Integrated Health Care Training Corps

The Integrated Health Care Training Corps A collaboration between The University of Pittsburgh School of Social Work and UPMC Health Plan

Daniel Rosen, PhD, MSW

John Lovelace, MS, MSIS

Rafael Engel, PhD, MSW

James Schuster, MD, MBA

Melissa Brusoski, MPH

Michele Gordon, PhD, MSW

Elizabeth Zimmerman-Clayton, MSW, LCSW

Sara Liber, MSW, LCSW

Overview of the program In 2015, the University of Pittsburgh School of Social Work (SSW) established the Interdisciplinary Workforce Development Training program for the UPMC Health Plan. This innovative, collaborative program incorporated customized, specialized curriculum for on-site continuing education for UPMC staff and field internships for current social work students.

Now, in the sixth year of partnership with the UPMC Health Plan, the SSW has designed and implemented an interdisciplinary, culturally-competent seminar program that features learning modules focused on the creation of high-performing teams that address the social determinants of health. The UPMC Health Plan has also provided specialized on-site curriculum for social work students in integrative healthcare.

The Vision Broadening the skills of health care professionals will help them to address the complex challenges that many patients face and will ultimately support improved health care outcomes and enhanced access and engagement in services for these individuals.

Daniel Rosen, PhD University of Pittsburgh School of Social Work

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The Integrated Health Care Training Corps

UPMC Health Plan + The University of Pittsburgh School of Social Work:

Six Years of Partnership

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Total for all years: UPMC Staff Trained 2021

2020

2019

2018

2017

2016

190

35

27

31

64

81

Total: 428 Years 1-3 featured training centered around building interprofessional teams • In 2016, a 4-session Course, “Advanced Teamwork Training”, developed by the SSW was offered for the community team. This program was designed to expand participants’ understanding of factors contributing to more effective collaborative communication.

• In Fall 2017, the Integrated Healthcare students at the University of Pittsburgh School of Social Work had the opportunity for interprofessional education when they participated in the Silverscripts program in conjunction with the School of Pharmacy. In this program, social work and pharmacy students were paired together to conduct comprehensive medication reviews for older adults in senior centers around the city.

The challenge was the interdisciplinary collaboration, and at the same time, I think it is the greatest takeaway for me from the experience. It is important to address our role as social workers with working with different professions… at the core is whether different professions can really collaborate to improve clients’ needs instead of putting their profession as a priority.

—Integrated Healthcare Certificate Student, on her experience in Silverscripts

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The Integrated Health Care Training Corps

Years 4-6 focused on building practitioners’ skills in assessing and addressing the social determinants of health that may be influencing member outcomes.

• In 2018, the UPMC social work staff began training the first cohort of Roth Fellows.

The Roth Field Fellows program was named in honor of Dr. Loren Roth for his long-time commitment to the inclusion of social workers in health care settings.

While interning at the UPMC Health Plan, Roth Fellows developed the knowledge and skills needed by social workers to help members maintain good health, prevent or minimize illness, and to manage the psychosocial components of chronic conditions.

UPMC Social Work Leadership • In 2019, UPMC Healthplan Social Workers began volunteering as mentors for Pitt Social Work interns placed primarily in UPMC field sites that lacked a qualified Social Worker to train them. Qualified MSWs supervised and mentored students for a commitment of 1-2 hours per week in both group and one-on-one sessions.

Michelle Hankinson has worked for the UPMC Health Plan for over 5 years as a Senior Health Manager with the Adult Telephonic Case Management Team for over 5 years, and was one of the first Social Workers to volunteer for this program.

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2020-2021 Integrative Healthcare Training Lunch and Learn Seminar Series

Building Relationships and Social Capitol Al Condeluci, PhD

Difficult Conversations: Skills for Engaging Members Amy DeGurian, MSW

Creating High Performing Teams that Address the Social Determinants of Health Dr. Jeanette South-Paul, MD

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The Integrated Health Care Training Corps

Al Condeluci, PhD Speaker: Building Relationships and Social Capital Al Condeluci is the former CEO of CLASS, a nonprofit, community-based support system for individuals with all types of disabilities in Pittsburgh, PA from 1973 to 2018. He holds an MSW and PhD from the University of Pittsburgh, where he is on faculty in the School of Health and Rehabilitation Sciences and the School of Social Work. He has authored 7 books, including the acclaimed, Interdependence: The Route to Community (1991) and the most recent, The Macro Change Handbook (2015).

Building Relationships and Social Capital This presentation examined why systems have not been more successful in creating communities where all people are safe, have an opportunity for accessible and affordable homes, jobs, or meaningful daytime opportunities, and lifestyles of their choice.

Many vulnerable people—children and adults—have found themselves in isolation with limited options for friendships and important social relationships. Staff learned to define and delineate the concept of social capital with a focus on the relationship between social capital and health.

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Amy DeGurian, MSW, LSW Difficult Conversations: Skills for Engaging Members Amy has been a full-time faculty member of the University of Pittsburgh School of Social Work Field Education department since 2013. Amy draws from her clinical and program coordination skills developed through 27 years of experience in health care, hospice and gerontology. She currently teaches Social Work Field Seminar, Generalist Social Work Practice, and Grief and Loss in the Master’s of Social Work program.

Difficult Conversations: Skills for Engaging Members This session provided staff with skills to approach difficult conversations with members when they have become upset or angry. The course focused on utilizing a person-in-environment, strengths-based approach to problem solving and communication. Participants were given the tools to have serious conversations that lead to focused and productive outcomes, and learned to identify personal traits that may influence a practitioner’s communication style. Staff were provided with a collaborative approach to engage members in careconversations, including the review and practice of the “Ask-Tell-Ask” Model.

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The Integrated Health Care Training Corps

Dr. Jeanette South-Paul Creating High Performing Teams that Address the Social Determinants of Health Dr. Jeannette E. South-Paul retired from the University of Pittsburgh School of Medicine in 2020. Prior to this, she was the Andrew W. Mathieson UPMC Professor and Chair of the Department of Family Medicine since 2001. Before joining the faculty at the Pitt School of Medicine and UPMC, she served as a Medical Corps officer in the U.S. Army, retiring in 2001 while serving as Chair of Family Medicine at the Uniformed Services University of the Health Sciences and previously as Vice President for Minority Affairs at the same institution. She was responsible for the academic missions of 5 additional UPMC Family Medicine residencies in Pennsylvania.

Creating High Performing Teams that Address the Social Determinants of Health This session offered a case-based approach to understanding how social determinants of health influence the health outcomes of members with complex needs. Specific examples of the complexity of factors influencing the health of populations — such as history, community resources, institutional structure — and thus impact their health status.

Staff gained a deeper understanding of factors that can obstruct access to usual resources. Federal and County data was discussed to recognize the sources of health information and the need for identifying both health system and community resources to mitigate disparities often seen among health plan members, their families, and the communities they represent.

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2020-2021 Integrative Healthcare Training Seminar Series

Outcomes In 2020-2021 18 “lunch and learn” seminars were offered to UPMC staff * Some participants attended more than one session

148 Creating High Performing Teams that Address the Social Determinants of Health

Total* 516

190 Building Relationships and Social Capitol

178 Difficult Conversations: Skills for Engaging Members

235 Case Management (CCM)

Total CEUs *

647

Social Work

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167

The Integrated Health Care Training Corps

245 Nursing

$16,175

in 2021 toward continuing education for UPMC nurses, social workers, and case management * Many participants obtained more than one type of CEU (for example, Nursing and CCM)

Feedback

I enjoyed the entire series. It is relevant to my practice and reminds us of the inequalities that still exist in healthcare accessibility.

UPMC Staff Participant

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What activities or parts of the seminar did you like the most and why?

I liked the examples of the different types of [communication] styles. I was able to identify what I have been doing and will help with other people in the future.

Dr. South-Paul’s presentation, brilliant, engaging, passionate!

[The instructor] knew the content and believed what he was teaching.

I enjoyed learning about the biology of loneliness & isolation.

Reviewing the communication styles. This caused me to stop and think about my own style, how I can be perceived.

...we were asked to think about why someone will not comply with the treatment plan and it really made me think about the reasons why my patient will not take their medications or visit their doctor.

Discussion around social isolation, because so many of the participants I support have this issue, before and since the pandemic.

Satisfaction scores for all sessions 2020-2021 On a scale of 1 to 6, to what extent did the program meet the learning objective?

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5.4

5.4

4.9

Difficult Conversations Learning Objectives

Social Determinants Learning Objectives

Social Capital Learning Objectives

5.6

5.6

5.3

Difficult Conversations Course Objectives

Social Determinants Course Objectives

Social Capital Course Objectives

The Integrated Health Care Training Corps

Overall, what are the three most important skills you learned?

Reminder to have participants summarize conversations and to create action plans to explore understanding and comprehension.

Empathy through compassionate dialogue, self actualization for internal bias, creativity in care management.

Listen to understand, be open and honest — even with myself, stand up straight, and assertive communication involves self respect.

Listening more effectively, being aware of my body language in conversation, staying focused.

Information about individuals at risk of isolation.

The difference between social isolation and loneliness.

The impact of isolation.

The need to work as a team to begin breaking these barriers down is important to remember.

Assessing and identifying social isolation

Pre- and Post- test scores for all sessions 2020-2021 Difficult Conversations — 10 items / Mean difference significant at P<.005 Pretest

7.6

Posttest 8.6

Social Determinants — 12 items / Mean difference significant at P<.005 Pretest

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Posttest

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Social Capital — 12 items / Mean difference significant at P<.000 Pretest

4.9

Posttest 6.4

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A virtual format in 2020-2021 allowed for a greater geographic reach

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The Integrated Health Care Training Corps

UPMC Specialized Training for Pitt Social Work Students

186,480 hours From 2015 – Present, 259 Integrated Healthcare Certificate and Hartford students completed specialization field placements. This equals a total of 186,480 hours contributed to community agencies over a 6-year period. The total value

Pitt Social Work Students trained 2020-2021

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The Roth Fellowship

Pitt SSW students spend two semesters with the talented interdisciplinary teams (IDT) of the UPMC Health Plan (Practice based care management and Community Care Behavioral Health). Students gain experience addressing the social determinants of health that impede many Health Plan members’ ability to engage in treatment such as poverty, social support, neighborhood conditions, and access to health education.

of these intern hours* equals

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$5,322,139

UPMC was one of the original community partners when the Hartford Fellowship was established. The Hartford Partnership Program for Aging Education is a unique educational program designed to enhance leadership skills in gerontology. The program is based upon development of specific geriatric competencies across services sectors and with the diverse older adult population. It is offered, with appropriate variation in course work, competencies, and field experience, for both Master’s and Bachelor’s students.

* In their second year of the Masters of Social Work program, students complete a 720-hour concentration field placement. Independent Sector, a national membership organization for non-profits, foundations, and charities, estimates that the average value of a volunteer hour is $28.54.

Hartford Fellowship

Social Work students that are supported by UPMC go the extra mile in their field sites With support from UPMC Senior Services, Hartford Fellow offered two presentations entitled: “Older Adults in the LGBT Community,” and “Technology Use and Older Adults: Framing the Conversation.

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2126 Cathedral of Learning 4200 Fifth Avenue Pittsburgh, PA 15260 socialwork.pitt.edu