Interprofessional Education and Practice: Creating Leaders and Opportunities

1. Interprofessional Education and Practice: Creating Leaders and Opportunities for Clinical Learning MODULE 6 Collaborative Leadership Funded by the Australian Government Office of Learning and Teaching

2. Learning outcomes • Explore your organisation’s readiness for interprofessional education/interprofessional practice • Understand key approaches to collaborative change leadership

3. Catalysing change: collaborative change leadership (ehpic™, 2013)

4. IPE/IPP cornerstone of health human resource strategy Advancing Teamwork in Healthcare will require a significant paradigm shift. It will require all stakeholders to be involved, engaged & willing to collaborate for change. www.healthforceontario.ca

5. Critical success factors in Ontario • IPC champion – Assistant Deputy Minister of Health Human Resources – reporting to both Education & Health • Accreditation standards for interprofessional education • Legislative regulatory changes across professions – Bill 179 • Government funding provided for interprofessional education to support universities & colleges • Innovative partnership grants between education and practice awarded

6. US Advisory Committee on Interdisciplinary Community-Based Linkages • Adopt accreditation standards for interprofessional education • Conduct evaluations to further assess effectiveness of interprofessional education and practice • Implement knowledge-sharing resource to disseminate best practices • Facilitate establishment of reimbursement policies that support interprofessional practice • Establish standards for information systems & data elements to facilitate collaboration • Provide interprofessional faculty development & curriculum development resources to health professions schools

7. Is your organisation ready? Defining organisational culture “… shared philosophies, ideologies, values, assumptions, beliefs, expectations, attitudes and norms in organizations.” “... is nurtured and shaped gradually over a period of time, reflected in terms of collaboration, trust and learning, and it can shape the behaviours of people in that organization.” (Zhu & Engels, 2013, p. 2)

8. Culture • Culture is embedded in artifacts • Artifacts are tangible things that demonstrate culture through language used, organisational structures, leadership models, practices etc. (Martin, 2002; Schein, 1996)

9. Cultural change What would it take to transform your setting to one that supports interprofessional education and interprofessional practice?

10. IP-COMPASS: Interprofessional Collaborative Organization Map and Preparedness Assessment Tool A guided self-assessment, quality improvement framework to help understand the types of organisational values, structures, processes, practices & behaviours required to create an environment that is conducive to interprofessional education https://nexusipe.org/ http://www.youtube.com/watch?v=dfBJRSw2xeg

11. The IP-COMPASS Framework The 4 constructs: – The organisation is committed to interprofessional practice (IPC) – The organisation is committed to interprofessional education – Structures and supports exist to facilitate interprofessional education – Structures and supports exist to facilitate interprofessional practice

12. Construct one: the organisation/unit Commitment to interprofessional collaboration Examples 1.2 Interprofessional collaboration is part of strategic planning 1.3 Time, people & money are committed to interprofessional collaboration 1.4 Leaders promote interprofessional collaboration among team members 1.7 The effectiveness of interprofessional collaboration is measured

13. Example (1.2) Interprofessional collaboration is part of strategic planning in the organisation When this attribute is strong…IPC is almost always considered when strategic-level decisions are made that impact (a) how care providers work together and (b) how clients/patients are cared for. These decisions might be at any level (e.g., organisation, program, department or unit).

14. Evidence… • IPC is in formal planning documents, for example… Is IPC in the organisation’s overarching strategic plan and/or ‘scorecards’? • In our clinical setting, this attribute is…

15. Using the IP-COMPASS Tool • Apply the IP-COMPASS to your context to reflect upon its readiness for interprofessional education and practice • Choose the construct that most stands out to you (if time permits start another) • Facilitators are assigned at each table to assist you.

16. Large group debrief • Describe your experience using IP-COMPASS. 2) What strengths did you identify demonstrating interprofessional education and practice?

17. Large group debrief Now consider how you can lead the use of this tool in your own setting.

18. Leading from where you stand

19. What do we mean by leadership? Margaret Wheatley defines a leader as: “Anyone who sees an issue or opportunity and chooses to do something about it .” The real work of leaders is to help people discover the power of seeing. (Wheatley, 2009, p.144)

20. Change curve

21. Kotter’s 8 steps for transformational change 1. Establish a sense of urgency 2. Form a powerful guiding coalition 3. Create a vision 4. Communicate the vision 5. Empower others to act on the vision 6. Plan for & create short-term wins 7. Consolidate improvements & produce more change 8. Institutionalise new approaches – embed into organisation’s culture (www.kotterinternational.com)

22. Collaborative leadership • Asking questions • Pausing and reflecting • Sensing what is needed • Modelling collaboration (Adapted from Scharmer’s (1997) Theory U)

23. Appreciative leadership Appreciative Inquiry Involves the art & practice of asking questions that strengthen a system’s capacity to heighten positive potential Empowers others to act on a vision (Cooperrider& Whitney, 1999)

24. Questions as a strategy • The change has started simply by asking the question • Questions can be used: - to gain and sustain momentum - to foster reflection “Organizations grow in the direction of what they are repeatedly ask questions about and focus their attention on” (Bernard Mohr, 2001)

25. Appreciative inquiry 4-D cycle

26. Paired interviews - what would interprofessional education and practice look like at its best? • Instructions in your resource file • Partner with the person next to you • Nominate person A and person B • A interviews B using the questions in the interview instruction sheet • B interviews A using the questions in the interview instruction sheet • Come back to your group to share Be curious

27. Summary • Paired interviews allow everyone to have a voice • Often generate a lot of energy • New possibilities come to light when you listen to your own & others stories • Sharing stories can establish common ground • Stories can hint at what could be created (co-created)

28. Appreciative leadership 5 core strengths of an appreciative leader: Inquiry – ask for others to contribute – sends message of valuing them Illumination – show their strengths & how they can best contribute Inclusion – collaboration, give sense of belonging Inspiration – provide with a direction Integrity – let people know they’re expected to do their best & that they can trust others to do the same (Whitney, Troston-Bloom & Rader, 2010)

29. Systems thinking to understand complex situations • A system is something that maintains its existence and functions through the interaction of its parts • When dealing with a system you never do just one thing – system effects cross boundaries (Collopy, 2009)

30. Leaders with multiple frames A leader who can draw upon multiple frames is a more comprehensive leader than one who relies exclusively upon one for all situations. (Bolman & Deal, 1991)

31. Lessons learned (Bolman & Deal, 1991)

32. Lessons learned (Bolman & Deal, 1991)

33. Lessons learned (Bolman & Deal, 1991)

34. Lessons learned (Bolman & Deal, 1991)

35. Using multiple change approaches