Academic Patient Aligned Care Team (Academic PACT or APACT)
San Francisco VA Medical Center
Academic Partners: University of California San Francisco Schools of Medicine and Nursing
The San Francisco Center and Education for Patient Aligned Care Teams (EDPACT) is working to develop and implement a model of patient-centered, interprofessional education. The goal is to bring together teams of trainees, physicians, advanced practice and other nurses and associated health care providers to build shared knowledge and incorporate design principles for optimal workplace learning. Examples include using experiences from clinical practice as the primary curricular material, establishing a culture and supportive working relationships that reinforce patient-centered approaches to care, and activating providers/staff/trainees to take responsibility for improving patient care. Communication, teamwork, and continuous performance improvement are a primary focus of most workshops and weekly interprofessional skill-building sessions. Teams and trainees in EDPACT have (yearlong) precepting and mentoring relationships with faculty and receive regular formative assessment on skills observed during weekly clinical activities.
Trainee Triads: University of California San Francisco (UCSF) Second year adult NP students partner with two UCSF internal medicine residents to form practice partner triads. At UCSF residents rotate from inpatient to outpatient in 2 month blocks. The two residents in the triad are on opposite blocks. Trainee partners each have their own panels of patients but cross cover each other.
Trainee Huddles with teamlet staff- Interprofessional trainees including pharmacy, social work, dietetics, and psychology trainees join NP student-internal medicine resident primary care partner triads to prepare for the care of the veteran. We use a Huddle Coaching Program with Huddle Coaches and Huddle checklist to make the most out of this interprofessional workplace learning opportunity.
Shunk R, Dulay M, Chou CL, Janson S, O'Brien BC.
Huddle-coaching: a dynamic intervention for trainees and staff to support team-based care. Acad Med. 2014 Feb;89(2):244-50. doi: 10.1097/ACM.0000000000000104. PubMed PMID: 24362383.
Collaborative Case Conferences via Video Technology engages primary medical center and remote clinics in support of continued/standardized learning practices and enhanced patient care.
Shared Medical Appointments (pain, diabetes, smoking cessation, advanced directives)
Ambulatory Quality and Safety Curriculum: Interprofessional trainees learn key quality and safety concepts in the context of their own trainee driven quality improvement projects within their own clinics and practice.