PRESQUE ISLE, Maine — Teamwork among health care professionals can lead to better patient outcomes, and Dr. Dora Anne Mills, vice president for clinical affairs at the University of New England (UNE), wants that message to be heard loud and clear.
“About 210,000-440,000 Americans die every year in hospitals due to medical errors, mostly health care associated infections and medication mistakes,” she said. “When you do a root cause analysis of those errors, what you find out is that 80 percent of them are due to poor teamwork; that is the health care professionals, especially with professionals from other health professions, have ineffective communication, coordination and/or collaboration.
“The Institute of Medicine recommends that health professionals learn how to be effective team members, especially with students from different professions and with patients through strategies called interprofessional education (IPE),” said Mills, who had been Maine’s public health director for 15 years.
Mills said she spent four years in medical school and three years in residency, and “never once during those seven years was intentionally placed with a nursing student or a dental student or anybody else.”
“I only trained with other medical students. It’s sort of like training the first baseman together with just other first basemen, training the outfielders together with just other outfielders, and so on and so forth, and then on opening day say, ‘OK, now you guys get on the field and play together.’ They don’t really know the language that each other uses, they don’t know the strategies each other uses; they’re all hanging onto a different part of the elephant,” she said.
“Health professionals generally are very dedicated to their patients,” said Mills, “but because we are traditionally educated and trained in the silos of our separate professions, working in a team with those from other professions is not necessarily easy.”
For about 15 years, Mills said, UNE has been educating health profession students from the 13 degree programs (including medical, dental, pharmacy, nursing, physician assistant, dental hygiene, occupational therapy, physical therapy and social work) together on campus.
“The students learn from each other how a doctor approaches a patient versus how a nurse might or a pharmacist might, differences in their scope of practice, differences in language, etc.,” she said.
Thanks to a Josiah Macy Jr. Foundation grant, UNE is expanding the efforts that were initiated on campus, now fully integrating them into clinical settings by implementing clerkships in which students from different professions work together in the same clinical settings, Mills said.
“We’ve done that in several pilot sites in southern Maine where we have a team of students with different professions represented — a medical student, a nursing student and a pharmacy student, for example. They go together in the same clinical setting and they’re training together in that same clinical setting versus separately,” she said. “We’ve had some very good success with the pilots in southern Maine, and what we wanted to do is really expand this to rural Maine where there’s so many workforce shortage issues and challenges.
“We chose Aroostook County to be the first rural area to do this in, and we hope to expand it after this to downeast Maine and other parts of the state. We feel like it addresses both the team issue, but also the health care workforce shortage areas,” said Mills. “We think that by putting interprofessional teams of students up here that it will increase the chance that they’ll come back to practice.”
To help inform community health centers and area hospitals that are interested in hosting teams of students or learning about this approach to team-based care, an Interprofessional Collaborative Practice Summit was held April 14 on the NMCC campus.
“We had about 80 registered for the summit, and it was really a chance for us to share the principles of interprofessional education,” said Mills. “We introduced the concepts in the morning, and had a discussion about next steps in the afternoon. It was a wonderful success.”
Mills said she anticipates such student teams will start clerkship experiences in northern Maine this fall.