For David Pole, Ph.D., MPH, improved patient outcomes, quality care, and patient safety exist at an interprofessional crossroad of collaboration. As an Assistant Professor of Family and Community Medicine and the Director of the Center for Interprofessional Education (IPE) and Research at Saint Louis University, Pole has dedicated much of his 15 years at the university to strengthening the interprofessional education, practice, and research programs that allow medical students to train with students from other professions, and provide experiences where they learn about, from, and with each other to improve collaboration and patient outcomes. The IPE programs work across nine health profession programs at the schools of medicine, nursing, social work, Doisy College of Health Sciences and the St. Louis College of Pharmacy.
Breaking Out of Silos
“The Center for IPE, which started integrating interprofessional team seminars into all graduate health programs in 2008, is focused on how to increase the capacity of students and practitioners to engage in effective collaboration and teamwork that improves individual patient care and outcomes,” said Pole. “Our contribution to the learning environment is to help build skills and capacity for interprofessional collaboration that supports providers moving out of their silos for the benefit of their patients. Students practice developing shared goals for patient care and outcomes, determining which professionals need to be on the team to contribute to that outcomes.”
A New Way to Treat Addiction?
“Addiction treatment isn’t simply about getting a patient to stop their substance use—it’s about approaching treatment from a holistic perspective and addressing multiple factors,” said Pole. “We have to look at the individual’s history of trauma, their physical and mental health, and their skills at making better choices. You can’t treat only one aspect of a problem and expect a sustainable outcome. This is where interprofessional collaboration can have a big impact.”
New approaches to treating addiction focus on an effective team of healthcare providers working closely with a patient, and with each other. “Putting people in isolated, in-patient addiction treatment programs is not as successful as we once thought,” Pole said. Today’s model for treatment examines the physical and psychosocial aspects of addiction and an individual’s experiences, and seeks to address these factors through comprehensive, multi-faceted interventions provided by a cohesive treatment team. This new approach to treatment is supported by research being conducted at SLU and the groundbreaking work of
SLU’s community partners at Assisted Recovery Centers of America (ARCA) and the Missouri Opioid State Targeted Response (STR).
SHARE Approach – Engaging the Patient
Pole also described a new framework for provider-patient collaboration created by the Agency for Healthcare Research and Quality (AHRQ) (one of 12 departments within the United States Department of Health and Human Services) that the Center for IPE at SLU has integrated into courses. The SHARE approach provides a framework for training healthcare professionals on how to engage patients in their healthcare decision-making. SHARE is an acronym for: SEEK your patient’s participation; HELP your patient explore and compare treatment options; ASSESS your patient’s values and preferences; REACH a decision with your patient; EVALUATE your patient’s decision and progress. According to Pole, this shared decision-making model starts with the belief that providers and patients are both experts coming to the care setting. “How can we work together to determine the best plan of care that works for you?” he asked. Patient engagement in the decision-making process and care aligned with patient values and preferences have been shown to increase engagement, adhere to health behaviors and improve health outcomes. The SHARE approach is not prescriptive, but rather, exploratory. SHARE is about understanding where the patient is now and what they want to do; then asking yourself, ‘How can I help get them there?’
SLU’s collaborative model ensures we are positioned to be a leader in addiction medicine. “Cutting edge research on how the brain is impacted by opioids is occurring right now at SLU. Likewise, there is excellent work being done in interdisciplinary team approaches to pain management and approaches to reducing the stigma of addictions. Unfortunately, research discovered and advanced in a silo may take 15-17 years to reach the bedside,” said Pole. “A model and framework that integrates numerous elements--from research to clinical practice to teamwork and collaboration--is the most promising approach to not only addressing the opioid addiction epidemic, but to developing sustainable solutions and building an effective healthcare workforce. SLU has these components, and has a strong history of academic and community-engaged collaborations,” said Pole.
Aligning with the SLU Mission
Pole believes that interprofessional collaboration and multidisciplinary teams are supporting a change in the culture of healthcare and community partnerships around addictions.
The IPE programs at SLU are based on the core premise that interprofessional practice and patient-centered care must be applied and demonstrated within the context of wellness, patient safety and quality and social justice. Whether we are addressing addiction, chronic disease prevention or inequities in healthcare and outcomes, effective collaboration and team-based care are essential components aligned with Saint Louis University’s mission.
“You don’t have to fix it all as an individual provider, but you can make sure that your patient gets the right care, at the right time, from the right person,” said Pole. “That’s what’s special about SLU’s mission.”
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