Together: Stories of Collective Impact (Vol. 2.1 Fall 2023), An international magazine by CACHE

An international magazine by the Centre for Advancing Collaborative Healthcare & Education (CACHE)

Volume 2 , I s sue 1 Fall 2023

WELCOME W e l co m e t o o u r i n t e r n a t i o n a l m a g a z i n e , Togethe r : Stories of Colle c tive Imp ac t Welcome to volume two of our international magazine, Together: Stories of Collective Impact. As we launch into the second year of Together, let’s take a moment to celebrate our one year anniversary!

In fall of 2022, our longstanding newsletter was transformed. We launched Together, a magazine that recognizes the international community engaged in collaborative healthcare and education, and shares our communities’ innovations, research, and initiatives.

Together invites everyone in this collaborative space to connect, celebrate, and champion how we work and learn together for a healthier world. What better way to elevate this community than to celebrate the ways we are cocreating meaningful intersections, engagement, and opportunities for all who connect with CACHE and its partners.

Our hope is that Together will continue to foster this connected community, building connections and sharing stories.

In this issue, we welcome new members to the CACHE team, and thank others for their tremendous work and leadership, especially Noor Yassein who left her full-time role with CACHE in September 2023 in pursuit of her master’s degree in Scotland. Noor was an essential member of the magazine’s editorial team, having written, edited, and designed graphics for Together and beyond. Thank you Noor for bringing your unique set of skills and elevating every issue in volume 1 of Together.

Please note that the next issue of Together will be in Spring 2024, as CACHE will be publishing a biennial report in Winter 2023 - stay tuned!

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 future submissions, feedback, and reactions.

With Gratitude, Elizabeth (Eli) Cadavid Lead Editor, on behalf of the CACHE Team CACHE Editorial Team, Fall 2023 Eli Cadavid (Lead Editor) Farah Friesen Stella Ng Denise Ponte Belinda Vilhena

COVER ART Cover Art for Together: Stories of Collective Impact Heartfulness Benji Nova (BenjiNova.com) ”Heartfulness” is an abstract painting that captures the essence of mindfulness through a sense of motion and flow. Each mark on the canvas was created from a state of pure awareness, with each upstroke and downstroke coinciding with an in-breath or out-breath. The piece represents the concept of mindfulness, but more specifically, “heartfulness”, which Jon Kabat-Zinn once said better described the whole-heartedness activity that is mindfulness, with mind and body connected.

This painting is raw, unplanned, and genuinely from the heart, and is a true representation of the creative process that arises from being present in the moment. The colours, lines, and textures all flow together to create a sense of movement and energy, inviting the viewer to enter into a state of mindfulness as they contemplate the piece.

As a cover piece for a magazine focused on collaborative healthcare and education, “Heartfulness” speaks to the importance of mindfulness and whole-heartedness in these fields. By connecting the mind and body and being fully present in the moment, healthcare providers and educators can improve their ability to provide compassionate care and effective education.

This piece also serves as a reminder of the power of creativity as a tool for mindfulness and self-expression. By engaging in creative activities, individuals can tap into their inner selves and connect with the present moment, promoting well-being and reducing stress.

Overall, “Heartfulness” is a celebration of the beauty and power of mindfulness, and an invitation to connect with the present moment and tap into the wisdom that lies within. It speaks to the goals of collaborative healthcare and education, working together to promote well-being and improving outcomes for individuals and communities.

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T O G E T H E R : S T O R I E S O F CO LLEC T I V E I M PAC T i s C e l e b r a t i n g O u r 1 Ye a r A n n i ve r s a r y!

In fall of 2022, CACHE launched Together: Stories of Collective Impact, a magazine that recognizes the international community engaged in collaborative healthcare and education, and share our many innovations, research, and initiatives.

In honour of Together’s first birthday, we’ve rounded up five stories from our first year. We hope you’ll enjoy walking down memory lane with us—and that you’ll stick with us for the long run. Oh, and by the way: If you’ve ever wanted to know a little more about our Centre and our team, you can meet us here. We invite you to read, share, and contribute to future issues and sign up for our magazine here.

Thanks for choosing Together! We appreciate the opportunity to learn, work with, and celebrate, this collaborative community.

Here are five stories from our first year (Volume 1, Issues 1-4): •

Elevating Impact: What Our Uniqueness Offers the Post-Pandemic World (Maria Tassone) Vol. 1.1 Fall 2022, p. 18

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Strengthening Collaboration Among Health Students To Help Communities Improve Their Health (Happy Indah Kusumawati, Spriyati Supriyati, & Siti Rokhmah Projosasmito) Vol. 1.2 Winter 2023, p. 11

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Historic Grant Given to Transform Interprofessional Primary Care Training and Education Across Canada (Lily Winnebota & Denise Ponte) Vol. 1.3 Spring 2023, p. 24

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Collaborating Across Borders (CAB) VIII Conference Special (Elizabeth Cadavid & Jody Thompson) Vol 1.4 Summer 2023, p. 8

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CACHE & Patient Engagement: What, Why, How, and Who? (CACHE Editorial Team) Vol. 1.4 Summer 2023, p. 30

TA B L E O F C O N T E N T S STAYING IN TOUCH: NEWS & CELEBRATIONS Climbing Moutains Welcome Sasha & Donny to the CACHE Team CACHE Awards of Merit for Excellence in IPE: 2022-23 Awards Celebration

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LEARNING IN MOTION: EDUCATION & PRACTICE Applying an Interprofessional Approach to Addressing the Health Impacts of Climate Change Meta-Simulation Game Worlds to Promote Collaborative Healthcare Practice Virtual Student Internships in Long-Term Care Patient Centered Care and Communication

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COLLABORATIVE CHANGE LEADERSHIP™ (CCL) PROGRAM

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COVER ART FOR TOGETHER: STORIES OF COLLECTIVE IMPACT

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INTEGRATING WAYS OF KNOWING: RESEARCH & INNOVATION Personal and Professional Development in the Nursing Innovation Program at MGH Enhancing Veterans’ Well-Being during Isolation through Interprofessional Collaboration

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INSPIRING CHANGE: SYSTEMS, POLICY & LEADERSHIP Strong Interprofessional and Family Collaboration Driving Autism Assessment Process Redesign Use of the Relational Coordination Theory and Framework to Build IPC Practice and Integrated Healthcare Systems How Leadership Team Development is Helping the University of Michigan Center for Interprofessional Education “Walk The Walk” of Building Better Teams University of New England ‘Doing Our Part’

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COMING TOGETHER: EVENTS & ANNOUNCEMENTS Collaborative Community of Practice BOOST! Building Optimal Outcomes from Successful Teamwork Workshop Sunnybrook Annual Education Conference Simulation Canada - SIM Expo Collaborative Change Leadership™ (CCL) Program Teaching for Transformation: Annual Conference+ (TforT:AC+) 2024 ICAM 2024 VITAL: Virtual Interprofessional Teaching And Learning Program

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STAYING IN TOUCH NEWS & CELEBRATIONS Climbing Mountains Th i s i s n ot a fa rewe ll m e s s a g e .

Noor Yassein, BA(Hons) (Master’s student at University of Strathclyde in Scotland)

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ver the past year, I have been the Curriculum & Communications Assistant at the Centre for Advancing Collaborative Healthcare & Education (CACHE), supporting the University of Toronto’s Interprofessional Education (IPE) Curriculum, as well as general communications work with CACHE. From coordinating the Health, Arts, & Humanities program, to coordinating the launch of Collaborative Advocacy & Partnered Education (CAPE) social media campaign for the inaugural Personal Support Worker month in May 2023, I have had the pleasure of working with and meeting many incredible and inspiring people. Thank you to everyone at CACHE and the broader community for making it such an amazing experience!

This year, I have begun my Master’s degree, studying Data Science for Politics and Policymaking at the University of Strathclyde in Scotland. I am excited to expand my knowledge of research and policy, as well as explore a new country! So far there have been several new things I’ve noticed - including seeing mountains everywhere I go, which is certainly a new experience. As I climb the learning curves of my new life, the mountains are there as a real life reminder that all is possible.

I wish everyone good luck climbing their own mountains as we head into the new school year.

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S TAY I N G I N T O U C H N E W S & C E L E B R AT I O N S

We l co m e S a s h a & D o n ny to t h e C AC H E Te a m

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asha Bagnall joined the CACHE team as one of two new Education Coordinators. Sasha completed her Bachelor of Physical Health and Education from the University of Toronto, followed by a Bachelor of Education from the Ontario Institute of Studies in Education. With several years of diverse experiences in education in Canada and in the UK, in 2013 Sasha started volunteering with and then subsequently working at Toronto Rehabilitation Institute at University Health Network (UHN), where she saw collaborative healthcare in action. “I have witnessed the valuable skills health professionals use in practice spotlighted in many of the IPE Curriculum activities at the University of Toronto, and for me that makes this curriculum practical. My hope is that learners take every opportunity to collaborate with their peers; it really is preparing you because in healthcare no one works in a vacuum.”

Sasha assists with coordinating the University of Toronto IPE Curriculum elective activities. Sasha has a passion for grassroots sports and instilling the love of being active in children, with the hope that active kids become active adults, which can have a positive outcome on the quality of their lives.

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onny Bettencourt joined the CACHE team as an Education Coordinator in July 2023, offering additional coverage as Sabrina Bartlett (Manager, Curriculum & Education Innovation) will be on maternity leave as of November 2023. He provides coordination support within the IPE Curriculum, as well as a member of IPE Curriculum Foundational activities’ working groups, Senior Interprofessional Projects, and the Health, Arts & Humanities Certificate program. Donny provides coordination support with professional development programs as well. Donny graduated from the Ontario Institute of Studies in Education with a Master of Education in Curriculum & Pedagogy, and is also an Ontario Certified Teacher. In his role with CACHE, he is committed to promoting inclusive, equitable, and socially conscious education through critical reflection.

In his spare time, Donny enjoys exploring nature spaces and places, learning new plant-based recipes, and both reading and watching British mysteries.

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STAYING IN TOUCH NEWS & CELEBRATIONS

C AC H E A wa r d s of M e r i t f o r E xce l l e n ce i n I PE 202 2-2 3 A wa r d s C e l e b r at i o n Sabrina Bartlett, M.Ed., B.Ed (Manager, Curriculum & Education Innovation, CACHE)

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nnually the Centre for Collaborative Healthcare & Education (CACHE) recognizes educators, preceptors, leaders, students, and others who have demonstrated dedication and engagement in interprofessional collaboration, education and practice through the CACHE Awards of Merit for Excellence in IPE. These awards celebrate not only the outstanding achievements of these dedicated professionals and students, but also their unwavering commitment to advancing interprofessional collaboration in health and social care and education. Their exceptional contributions have undoubtedly transformed the landscape of healthcare education, paving the way for a brighter future with increased collaboration and integrated care.

Ivy Oandasan Leadership Award for Outstanding Contributions in Advancing IPE Darlene Hubley, MScCH, BScOT, OT Reg. (Ont.) IPE Leader, Teaching and Learning Institute, Holland Bloorview Kids Rehabilitation Hospital and Lecturer, Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto “Darlene’s attention to the development and celebration of all whom she collaborates with is exemplary and fosters a deep sense of trust with any team that she leads. A humble leader who ensures that all voices are heard, her ability to go with the flow creates a certain freedom from anxiety and allows frustrations in the team to be more fleeting.”

CACHE’s Annual Awards of Merit for Excellence in IPE celebration was held on October 24th, 2023 in person (BMO Education & Conference Centre, UHN) for the first time since 2019. The return of our annual awards celebration brought together many members from our community to congratulate and support the award recipients.

Janet Newton, Senior Vice President at UHN, gave a warm welcome message of appreciation for the work done to strengthen collaboration in the healthcare system. Lynn Wilson, Vice Dean, Clinical and Faculty Affairs, Temerty Faculty of Medicine, University of Toronto, celebrated the success of our award winners and CACHE. What an honour to have such remarkable colleagues and leaders kickoff the awards this year.

Photo Above: Darlene Hubley joined by her husband, daughter and parents.

Susan J. Wagner Student Leadership Award in Interprofessional Education Brennan Snow, Factor-Inwentash Faculty of Social Work, University of Toronto “Brennan has demonstrated leadership, enthusiasm and engagement promoting interprofessional education in his interactions with other social work students and the health professions student body more generally. Brennan has jumped into opportunities to promote IPE within the faculty. As a student facilitator, speaker, and leader, Brennan has demonstrated exemplary commitment to mentorship and role modeling.”

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Kayli Chen, Medical Radiation Sciences, Temerty Faculty of Medicine, University of Toronto “During her time in the program, Kayli has fully embraced the interprofessional education curriculum and has been its champion within the MRS Program. She has consistently contributed to the well-being and advancement of the interprofessional (IP) community within the MRS program and at Michener, and embodies what it means to be a future IP collaborator and leader.”

Photo Above: Brennan Snow & Rachelle Ashcroft, MSW, PhD, Factor-Inwentash Faculty of Social Work, University of Toronto

Andrea Alves, Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto “In her academic program, Andrea has demonstrated a strong commitment to IPE, having completed all core activities and 8 elective credits. In addition to this, Andrea has facilitated several interprofessional learning activities (e.g., Conflict in Interprofessional Life, Collaborating for Quality, Roles of Health Professions and Team Dynamics, Climate Change & Health parts 1 and 2, etc.). As a facilitator, Andrea has always aimed to create a collaborative and encouraging dynamic within small groups, and has consistently received positive feedback from her peers.”

Photo Above: Susan Wagner and award receipent Kayli Chen on the big screen, joining virtually.

Thank you to this year’s Master of Ceremony Kathryn Parker, Associate Director, CACHE, Kathryn who concluded the ceremony quoting Bob Dylan, “The highest purpose of art is to inspire. What else can you do? What else can you do for anyone but inspire them?”

Photo Above: Susan Wagner, B.Sc. (SPA), M.Sc. (CD), Reg. CASLPO, S-LP (C), Dept. of Speech-Language Pathology, Temerty Faculty of Medicine, University of Toronto & Andres Alves ipe.utoronto.ca

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Photo Above: Members of the CACHE community.

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LEARNING IN MOTION EDUCATION & PRACTICE A p p ly i n g a n I n te r p r of e s s i o n a l A p p r oa ch to A d d r e s s i n g t h e H e a lt h I m pa c t s of C l i m ate C h a n ge

clinicians) developed a two-part interprofessional learning activity focusing on the impacts of extreme and rising heat. In Part 1, students were encouraged to explore the disproportionate impact of climate change on the health of marginalized populations and strategies to address the impacts both individually and as a team. In Part 2, students considered how individual professions and interprofessional teams can prepare for the health impacts and inequities in clinical practice, as well as strategies and practices that can be implemented in practice to minimize harm. The group curated a rich bank of resources to supplement student learning. Students recognized the importance of the topic and their future role, and provided very strong evaluation results for the first iteration of the activity. Selected quotes include:

Sylvia Langlois, MSc (Centre for Advancing Collaborative Healthcare & Education, University of Toronto); Jenna Rines, MSW, RSW (Factor-Inwentash Faculty of Social Work, University of Toronto); Samantha Green, MD, CCFP (St. Michael’s Hospital Sumac Creek Health Centre; Assistant Professor, Dalla Lana School of Public Health, University of Toronto); Fiona Miller, PhD (Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto); Janet Craik, MSc (Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto); Minna Allarakhia, PhD (Management Science And Engineering, University of Waterloo); Andrea Alves, MSc OT (Graduate Student Researcher & Program Development Coordinator, University of Toronto); Amanda Hage-Hassan, MSc OT (Swift Health Services); Gurleen Kaur (Medicine student, Temerty Faculty of Medicine, University of Toronto)

“Thank you for an engaging IPE. It was very important to discuss such an important and often overlooked aspect of healthcare and that is the environment.”

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s healthcare educators, we have a responsibility to prepare our students for future practice. In the context of climate change, and escalation of extreme weather events and record temperatures, students must have the knowledge and skills required to address impending health and system impacts.

Although all health and social care professionals will be impacted, there are limited examples of collaborative preparation. The University of Toronto Climate Impact Working Group (with representation from patient partners, faculty experts, students, and

“I loved the additional resources and the personal story.”

Andrea Alves, Gurleen Kaur, and Amanda HageHassan were successful in receiving the University of Toronto Adams Sustainability Student Grant allowing them to continue to provide leadership to this working group, and to support ongoing development of the next component focusing on sustainability.

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M e t a -S i m u l at i o n G a m e Wo r l d s to Pr o m o te Co l l a b o r at i ve H e a lt h c a r e Pr a c t i ce Raquel Meyer PhD, RN (Ontario Centres for Learning, Research and Innovation in Long-Term Care [CLRI]) Natalie Leventhal MSW, RSW (Centre for Aging + Brain Health Innovation) Rachel Walker, BA (Hons) (Ontario Centres for Learning, Research and Innovation in Long-Term Care [CLRI]) Christina Gallucci MHE, PMP, DASM (Ontario Centres for Learning, Research and Innovation in Long-Term Care [CLRI])

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IPHA, the Learning Inter-Professionally Healthcare Accelerator, offers innovative interprofessional learning experiences through online metasimulation game worlds. A meta-simulation is a curated series of progressively complex simulations to deepen competencies in a given area of study. A game world is an open, simulated environment with its own rules, boundaries, and milieu. Grounded in educational theory, neuroscience, and simulation best practices, LIPHA combines simulation-, case-, team-, and story-based learning for hybrid or asynchronous interprofessional education.

Funded by the Ontario Ministry of Long-Term Care, LIPHA is available for free in Ontario to all personal support and nursing education programs and longterm care home new hires. Join the many schools integrating LIPHA into their curricula. Participating organizations and student groups receive tailored, specialized implementation, education, and technical support to achieve successful implementation and enhance learning outcomes.

References • Chandross, D., (2020). Tripping the Light Fantastic, Online Learning, Autopoiesis and Hyperreality in Open Gameworlds. International Journal on Innovations in Online Education 4(3). DOI:10.1615/ IntJInnovOnlineEdu.2020029872 • Kaufman, D., & Sauvé, L. (Eds.). (2010). Educational Gameplay and Simulation Environments: Case Studies and Lessons Learned. IGI Global. https://doi. org/10.4018/978-1-61520-731-2.

• INACSL Standards Committee (2016, December).

INACSL standards of best practice: SimulationSM: Simulation design. Clinical Simulation in Nursing, 12(S), S5-S12. http://dx.doi.org/10.1016/j.ecns.2016.09.005.

• University of Toronto. (2010). A framework for the development of interprofessional education values and core competencies. Toronto, Canada: Centre for Interprofessional Education.

Evolving from an in-person interprofessional student internship, LIPHA was prototyped, expanded, and scaled to teach aging care. While immersed in a hero’s journey (in the role of a new healer) in a fictional universe, learners are rewarded for mastering linked and increasingly complex cases, mini-games, resources, quizzes, eLearning, and other activities that deepen their competencies in aging and personcentred care, safety, and teamwork.

With a focus on collaboration, communication, values, and ethics, LIPHA aims to attract the next generation of learners into healthcare and to augment clinical placement experiences. The platform achieves this by: • fostering specialized competencies; • supporting socialization to the profession, role, and setting; • promoting skilled interprofessional care; • promoting readiness for values-based clinical practice.

Although the first versions of LIPHA focus on aging care, this self-authoring platform is available to be adapted to teach interprofessional care for any healthcare specialty or context. Given that our future workforce has grown up gaming, it’s time to tap into the learning potential of serious game worlds for these digital natives!

Photo Above: The Learning Inter-Professionally Healthcare Accelerator, an online meta-simulation game world.

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V i r t ual St u d e n t I n te r n shi p s i n Lo n g -Te r m C a re : “Fe el i n g s o P re pa re d a n d Rea d y to b e a n I n te r p ro fe s s i o n al Tea m M e mb e r !”

Emi Giddens, RN, MN (Ontario Centres for Learning, Research & Innovation in Long-Term Care, Baycrest Academy for Research and Education) Anitha Ithayalingam, BSc, MPH (Ontario Centres for Learning, Research & Innovation in Long-Term Care, Baycrest Academy for Research and Education) Shoshana Helfenbaum, BA, MSW, RSW, DGer, DRRP (Ontario Centres for Learning, Research & Innovation in Long-Term Care, Baycrest Academy for Research and Education) Raquel Meyer, PhD, RN (Ontario Centres for Learning, Research & Innovation in Long-Term Care, Baycrest Academy for Research and Education)

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his past June, 10 entry-to-practice healthcare students from diverse disciplines participated virtually in the 9th Interprofessional Internships in Innovation & Aging with the Ontario Centres for Learning, Research and Innovation in Long-Term Care (LTC) at Baycrest.

This 4-week paid internship aims to: 1) promote the field of aging and early student interest in careers in geriatrics; 2) provide foundational knowledge, skills, and attitudes in caring for the aging population; and, 3) develop and practice interprofessional behaviours and values in gerontological work.

Interns engage in synchronous and asynchronous activities with LTC residents, mentors, and leaders from the Baycrest community as part of an experiential learning cycle. Through daily interactions in a simulation and game-based app called LIPHA (Learning Inter-Professionally Healthcare Accelerator), interns collaborate in the care of simulated residents in an online game world. They also engage in an innovation-focused project addressing interprofessional practice challenges in LTC settings.

With a growing demand for healthcare professionals specializing in geriatric care, we take pride in our program’s continued success. Intern feedback and evaluation data demonstrate an increased understanding of geriatric conditions and concerns and an increased confidence in applying interprofessional skills to practice. Our interns also expressed an increased interest in the field of aging and an appreciation for other roles in practice.

“Not only did I get the chance to learn more about resident experiences in LTC, I also got to understand the many roles and avenues within LTC that enable its effectiveness and holistic provision of care. Understanding the many facets of the many professionals and organizations involved has allowed me to venture deeper into this field using critical thinking, and an equity, diversity, and inclusion lens.” 2023 Internship alumnus.

To learn more about the internship and to refer students to apply for our 10th cohort in 2024, please see our internship website: www.clri-ltc.ca/internship.

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LEARNING IN MOTION E D U C AT I O N & P R A C T I C E

Pat i e n t C e n te re d C a re a n d C o m m u ni cat i o n : A C o l l ab o rat i v e O cc u pat i o n al T h e ra p y & Re c reat i o n T h e ra p y Sto r y

Ms. E greatly values feeling oriented and found the monthly calendar helpful. Ms. E has always enjoyed word searches, colouring, and listening to music (particularly Elton John), which Mary Anne provided, including a radio and personalized mp3 player.

Mary Anne Garcia, CTRS, R/TRO (Toronto Rehabilitation Institute, University Health Network) Emily MacPherson OT Reg. (Ont.) (Toronto Rehabilitation Institute, University Health Network) This story is written in the 3rd person to highlight a true case study.

Emily and Mary Anne created a routine to provide structure which ultimately helped to provide a sense of predictability and control for Ms. E: • 9 AM: Breakfast (dining room) • 9:30 AM: Wash; change clothes • 12 PM: Lunch • 1 PM: Physiotherapy • AFTERNOON: Independent activities • 5 PM: Dinner • 7 PM: Wash; change to pyjamas • 8:30 PM: “turn off radio” reminder • 9:00 PM: Radio off (offer mp3 player with headphones)

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s. E presents with sleep disturbance, mood disorder, and responsive behaviours in the context of care. Her team in long-term care (LTC) realized they needed help and transferred her to the Specialized Dementia Unit (SDU) at Toronto Rehab, University Health Network (UHN). SDU is an inpatient behavioural assessment unit that consists of a team of nurses, psychiatrists, and allied health professionals who has an overall goal of creating individualized care plans, utilizing pharmacological and nonpharmacological approaches, to support older adults with moderate to severe dementia.

By working collaboratively to develop and support the use of a structured routine, we saw an overall decrease in responsive behaviours. Ms. E participated in her care and enjoyed her autonomy to access music and leisure activities during the day! The partnerships highlight how effective interprofessional collaboration and a focus on person-centered care can improve quality of life.

As part of the interprofessional team, Mary Anne (Recreation Therapist) and Emily (Occupational Therapist) collaborate to: • understand the person’s routines and interests; • assess their behaviours; • assess contributing factors; • assess their cognitive and physical abilities.

They then explore behavioural modification strategies (including limit and boundary setting) and create cognitively stimulating and meaningful routines with the person. They also liaise with the LTC facilities to balance between needs and what is sustainable.

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Fe b r u a r y - D e ce m b e r 2 02 4 A p p l i c a t i o n s D u e N ove m b e r 10 , 2 0 2 3!

W hy CC L?

C l i c k t h e v i d e o to l e a r n m o r e .

The Collaborative Change Leadership™ (CCL™) Program is a certificate program offered by the University Health Network in collaboration with the University of Toronto Centre for Advancing Collaborative Healthcare & Education (CACHE)

www.collaborativechangeleadership.ca

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Cover Art for Toget h er : Storie s of Colle c t ive Imp ac t We welcome COVER ART submissions if you would like to have your ar twork considered for the next issue.

Volume 1.1 (Fall 2022)

Volume 1.2 (Winter 2023)

SUBMIT Cover Art for Together’s Vol. 2.2 (Spring 2024) and/or Future Issues!

Volume 1.3 (Spring 2023)

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Volume 1.4 (Summer 2023)

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INTEGRATING WAYS OF KNOWING RESEARCH & INNOVATION Personal and Professional Development in the Nursing Innovation Program at Michael Garron Hospital (MGH)

to support a research study and co-lead a new quality improvement (QI) project. Both projects involved collaboration with members of the interprofessional team. For Winnie, working collaboratively led to greater practice insights and opportunities for shared solutions.

Angel Wang, RN, MN (Corporate Professional Practice Leader, Manager, Nursing Innovation and Academic Affairs, Michael Garron Hospital; PhD student in Nursing, Queen’s University); Winnie Lam, RN (Clinical Resource Leader, Complex Continuing Care, Michael Garron Hospital); Rozina Ramrattan, RN, MCISc (Clinical Resource Leader, Inpatient Surgery, Michael Garron Hospital); Emma MacGregor, RN, MN (Research Coordinator, Nursing Practice and Education, Michael Garron Hospital; PhD student, Curriculum and Pedagogy, Ontario Institute for Studies in Education (OISE), University of Toronto)

To meet the needs of these projects, Winnie developed excellent interprofessional communication and collaborative leadership: inspiring participation in research and interprofessional partnerships at MGH. By doing so, Winnie has developed strong relationships with her colleagues, patients and families: role modeling the connection between theory, research and practice. This has helped her to be the authentic and transformative leader she is today, as a Clinical Resource Leader (CRL).

Rozina Ramrattan

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Rozina has been with MGH for over a decade and joined the program in 2022 as part of her master’s degree capstone project.

he Nursing Innovation Program at Michael Garron Hospital (MGH) offers nurses opportunities to develop scholarship competencies across their career trajectory. Accordingly, we highlight the professional development of two nurses on our team.

Drawing on existing interprofessional relationships, Rozina supports nursing staff to engage in research, carrying their contributions forward with implications to interprofessional collaboration within the organization.

Winnie Lam After reflecting on her own development and the needs of her unit, Winnie joined the program as a bedside nurse in 2020. Her role was 14

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In doing so, Rozina developed transferable skills: data collection & analysis; communication; research methodologies; critical thinking and problem-solving; and ethical considerations.

ur Veterans Centre interprofessional team at Sunnybrook Health Sciences Centre cares for some of the most vulnerable residents, primarily Veterans from the Canadian Forces, and Allied Veterans of World War II and the Korean War. When the World Health Organization declared COVID-19 a global pandemic in March 2020, residential nursing homes and complex continuing care facilities across Ontario were required to make significant changes including implementing a 14-day period of isolation for newly admitted residents. Isolation prohibited routine social interactions, as well as group activities and visitations, which are crucial to support the overall wellbeing of residents. It is well known that social isolation can negatively impact aspects of residents’ health including their physical, cognitive and emotional wellbeing.

As Rozina puts it, “My journey of self-reflection has combined academic success and personal growth, putting me in a position to significantly impact healthcare and education [...] I am now equipped to influence healthcare systems and promote knowledge sharing on the frontline.” Today, Rozina remains a valued member of the team as a Master’s-prepared CRL at MGH.

Our interprofessional research team observed these changes in our new residents from the first day of their admission to the end of their 14 day isolation period. We conducted a retrospective qualitative study to better understand this impact.

Our results showed that some residents primarily experienced negative emotional impact during isolation. By contrast, staff observed that for other residents, there were negative impacts on all aspects of cognitive, emotional and physical wellbeing. These findings served as an impetus to pursue a quality improvement initiative aimed at reducing the impact of isolation on our residents through a generous grant from Veterans Affairs Canada.

Winnie and Rozina helped expand nursing innovation at MGH. They have shown their colleagues how engaging in nursing innovation can advance careers and professional development, while paving new pathways for interprofessional collaboration. Winnie and Rozina developed as leaders, showcasing how the interprofessional team works together for excellence in patient-centered care. Thanks to their leadership, there is increased engagement in nursing research and QI at MGH: we invite other nurses to join them on this journey.

E n h a n c i n g Ve t e r a n s ’ W e l l Being during Isolation through Interprofessional Collaboration

Drawing on the unique knowledge bases and expertise from multiple professions, our team designed and implemented multiple interventions, including: a poster containing chair-based exercises, a poster with care tips to enhance unit staff in their engagement with residents in isolation, and a checklist offering various activity materials from toolkits. Some of the items in the tool kit include puzzles, radios, magazines, silk plants and spiritual materials. The feedback from this initiative has been extremely positive, particularly from residents expressing that they felt that they truly mattered and were well supported by staff.

Susan Deering, MD, MSc, FCFP (Assistant Professor, Department of Family and Community Medicine, University of Toronto, Sunnybrook Health Sciences Centre [SHSC]); Selena Sun, BScPT (SHSC); Kathryn Yakymyk, RN, HBScN, MSN, GNC (SHSC); Jennifer Kivell, MSW, RSW (SHSC); Jim Huth, PhD, MA, MDiv, RP (SHSC); Linda Nusdorfer, RN, BScN, MN, CNCC (SHSC); Samantha Findlay, BA Psych, PGDip (TR), R/TRO (SHSC); Sayanthen Sathyakumar, BSc (Sunnybrook Research Institute)

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INSPIRING CHANGE SYSTEMS, POLICY & LEADERSHIP Strong Interprofessional and Fa m ily Co l l a b o r at i o n D r i v i n g Autism Assessment Process Redesign

One year after beginning this project, the majority of our group members still enthusiastically attend our monthly meetings and participate in smaller, interprofessional working groups. These collaborations have so far led to the design of a new telephone screening and information session (conducted by clinicians from three different professions); five new clinical pathways to triage families into; a live, parent-led chat for families awaiting their assessments; and a video to help inform members of the public who may be curious or apprehensive about a referral to Holland Bloorview.

Ian Roth, M.H.Sc., SLP(C), Reg. CASLPO (Holland Bloorview Kids Rehabilitation Hospital, University of Toronto); Andrea Hatherell, M.Cl.Sc., Reg. CASLPO, M.Sc (Holland Bloorview Kids Rehabilitation Hospital); Josh Scroggy, M.S.W., M.H.Sc (Holland Bloorview Kids Rehabilitation Hospital)

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Our senior management team made it clear from the beginning that our mandate was to make the assessment process more transparent and more supportive of families’ needs. Family involvement in this project has therefore been essential. And while there are plans to roll out many additional components, our productivity, momentum, and the audacity with which we have reinvented the diagnostic assessment process at Holland Bloorview have only been possible through the synergy of teamwork between family members and professionals.

n 2021, a provincial requirement to incorporate screening and triage into our autism diagnostic processes at Holland Bloorview Kids Rehabilitation Hospital created an opportunity to review and improve the ways we currently conduct our autism assessments.

Though our team is made up of clinicians from nine different professions, the two who were first approached to lead this initiative were a speech pathologist, and a quality improvement specialist who is also a clinical speech pathologist from a different program. Not exactly a strong interprofessional start! But when we asked for volunteers to join our working group, we were overwhelmed with around 16 volunteers representing almost every profession on staff plus 5 parents of autistic children. Add to that a new operations manager who inherited this huge task, and for the past 12 months, our team has been swept up in collaboration fever!

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INSPIRING CHANGE SYSTEMS, POLICY & LEADERSHIP

Use of the Relational Coordination Theor y and Framework to Build Interprofessional Collaborative Practice and Integrated Healthcare Systems

1. interprofessional communication; 2. patient/client/family/community-centred care; 3. role clarification; 4. team functioning; 5. collaborative leadership; 6. interprofessional conflict resolution.

Both the RC and CIHC frameworks provide an integrative approach to build essential collaborative relationships and effective communication strategies.

The RC Survey has been widely used to improve quality, client engagement, efficiency, and worker well-being.4 Because the RC Survey is a fully validated network measurement tool, this can be used by managers and leaders to demonstrate collaboration at multiple levels, including micro, meso, macro, and meta. We conducted a pilot research study using the RC Survey to assess the level of collaboration and communication among the leaders of various healthcare and social care organizations (Ontario, Canada). The RC survey can guide stakeholders by identifying strengths or areas for improvement to support interprofessional collaborative practice and strengthen integrated healthcare systems.

Grace Liu PT, BScPT, MBA, PhD (School of Health Policy and Management, Faculty of Health, York University); Peter Tsasis PhD (Associate Professor of Management, Faculty of Health and Faculty of Liberal Arts and Professional Studies, York University); Jody Hoffer Gittell PhD (Professor, Heller School for Social Policy and Management, Brandeis University; and Co-Founder and Board Member [Relational Coordination Analytics])

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here is a need to build interprofessional collaborative practice and integrate healthcare systems in Canada. This article provides guidance for policymakers, leaders, and managers to inspire change using the Relational Coordination theory and framework developed by Dr. Jody Hoffer Gittell at the Heller School for Social Policy and Management (Brandeis University, US).

Relational Coordination (RC) is understood as “communicating and relating for the purpose of task integration”.1 RC theorizes that highly interdependent work is most effectively coordinated through collaborative relationships and strong communication. The domains of RC are: 1) shared goals, 2) shared knowledge, 3) mutual respect, 4) frequent communication, 5) timely communication, 6) accurate communication, and 7) problem-solving communication. In numerous research studies in healthcare and other sectors, higher levels of RC have been associated with better performance and patient outcomes. 2

References: 1. Brandeis University. (2023). What is Relational Coordination. Retrieved from https://heller. brandeis.edu/relational-coordination/about-rc/ index.html 2. Bolton, R., Logan, C., & Gittell, J. H. (2021).

Revisiting Relational Coordination: A Systematic Review. The Journal of Applied Behavioral Science, 57(3), 290-322. Retrieved from https://doi. org/10.1177/0021886321991597 3. Canadian Interprofessional Health Collaborative.

(2010). A National Interprofessional Competency Framework. Retrieved from https://phabc.org/ wp-content/uploads/2015/07/CIHC-NationalInterprofessional-Competency-Framework.pdf 4. Brandeis University. (2023). Relational Coordination Survey. Retrieved from https://www.rcsurveyhelp. info/

We believe the RC framework aligns with the National Interprofessional Competency Framework established by the Canadian Interprofessional Health Collaborative (CIHC). 3 The CIHC`s 2010 competency domains (Editor’s note: CIHC Competency Framework currently under revision) are:

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INSPIRING CHANGE SYSTEMS, POLICY & LEADERSHIP

How Leader ship Team Development is Helping the Univer sit y of Michigan Center for Inter profes sional Education “ Walk The Walk” of B uilding B et ter Teams

“We are fortunate to have an incredible team of IPE leaders who come from so many different parts of our university,” shared Rajesh Mangrulkar, M.D., director of the Center for Interprofessional Education. “We made a deliberate decision to make this coaching investment in their individual development, but more importantly, to help us do our work together as a team. How can we be in the business of developing teams in health and health care, if we don’t walk the walk ourselves?”

Jessica Bixby, MFA (Marketing Communications Specialist, University of Michigan Medical School, Michigan Center for Interprofessional Education)

The team met regularly throughout the 2022-23 academic year, culminating in a graduation event in August. Participants shared their autobiographies, an exercise in holding space to speak, share, and lead — something that all leaders must do but few are trained to do well. The practices are now being integrated into C-IPE’s everyday work.

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eamwork and building better teams are at the center of everything the Center for Interprofessional Education (C-IPE) stands for. Having leaders who are equipped to build and nurture teams is key to building successful teams, so the C-IPE decided it was time to invest in what they have long focused on.

To support this, C-IPE partnered with The Marteney Group to guide the leadership team, consisting of the C-IPE team and faculty co-chairs of their committees and strategic work groups that support the Center’s strategic plan. Their work is highly interconnected, so bringing them together as a team of leaders was critical in maintaining a unified mission. There was intentionality around the concept of the “leadership team” with both the mission in mind but also the ways in which those leaders could lean on one another and help each other with their work.

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Univer sit y of New England ‘Doing Our Par t ’ Alan Bennett, B.A (University of New England)

The University of New England’s (UNE) “Doing Our Part” represents a profoundly transformational moment for UNE, in which strategic, student-centric investments in programs and infrastructure will enable the university to provide an unmatched educational experience.

Last November, UNE broke ground on the Harold and Bibby Alfond Center for Health Sciences (HBACHS) — the new home of UNE COM — on the University’s newly renamed Portland Campus for the Health Sciences.

Together Stories of Collective Impact

The expansion of its medical school will allow UNE to graduate 35 more doctors each year and will bring together nearly all of the University’s health professions programs onto a single, interprofessional campus — an unprecedented model in New England, in which students in the state’s only medical school, dental school, and physician assistant program, will collaborate directly with their peers studying nursing, social work, pharmacy, physical and occupational therapy, nurse anesthesia, and psychiatric nursing, among others.

Did you read our previous issues?

Click HERE to read Together: Stories of Collective Impact, Volume 1.1 (Fall 2022) Click HERE to read Together: Stories of Collective Impact, Volume 1.2 (Winter 2023)

“UNE has been growing its programs and reputation across a variety of essential fields in recent years,” said UNE President James Herbert. “Thanks to the success of our students and alumni, we have so much momentum — and we want to make the most of it.

This transformational campaign will allow UNE to invest even more heavily in the unique educational experience that we provide for our students, so they can graduate ready to embark on valuable careers and lives that make the world a better place.”

Click HERE to read Together: Stories of Collective Impact, Volume 1.3 (Spring 2023) Click HERE to read Together: Stories of Collective Impact, Volume 1.4 (Summer 2023)

Please share widely with your colleagues & networks

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COMING TOGE THER : E VENT S & ANNOUNCEMENT S

Collaborative Community of Pratice Reflecting on Equity, Diversity, Inclusion & Accessibility November 8, 2023 | 4:00 - 5:30pm EDT | Virtual on Zoom Mainstreaming Disability Inclusion: Using a reflexive approach, participants will engage in dialogue about definitions of disability, impairment, inclusion, belonging, ableism, accommodations, etc. We will discuss existing power structures in the context of providing healthcare and healthcare education. Finally, we will identify barriers to accessing Healthcare services.

Curiosity Killed the Cat, Which Made Room for the LEON: Many initiatives are birthed out of crisis. While organizations have created Equity, Diversity & Inclusion programs to address realized social injustice, discrimination and racism, we are now seeing an undeniable shift away from, abandonment and deconstruction of effort. Best laid plans are not enough to prevent ‘cats from being killed’. However, there is noble insights in going back to the drawing board to regroup, revisit our practices, and ask questions like ‘why was this not successful?’. This learning allows us to ‘try again’ and ‘will go in now as a LEON, ready’.

Presenter: Janet Rodriguez Janet Rodriguez (she/her) is a racialized cis gender immigrant woman. Her own journey of illness and disability has informed her of the systemic barriers that exist in the Health care and Health Education systems. Janet actively participates in cross disability movements and applies what she learns in her volunteer work for disability inclusion. She has been a Health Mentor with CACHE’s Interprofessional Education Program. She co-chairs the Temerty Faculty of Medicine Disability Justice Work Group. She the Subject Matter Expert collaborator for the first ever appointed Accessibility Theme Lead in the MD program at U of T. Janet has learned about, from, and with fellow disability justice advocates. Currently she co-leads the Accessibility For All, a social justice project at her Family Health Team (SMHAFHT). She is a professional interpreter and has post grad certificates in Adult Education and HR Management.

Presenter: Michelle Leong Francis Canadian Health Food Association award winner, Michelle is an Adult Educator, graduate of Cross Cultural Counselling, Certified in Governance by the Ontario Health Association and Health Equity by the College of Family Physicians of Canada. Michelle is a practitioner of Human Resources & Member of the Law Society of Ontario.

As a first generation Caribbean Canadian of Asian Cultural Influence and African Ancestry Michelle Leong Francis was recognized in 2020 as Top 100 Accomplished Black Women Entrepreneurs in Canada – named after the trailblazer and first African-Canadian woman to be elected to Canada’s House of Commons Jean Augustine. Michelle also toute a sequential year nomination for RBC Women of Influence.

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EVENTS & ANNOUNCEMENTS

Sunnybrook Annual Education Conference From Teaching to Coaching: Exploring a New Approach to Elevate Clinical Education Performance December 1, 2023 | 8:00AM – 1:00PM EDT | Sunnybrook Health Sciences Centre, Toronto, ON Join us in December for an in-person learning experience! The Sunnybrook Annual Education Conference will welcome the healthcare community and external partners in education across the Greater Toronto Area (GTA) to engage in meaningful discussion as well as inspire action through a broad range of speakers, presentations and six interactive workshops focused on different coaching approaches to support clinical teaching performance.

Interfluence: Curating Stories of Purpose, Possibilities, and Progress Keynote Speaker: Haesun Moon Ph.D. Learn how you can facilitate a “curative” conversation with your learners. Dr. Moon introduces how conversations, our “dwelling place”, form intricate narratives that shape our existence and futures, using evidence-based coaching and communication science.

The core concepts explored in the session include coaching as interactions, revitalizing learner dialogues, embracing heutagogy, fostering autonomy and insight, and understanding the balance between valuing and evaluating in coaching and education.

Visit the website to learn more and to register, https://sunnybrook.ca/education/content/?page=educationconference

Simulation Canada - SIM Expo 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.

Visit the website to learn more, SIM Expo - Simulation Canada

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Collaborative Change Leadership™ (CCL) Program February - December 2024 | Virtual Program Applications deadline November 10, 2023!

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.

Program Dates: • February 1 - 2, 2024 • April 4 - 5, 2024 • June 6 - 7, 2024 • September 26 - 27, 2024 • December 5 - 6, 2024 Applications deadline November 10, 2023!

For more information visit the program website or email, belinda.vilhena@uhn.ca

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Why CCL? Click the video above to learn more.

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Teaching for Transformation: Annual Conference+ (TforT:AC+) 2024 This year’s theme: Teaching toward Collaborative Approaches to Care March 25 - 27, 2024 | Virtual Conference Registration Now Open: https://bit.ly/TforTAC2024Registration Early bird deadline January 31, 2024: $650 Teaching for Transformation: Annual Conference+ (TforT:AC+) is a three-day immersion in the education paradigms and practices needed for today’s health care work. The theme for TforT:AC+ 2024 is Teaching toward Collaborative Approaches to Care. TforT:AC+ involves paired dialogic keynote sessions, workshops, short talks (submitted abstracts), dialogic roundtables, and space for open dialogue. TforT:AC+ will take place online, enabling an international reach.

This conference is relevant to health and social care providers, educators, researchers, health/education policy and decision makers, patients/family partners, caregivers, students, and all individuals who share an interest in advancing the theories and practices of humanistic and transformative education and critical pedagogies and practices.

Become a Community Supporter!

See Prospectus: https://teachingfortransformation.com/ac/ Are you interested in building capacity with your team for transformative education in health and social care? Please see the community supporter options in the prospectus.

By becoming a community supporter, your organization can become a part of the TforT community, accessing networks, resources, and shaping the future of the TforT conference, community, and overarching program.

Call for Abstracts Abstract Submission Deadline: November 15, 2023 at 11:59pm (EDT) Submit your abstract here.

We invite Short Talk abstracts on completed studies, works in progress, or innovations on the topics of transformative education, transformative learning, critical pedagogy, and more--within the context of health professions and health sciences education.

Submit your abstract here: https://forms.gle/mryAWgY VgcSg85QG6 Authors of selected abstracts will be notified in early December 2023.

Please note: all presenters will be required to register for the conference.

Please direct any questions related to abstract submissions or the conference to: info@teachingfortransformation.com Teaching for Transformation (TforT) is jointly offered by Centre for Faculty Development and Centre for Advancing Collaborative Healthcare & Education.

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The International Congress on Academic Medicine (ICAM) April 12th – 15th, 2024 | Vancouver, Canada The International Congress on Academic Medicine (ICAM) is the first international gathering dedicated to academic medicine. It will be the place for the academic medicine community to meet, network, and develop new relationships and collaborations with colleagues from around the world.

ICAM will showcase innovation and scholarship in medical education and health research. Medical students, residents and graduate students will have the opportunity to present their work, network and connect with medical education and research mentors as well as prospective employers.

For more information visit our website.

VITAL: Virtual Interprofessional Teaching And Learning Program 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.

Stay Tuned for 2024 Program Dates Module 1: Overview of IPE/IPC Evidence, Literature and Best Practices

Module 3: Interprofessional Communication and Conflict - Focus on Patient Safety / Quality Improvement

Module 5: Team Functioning/Teamwork Psychological Safety and Leadership - Pulling it All Together

Module 2: Role Clarification

Module 4: Relationship Centred Care: Patients / Caregivers and Teams

Module 6: Interprofessional Facilitation Simulation, Tips and Resources

For more information visit our website or email belinda.vilhena@uhn.ca

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Published By Centre for Advancing Collaborative Healthcare & Education (CACHE) University of Toronto @ Toronto Western Hospital, University Health Network 399 Bathurst Street, Nassau Annex Toronto, Ontario, M5T 2S8 ipe.info@utoronto.ca https://ipe.utoronto.ca/