The American Psychological Association defines integrated health care as an approach to care characterized by a high degree of collaboration and communication among health professionals.
Also sometimes referred to as interprofessional health care, it spans healthcare disciplines from nursing and primary care to behavioral health and specialties — connecting them whenever possible for the benefit of the patient.
“For me, integrated care is asking: ‘What can we do for our clients to ensure they can meet the goals they set for themselves?’” said Cory Crane, associate professor in the Department of Clinical Health Professions in the College of Health Sciences and Technology at the Rochester Institute of Technology. “The integrated health model doesn’t start at the clinical level, but at the training level.”
Across the Rochester region, colleges and universities with healthcare programs instruct their students about the importance and impact of integrated care on a daily basis via curriculum, clinical activities, and research. The Rochester Business Journal asked three area schools for some examples of how they’re teaching integrated care.
St. John Fisher University: New IPE Sim Center
If ever there was an example of how to teach integrated care, it would be the new Interprofessional Simulation Center (IPE Sim Center) at St. John Fisher University. The center, which was funded by a grant from the Mother Cabrini Health Foundation, opened this fall and further strengthens the interprofessional partnership between the university’s Wegmans School of Nursing and Wegmans School of Pharmacy.
“We’ve been engaging in the integrated educational model at Fisher for a very long time,” said Dr. Tricia Gatlin, dean of the Wegmans School of Nursing and co-principal investigator on the grant. “The center allows us to expand on that.”
Gatlin notes that her vocation — nursing — has always been a collaborative profession and the “keystone” of patient care in terms of pulling together many different disciplines so everyone is on the same page and able to provide the best outcome for the patient.
Inside the IPE Sim Center, nursing and pharmacy students engage in collective learning, professional role discovery and skill development. Among the features of the space are a primary care lab with six hospital beds and an electronic health record system, a medication dispensary, virtual reality and 3-D medical printing capabilities and technology, such as iPads on wheels, that allows telehealth capabilities.
“We know that interprofessional collaboration in health care delivers the highest quality of care to patients while reducing costs and medical errors, among many other positive impacts,” said Dr. Christine Birnie, Dean of the School of Pharmacy and co-principal investigator on the grant. “IPE [interprofessionalsm education] in health profession programs is critical to developing an understanding of the benefits of team-based approaches to patient care.”
More than a third of degrees conferred at Fisher in 2020 were in the health professions and the university is the only one in the Rochester region with a pharmacy school.
“Interprofessional education is woven throughout our program,” said Birnie, who notes that one-third of Fisher’s Doctor of Pharmacy curriculum is experiential and quite a few learning opportunities are done in collaboration with medical students and faculty at the University of Rochester’s School of Medicine and Dentistry. “We have students of all health professions learning alongside each other.”
Roberts Wesleyan University
At Roberts Wesleyan University, undergraduate nursing students are formally introduced to the concept of integrated care in their sophomore years in the Introduction to Professional Nursing Concepts course.
“If we think about integrated care as the care of mind, body, and person, it’s the backbone of our education here,” said Robert Dorman, director of traditional and graduate nursing programs and associate professor at Roberts Wesleyan. “We start our students early with teaching them about integrated care and how important it is to be collaborative, because collaborative care is a form of integrated care.”
Among the health-related programs offered at Roberts Wesleyan are nursing, social work, public health, health administration, and occupational therapy. Every spring, the university brings students from the health disciplines and criminal justice program together for a large-scale, hands-on simulation training event. One of the goals is to show students that the health and mental health care professions do not “work in silos,” Dorman said.
For their 2021 Interprofessional Education Simulation Training during a day in April, the school ran three live simulations consisting of ten patient-focused scenarios. The setting was a simulated emergency department with student nurses acting as emergency department nurses caring for patient volunteers with varying medical needs, including severe trauma and critical injuries.
Designated patients also served as simulated crime victims or perpetrators being investigated by criminal justice students acting as the police and at least one patient needed emergent transport to a higher level of care via Mercy Flight, which was on site for the training.
“The experience gets our students to think outside the world of nursing,” Dorman said. “We train them to be great nurses, but patients have many needs and when we have a simulation like this in place it’s a win-win for everyone.”
Rochester Institute of Technology
At RIT, the Department of Clinical Health Professions was founded to bring healthcare education, technology, experiential learning, and research focused together on an integrated manner to enhance patient care.
The department houses several programs, including diagnostic medical sonography, echocardiography, and the BS/MS physician assistant program. It also oversees the school’s priority behavioral health internship program, the second largest graduate pre-doctoral training program accredited by the American Psychological Association.
“One of the greatest benefits of digital care at RIT is that it really lends itself well to integrated care,” said Crane, whose recent $2 million grant from the U.S. Department of Health and Human Services’ Health Resources and Services Administration illustrates that.
The grant supports digital therapy treatments and digital intervention tools RIT researchers developed that give mental health and health care providers tools to reach patients in rural communities.
The project began in 2020 and addresses opioid addiction and other forms of substance abuse and co-occurring mental health conditions like trauma and anxiety for patients in New York’s counties of Genesee,Wyoming, and Cayuga, and the county of Grafton in New Hampshire.
Participating clinical sites were selected through the university’s alliance with Rochester Regional Health and a new partnership with Ammonoosuc Community Health Services in New Hampshire.
Caurie Putnam is a Rochester-area freelance writer.o