Notes

Outline

COMMUNITY PARTNERS & INTERDISCIPLINARY EDUCATION Susan Hanrahan, PhD Dean College of Nursing and Health Professions Arkansas State University

"Why have we come together..." Why have we come together today? Because we are DHEP Why are we in a partnership? Because of Robert Wood Johnson’s grant support Would this partnership be in place without financial support? No

What has been the focus of many federal/private grant health initiatives over the last 10 years? Target vulnerable/underserved/diverse population (Delta) Identify gaps in access/service delivery (Health) Deliver cost-effective methods of service (Education) Identify unmet needs/health workforce & service solutions (Partnership)

Interdisciplinary (leads to the most effective health care) Concept endorsed by: JCAHCO AACN (1995) President’s Advisory Commission on Consumer Protection & Quality in Health Care Industry American Geriatrics Society National Commission for Quality Assurance Standards for Accrediting Health Plans Academic Medicine (2001) Pew Health Commission (1991-1995)

New Model of Education Emphasize primary care Service quality Cost effectiveness Teamwork Prevention/management of chronic health problems (why-TQM,CQI, managed care, downsizing)

Differentiate Multidisciplinary-additive Educating more than one discipline at a time Perhaps appreciation for other disciplines

Interdisciplinary-Integrative Educating more than one discipline at a time Educational objectives relative to practice between or among professionals or disciplines

Flashback Trials & Tribulations Institutional inertia Preserve status quo Resistance to change Vertically organized curricula Faculty buy-in Professional territoriality Rigid curricula Inflexible academic rules & regulations Faculty aptitude for interdisciplinary education Faculty reward systems Traditional discipline  mind set Power imbalances Administrative commitment

Success Teamwork Collaboration Conflict Resolution Division of Labor Increased Accountability Evaluation/Assessment Managing Outcomes Change in Attitudes Leadership Distribution (team of leaders)

More to learn Interdisciplinary Education Which professionals should team Which patients truly benefit What methods are most effective for teaching Who should teach interdisciplinary concepts & teamwork What values are involved in teaming Are members of teams more satisfied with work What skill sets should be common to professionals When should interdisciplinary education begin in the education process

Community Based Education in the community vs Education about the community

University – .5 partner Ernest Boyer- Scholarship of engagement 1996 – Challenged higher education leaders to transform the academy to become “a more vigorous partner in the search for answers to our most pressing social, civic, economic & moral problems”.

Realities/Attitudes of University We study community and move on I’ll take care of mine – you take care of yours Divorced from realities of world Lack of commitment to external community One way flow of information (inside out) Service to community – usually lowest on academic priority list

Faculty & Community Can address complex issues (+ synthesis skills) New challenges Value community involvement Connection to community Different rewards & levels of satisfaction Student integration/”hands-on”

Community - .5 partner Infrastructure challenged Social norm & value concerns Economic woes

“yes” to partnerships Congress Some federal funding agencies State policy makers Private foundations

Labels Institutional – community partnership Community – academic partnership University – community partnership Community – campus partnership Integrated services model Service learning models, etc.

Processes in Collaboration Iterative Ongoing Constant Coalition Building Issue Crystallization Ongoing Formulation/Reformulation of Purpose

Framework for Collaboration & Community Linkages Networking Cooperation Coordination Leadership & Decision making Collaboration

Melaville (1993) Getting together Building trust & ownership Developing a strategic plan Taking action Going to scale

Models based on Respect for differences Equal representation in decision making Commitment to shared vision

Transformation University not as leader but, co-learner Shared vision was partnership “glue” Not doing to – doing with Equal Partners Trust building over time Two-way relationships As new partners emerged, reshape vision Unique leadership qualities

Still to learn - Partnerships Because of complexity & interdependence How do you measure What are significant outcomes Worth investment of time Worth investment of resources What is meaningful program Will this bridge withstand the test of time

DHEP tackled -multiple disciplines model using -multi-institutional/community partnership approach (across multiple states) -bonus

A new “norm” Interdisciplinary Grant & accrediting agencies say yes Money available Efficiencies noted Add value Merged expertise Ivory towers downsized Rewards & challenges Sustainable Institutionalizable Partnerships Policy & grantmakers say yes Money available Leverage resources Add value Merged expertise Ivory towers collapsed Rewards & challenges Sustainable Institutionalizable

Susan’s Perceptions Over Time Some don’t know “how” to play together or don’t “want” to play together (words vs actions)

Susan’s Perceptions Over Time Prevailing attitude What’s in it for me

Susan’s Perceptions Over Time Building the structure/IF most difficult part most time consuming

Susan’s Perceptions Over Time Administrative resistance (indirect, NIH, status quo)

Susan’s Perceptions Over Time Still “project” mentality – not accustomed to long-term engagements

Susan’s Perceptions Over Time What pieces are worth sustaining

Susan’s Perceptions Over Time Can/should  threads/pieces be institutionalized

DHEP relative to perceptions Can play together Know what you want Learning curve is over Administrative support Long-term relationship Pieces to carry forward Pieces that will endure beyond our lifetime

Partner achievements Way ahead in the game (this new norm) Have utilized the top of Bloom’s taxonomy Worked through trials & tribulations Impacted institutional status quo Stronger position to meet next set of challenges           (mature, responsive,networked, history, success)

Future (Interdisciplinary Education & Community Partnerships)