Health AGEnda

Team-Based Approach at Center of Health Care’s Triple Aim

Reflecting on The Gerontological Society of America’s (GSA) annual meeting, I am more confident than ever that teamwork and interprofessional collaboration are essential to improved care of older Americans. From the fabulous research work, to the clinical teams, to the interprofessional education efforts, I saw examples that made me sure that this is at the core of good care for older people and therefore an important direction for the Hartford Foundation.

I suppose that interprofessional collaboration was at the top of my mind because on my way from New York to the GSA meeting in San Diego, I had stopped for a site visit at the University of Minnesota to learn about the Health Resources and Services Administration’s (HRSA) newly funded $4 million National Center for Interprofessional Education and Colaborative Practice.

My colleagues and I visited the center as part of a consortium of funders interested in the issue who have been working with HRSA in designing and reviewing proposals for the center and who hope to add more even more support, building upon HRSA’s investment to advance this national agenda. I wouldn’t normally write about a grant in development for HealthAGEnda, at the very least for fear of bad luck, but in this case I think that our readers and stakeholders deserve to know what we are thinking and what is going on.

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Interprofessional Education Mk. II – Another Spin of the Wheel?

This week I had the privilege of attending a grantee convening of the Josiah Macy Jr. Foundation  – one of the agenda setting institutions in medical education. Macy’s insider role in medical education makes it even more significant that the topic of the meeting was Interprofessional Education in health care. Today, some ten years after the Hartford Foundation’s Geriatric Interdisciplinary Team Training initiative faded, the notion of teams in health care is again ascendant and I am struggling with hope: Is it going to be different this time? Can we make interprofessional education effective, widespread, and permanent so that people—especially older Americans— can get the care they need? Or, is this just another fleeting interest that will die away at any moment?

When George Thibault, MD, became the president of the Macy Foundation and began investigating options for his new agenda in 2008, we at Hartford were cautiously supportive of an interest in interprofessional education. But still smarting over the collapse of our own Geriatric Interdisciplinary Team Training program  in the early 2000s, I know I was just as glad to let someone else be first back into the battle (read about the evaluation of Hartford’s grants here).

In Hartford’s view, good care of complex older adults requires exquisite teamwork across disciplines/professions, time, and settings. The problems faced by older adults sprawl across silos of expertise – e.g., you never know if you’re going to need a pharmacist to help with an esoteric medication question, a nurse to educate family members on proper administration of the medicine, a social worker to help make the medication affordable, or a physical therapist to get the older adult physically active enough to get off the medicine. The high performing team that can flexibly respond to geriatric complexity needs lots of training and practice.  As our GITT tag line had it, “Good teams don’t just happen.” And, unfortunately, in our experience, mostly they still don’t.

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