discussing the thorny questions and pushing for solutions that lead to ACTION through this forum. This year, the Nexus Summit 2023: Working Together for Impact, prompts us to think even more critically about our role.
• What are the necessary knowledge, skills, and attitudes of interprofessional educators in order to effectively prepare future and current health professionals for collaborative practice/teamwork/delivery care in today’s changing health systems?
• How do people work meaningfully together in practice and education partnerships to have a positive impact on learning and health outcomes?
• How can we impact closing the gap between education and practice?
• How can and do we make a difference for health teams providing care and those they serve?
This year, we invite stakeholders in health to showcase their innovations to advance interprofessional practice and education for maximum impact on quality and costs of health care, on health equity, and on an empowered workforce. The Call for Abstracts has been intentionally designed to provide opportunities for groundbreaking new models and evidence-based interventions that enrich existing knowledge and move toward outcomes and impact.
We also have a new theme on interprofessional leadership to help us all think about the cultures and environments we need for this work for the future. The Nexus Summit continues to be the leading interprofessional gathering that empowers attendees to turn what they are learning into outcomes that matter most to the communities we learn from, collaborate with, and serve. And, as you have come to expect from the Nexus Summit, we will have plenaries and Conversation Cafes to push our thinking and dialogue together.
Nexus Summit 2023 returns to a fully virtual format, enabling diverse contributors to attend, learn and work together over four days on September 18-19, and 28-29. The National Center’s innovative More Than a MeetingTM platform empowers attendees to create their own learning plans, interact with synchronous sessions and asynchronous content, network and make real-time connections with mentors and collaborators.
Visit the Registration page on the Summit website to learn more about registration packages, pricing, and AIHC member discounts!
November 6 - 9, 2023
Welcome to the 11th International Conference on Interprofessional Education and Collaborative Practice (IPECP), All Together Better Health (ATBH) XI, to be held in Qatar on November 6-9th, 2023 bringing this biennial event to the Middle East for the first time! ATBH provides a collaborative forum for transnational champions to promote IPECP towards improving global health through consensus-based partnership, share ideas and address emerging healthcare challenges.
Our conference theme is Cultivating a Collaborative Culture: Sharing Pearls of Wisdom. We are now accepting abstract submissions in the following sub themes related to interprofessional education and collaborative practice:
• SHARING models of best practice
• INFORMING national, regional, and global policies and standards
• ADVOCATING for health and wellbeing
• EMBRACING diversity, equity, inclusion, and belonging
• PROMOTING safety in and beyond health services
Visit the website for more information.
December 11 - 12, 2023 | Ottawa, ON Canada | Free Virtual Simulation Workshop
Theme: The Rise of Simulation
Marking the 10th anniversary of SIM Expo, we look back at our progress and ahead to the importance of simulation to build a sustainable, equitable healthcare ecosystem.
The 2023 SIM Awards call for nominations is now open! All nominations are due August 25th, 2023. Nominate a leader now!
Call for Abstracts: We are now accepting abstract submissions! Present your simulation research, developments, and innovations at Canada’s interprofessional simulation conference!
Key Dates
• Abstracts due: Sunday May 7th, 5pm EDT
• Notification of Acceptance: week of June 5th
• RSVP & Registration of Presenters: Friday July 7th
Visit the website to learn more, SIM Expo - Simulation Canada
A six-module virtual learning series covers key best practices and core competencies for interprofessional education (IPE) and virtual facilitation. The newest technologies and virtual active learning strategies are co-facilitated and modelled by two CACHE faculty, leveraging didactic theory bursts, small group breakouts, large group discussions/reflections, virtual stretch breaks, real-time polling, chat boxes and team simulation videos. The unique use of best practice videoconferencing team norms supports participant psychological safety, equity, and attention to engagement in a new virtual environment.
Module 1: Overview of IPE/IPC Evidence, Literature and Best Practices
Module 2: Role Clarification
Module 3: Interprofessional Communication and Conflict - Focus on Patient Safety / Quality Improvement
Module 4: Relationship Centred Care: Patients / Caregivers and Teams
For more information visit our website or email belinda.vilhena@uhn.ca
Module 5: Team Functioning/TeamworkPsychological Safety and Leadership - Pulling it All Together
Module 6: Interprofessional Facilitation Simulation, Tips and Resources
Stay Tuned for 2023 Program Dates
We are offering an innovative foundational team-based care workshop in a virtual synchronous interactive 2.5-hour format with an aim to improve interprofessional collaborative practice for clinical and project teams across organizations.
We welcome interprofessional team members to come together to work collaboratively on their teamwork or individually to bring learnings back to their team. To optimize collaborative learning, we utilize virtual large group reflections, small group breakout discussions, video team simulation and best practices in virtual team facilitation. Teams in all areas of health care are striving to provide collaborative models of care that optimize patient outcomes and experiences, particularly with the challenges and silver lining of a COVID-19 impacted system. This is an opportunity to enhance the collaborative practice environment for all staff and students.
By the end of this workshop, participants will be able to:
• Apply interprofessional competency-based tools to optimize communication, conflict and performance for virtual and non-virtual teams
• Promote a climate of psychological safety and team functioning in virtual and non-virtual interactions and meetings
• Reflect on and develop an action plan for improving quality, safe team-based care in your context
For more information visit our website or email sabrina.bartlett@uhn.ca
Stay Tuned for 2024 Dates | Virtual Program
CCL is a certificate program offered by the University Health Network (UHN) in collaboration with the University of Toronto (UofT) Centre for Advancing Collaborative Healthcare & Education (CACHE).
During the COVID-19 pandemic, our alumni are reaching out to share that the Collaborative Change Leadership (CCL) Program has enhanced their ability to be the leaders needed for these challenging and uncertain times. As alumni are engaging their teams and communities in compassionate and meaningful ways to co-create and sustain system change, they are achieving rapid, efficient and unprecedented results. CCL is specifically designed for the time in which we find ourselves. The need for emergence, adaptation, co-creation, and highly effective implementation rooted in compassion has never been more critical. As such, we are delighted to continue offering a synchronous, virtual CCL Program in March 2023.
Why CCL? Click the video to learn more.
For more information visit the program website or email belinda.vilhena@uhn.ca
