Transforming the Future of Health Care Today with Interprofessional Education

Surfing the HIPE Line is a recurring column produced by the HIPE working group. The column will rotate among the Nancy Atmospera-Walch School of Nursing (NAWSON), the John A. Burns School of Medicine (JABSOM), the Office of Public Health Studies, the Myron B. Thompson School of Social Work, and the Daniel K. Inouye College of Pharmacy.

It is imperative for health care professionals from various fields to work together to advance the health of patients and populations. The formation of collaborative practice teams “is a key step in moving health systems from fragmentation to a position of strength (p. 10).”¹ Therefore, health care educators have been charged with implementing interprofessional education (IPE) and practice into their curriculum. Competency in IPE is a requirement for nearly all health professional students endorsed by Health Professional Accreditors Collaborative (HPAC) and supported by accrediting bodies.²

The Foundation

In 2014, answering the call for IPE, the leadership of the University of Hawai‘i Council of Health Sciences (CHS) indicated interest in actively expanding cross-school collaboration. At the time, faculty and students within the health-related schools engaged informally and/or for limited projects. The Deans/Directors of the CHS strongly supported more collaborative efforts for IPE to grow as a priority. They designated a workgroup of 12 faculty members, which included faculty from University of Hawai‘i at Mānoa (UHM) Nancy Atmospera-Walch School of Nursing (NAWSON), the UHM John A. Burns School of Medicine (JABSOM), the UHM Office of Public Health Studies, the UHM Thompson School of Social Work & Public Health, and University of Hawai‘i at Hilo Daniel K. Inouye College of Pharmacy. This workgroup was named the Hawai‘i Interprofessional Education workgroup (HIPE).

HIPE’s mission was to prepare all health professional students to collaborate in providing a safe, effective, and sustainable patient/consumer-centered and community/population-oriented health care system. Achieving this mission meant designing curriculum to help students achieve core competencies set forth by the Josiah Macy Foundation (2011) and the Interprofessional Education Collaborative (IPEC).^3,4 The 4 competency domains included: (1) values and ethics, (2) roles, responsibilities, and leadership within the interprofessional team, (3) interprofessional communications, and (4) interprofessional teamwork and team-based care. The competencies were updated in 2016,⁵ and HIPE evolved to incorporate those updates.

Defining IPE

What IPE is: IPE “occurs when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes (p. 10).”¹ IPE prepares students for interprofessional collaborative practice, where health professionals work together to effectively deliver patient-centered care and improve population health in an affordable and efficient manner, resulting in stronger health systems and improved outcomes.¹

What IPE is not: The act of learning to communicate with other professions alone does not encompass IPE. The following list encompasses common acts associated with professional education,⁶ but each of these items on their own does not qualify as IPE:

• Simply sharing electronic health records;

• Working in sole profession teams;

• Hearing a talk about another profession;

• Reporting at interdisciplinary meetings;

• Co-location without intentional collaboration;

• Decision-making without client/patient input.

Through the Years

HIPE has evolved since its inception and is now implementing clinical training experiences, simulation exercises, and online training for all health profession learners, including residents and students. HIPE has administered several continuing education sessions and produced a curriculum integration plan with a listing of IPE activities. All HIPE activities incorporate pre- and post-test assessments to support continuous quality improvement.

Prior to 2020, limited funds were available to support IPE efforts, with the majority of work performed as volunteer efforts by faculty and staff. In 2021, recognizing the essential nature of IPE, the Hawai.i Medical Service Association (HMSA) Foundation awarded $1 million to the UHM NAWSON to build an infrastructure to support statewide expansion and establish an endowed HMSA Distinguished Professorship for IPE. This grant recognizes past successes and supports future development of IPE. Under the leadership of the endowed HMSA Distinguished Professor, Dr. Lorrie Wong (NAWSON), HIPE has begun to utilize the 5-year gift to advance initiatives and to develop an IPE infrastructure that supports and coordinates innovative experiential team-based learning experiences.

The number of students participating in HIPE activities has grown exponentially over time. Table 1 summarizes the impact of HIPE from academic year (AY) 2017-2018 to AY 2021-2022 with numbers of IPE simulation sessions, student encounters, and professions represented.

Table 1.

Hawai‘i Interprofessional Education Impact Over Past 5 Years

Activity	Academic Years
	2017-18	2018-19	2019-20	2020-21	2021-22
IPE Simulation Sessions	54	71	64	157	159
Student Encounters	621	1138	1169	1174	1428
Professions Represented	10	12	12	10	11

Moving Forwar

During the Coronavirus-19 (COVID-19) pandemic, HIPE adapted to evolving COVID-19 protocols by providing online IPE simulations. During this period, telehealth rose to the forefront as a priority initiative for health care providers, students, and community members. In AY 2020-2021, HIPE partnered with the Hawai.i Department of Health Telegenetics and the Pacific Basin Telehealth Resource Center to produce Telehealth Interprofessional Education online educational modules. Faculty from UHM Schools of Social Work, Public Health, Nursing, and Athletic Training, along with University of Hawai‘i at Hilo College of Pharmacy, provided individual modules on telehealth concepts, practical applications, and legal and ethical implications unique to their professions.

Looking ahead, HIPE plans to accomplish several initiatives over the next several years:

• Incorporate (1) trauma-informed care, (2) palliative care/ hospice, (3) child/youth events, and (4) geriatric events into its yearly activities; and (5) continue exploring opportunities for clinical practicum IPE sites.

• Develop a statewide network of IPE partners that coordinates innovative experiential learning supporting the team-bas ed practice model to improve health outcomes for the state, recognizing that additional funding will be required

• Update the HIPE strategic action plan to support the directions and initiatives of the State of Hawai.i, the HP AC, and IPEC.

• Explore legislative opportunities to develop a funding st ream to support a statewide infrastructure for IPE through a fee from practicing clinicians.

• Continue to focus on the development of IPE clinical collaborative practice activities.

Conclusion

With continued university and community funding and support, HIPE has provided substantial IPE for health care providers and students to develop interprofessional collaboration skills and optimize the care of patients and health care status of our community. Continuous quality improvement efforts allow HIPE to meet the needs of the ever-changing health care environment, address population health issues, incorporate technological advances, and reflect evolving professional and educational standards. Future work could include broadening IPE to include synergistic professions such as law, engineering, and computer and environmental science to help prepare our health care workforce to be exceptionally equipped to take on the evolving challenges of tomorrow.

Abbreviations and Acronyms

CHS

University of Hawai‘i Council of Health Sciences

HIPE

Hawai‘i Interprofessional Education workgroup

HMSA

Hawai‘i Medical Service Association

HPAC

Health Professional Accreditors Collaborative

IPE

Interprofessional Education

IPEC

Interprofessional Education Collaborative

JABSOM

John A. Burns School of Medicine

NAWSON

Nancy Atmospera-Walch School of Nursing

UHM

University of Hawai‘i at Mānoa