Building Bridges in Palliative Rehabilitation: Pilot Testing of Evidence Based Strategies to Enhance Interprofessional Collaborative Practice and Improve Care Coordination for Seriously Ill People and Their Families in the Acute Care Setting

Seminar Description: 
Description: Palliative care and rehabilitation professionals have aligned goals and share a philosophy of person/family centered, holistic care that incorporates physical, psychosocial, and spiritual domains yet models of interprofessional collaborative practice are sparse. Barriers to collaboration for these philosophically likeminded teams include time constraints, role misunderstanding and inadequate interprofessional training. Mitigating barriers to collaboration and integrating rehabilitation services into the palliative care model can augment care delivery and empower people with serious illness to live life to the fullest. With IPEC Core Competencies as a framework, this seminar will report on an ongoing quality improvement project at an academic medical center that aims to equip palliative care and rehabilitation professionals with tools to develop the interprofessional core competencies (role clarity, communication, teamwork, shared values) necessary to provide coordinated, timely, effective care to people living life to the fullest with a serious illness. The five phased project included literature review, expert interviews, identification of barriers and facilitators, development of strategies to mitigate barriers and pilot testing of select strategies. As a result of this project, the PalRehab Toolkit was developed to provide educational support, implementation tools and guidelines to enhance interprofessional collaborative practice in the delivery of palliative rehabilitation services. The toolkit currently consists of 9 strategies and preliminary results of piloted strategies show positive results in increased communication across professions, improved role clarity and an increased likelihood of collaboration.

Theme: This presentation will explore a clinical model of interprofessional collaboration to improve outcomes for seriously ill people and their families (such as discharge to desired settings and reduced readmissions). It will explore workplace learning across teams through educational opportunities.

Learning Objectives:
• After attending this session, the learner will be able to:
• Describe the benefits of collaborative care to improve quality of life for people with serious illness and their families.
• Identify implementation strategies to enhance communication, teamwork, and role clarity among palliative and rehabilitation teams.
•Articulate next steps to facilitate interprofessional collaborative practice among palliative care and rehabilitation teams.

Actionable Skills: Attendees will return to their settings with evidence based tools to build connections across teams serving seriously ill people and their families as well as a renewed understanding of the value of rehabilitation services for this population to enhance quality of life and quality of care. Collaboration tools such as inservice slides, communication tools, and order sets will be shared and customizable to various settings.

Active Learning Strategies: Polling tools (mentimeter) will be used to assess current collaboration and likelihood of adoption of strategies among rehabilitation, palliative care, hospitalists and other providers serving seriously ill people. Case studies will be woven through the content to facilitate discussion. The chat will be monitored for questions and engagement.

Priority Criteria: Caregivers for seriously ill people benefit from psychosocial support, transfer training, equipment management and environmental modifications provided by rehabilitation professionals. Teams are strengthened when rehabilitation professionals provide caregiver training in a timely and coordinated manner leading to a better overall care experience.