Introducing integrative primary health care to an interprofessional audience: Feasibility and impact of an asynchronous online course

Workforce Development in Integrated Care: A Scoping Review

Introduction

Integrated care aims to improve access, quality and continuity of services for ageing populations and people experiencing chronic conditions. However, the health and social care workforce is ill equipped to address complex patient care needs due to working and training in silos. This paper describes the extent and nature of the evidence on workforce development in integrated care to inform future research, policy and practice.

Methods

A scoping review was conducted to map the key concepts and available evidence related to workforce development in integrated care.

Results

Sixty-two published studies were included. Essential skills and competencies included enhancing workforce understanding across the health and social care systems, developing a deeper relationship with and empowering patients and their carers, understanding community needs, patient-centeredness, health promotion, disease prevention, interprofessional training and teamwork and being a role model. The paper also identified training models and barriers/challenges to workforce development in integrated care.

Discussion and Conclusion

Good-quality research on workforce development in integrated care is scarce. The literature overwhelmingly recognises that integrated care training and workforce development is required, and emerging frameworks and competencies have been developed. More knowledge is needed to implement and evaluate these frameworks, including the broader health and social care workforces within a global context. Further research needs to focus on the most effective methods for implementing these competencies.

Self-Reported Antimicrobial Stewardship Practices in Primary Care Using the TARGET Antibiotics Self-Assessment Tool

The self-assessment tool (SAT) is a 16-question self-report of antimicrobial stewardship practices in primary care, available in the TARGET (Treat Antibiotics Responsibly, Guidance Education and Tools) Antibiotics Toolkit. This study analysed responses to the SAT and compared them to previous SAT data (2014-2016). Data from June 2016 to September 2019 were anonymised and analysed using Microsoft Excel and STATA 15. Clinicians reported engaging in positive antimicrobial stewardship (AMS) practices including using antibiotic guidance to inform treatment decisions (98%, 98% 2014-2016), discussing antibiotic prescribing within the practice (73%, 67% 2014-2016), using patient-facing resources (94%, 71% 2014-2016), conducting antibiotic audits in the last two years (98%, 45% 2014-2016), keeping written records and action plans (81%, 62% 2014-2016), using back-up prescribing (99%, 94% 2014-2016) and using clinical coding (80%, 75% 2014-2016). Areas for improvement include developing strategies to avoid patients reconsulting to obtain antibiotics (45%, 33% 2014-2016), undertaking infection-related learning (37%, 29% 2014-2016), ensuring all temporary prescribers have access to antibiotic guidance (55%, 63% 2014-2016) and making patient information leaflets easily available during consultations (31%). The findings offer a unique insight into AMS in primary care over time. The SAT gives primary care clinicians and commissioners an opportunity to reflect on their AMS and learning.

Professional development in integrative health through an interprofessional online course in clinical settings

BACKGROUND

Although there is mounting clinical and cost-effectiveness evidence supporting integrative healthcare (IH), a significant knowledge gap hinders widespread adoption by health professionals.

INTERVENTION

Foundations in Integrative Health (FIH), a 32-h online competency-based interprofessional course to address this knowledge gap.

METHODS

The course was pilot-tested by an interprofessional sample of providers in various clinical settings as professional and staff development.

OUTCOME MEASURES

Prior to and following the course, participants completed an IH knowledge test, an IH self-efficacy self-assessment, and validated measures of burnout, wellness behaviors, and attitudes toward IH, interprofessional teams, and patient involvement. Evaluation surveys were administered following each unit and the course.

RESULTS

Thirty-one percent of the participants (n = 214/690) completed the course. Pre/post course improvements were found in IH knowledge, IH self-efficacy, attitudes towards IH and interprofessional teams, and several wellness behaviors. The course was positively evaluated with 81% of the participants indicating interest in applying IH principles in their practice and 92% reported that the course enhanced their clinical experience.

CONCLUSION

This study demonstrates the outcomes of a multi-site, online IH curriculum offered to a diverse group of health professionals in various clinical settings. This course may allow clinical settings to offer an interprofessional, IH curriculum even with limited on-site faculty expertise.