Dr. Janet Heinrich, HRSA.

The Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation (RWJF), the Gordon and Betty Moore Foundation, and The John A. Hartford Foundation collectively pledged up to $8.6 million in grants over five years to support such a center, which will serve as a resource to accelerate teamwork and collaboration among health professionals and patients. Additionally, the center will focus on educational practices for the health professions and look to break down the traditional silos to create a more collaborative approach to care delivery.

Janet Heinrich, DrPH, RN, FAAN, the associate administrator for HRSA’s Bureau of Health Professions, noted of her division, “We are the lead part of the agency that focuses on a well-trained adequate workforce, especially primary care providers.”

In that role, she continued, the Bureau of Health Professions is tackling a number of health workforce challenges including curriculum development, faculty development and the expansion of the primary care workforce to meet the coming challenges inherent in an aging population and expanding rosters in the wake of the Affordable Care Act.

There has been a growing interest in interprofessional activities with a number of medical, nursing, public health, dentistry, pharmacy and other health profession schools forging collaborative partnerships. The growing movement gained traction last year when HRSA convened a meeting of experts, including representatives from the Macy Foundation, RWJF, and the American Board of Internal Medicine Foundation to work with a broad array of health professions groups to promote a set of educational core competencies developed by the Interprofessional Education Collaborative (IPEC). 

“The Robert Wood Johnson Foundation has been interested in really trying to help health professions work better together,” said Maryjoan D. Ladden, PhD, RN, FAAN, senior program officer for RWJF’s Human Capital Portfolio. She added that in the last 12-18 months, RWJF has been working closely with other funding organizations to move the IPEC agenda forward.

Although impressed with IPEC’s presentation at the February 2011 meeting, Ladden pointed out the next question was how to institutionalize those ideas. “It’s one thing to write a report but another to get the competencies embedded into education and practice,” she noted.

After many meetings and discussions, a consensus was reached that a “go to” national center was needed to provide leadership and coordination in expanding interprofessional education and practice collaboration. “The notion being,” said Heinrich, “when you work in teams, you improve efficiency, improve quality and decrease cost.”

To that end, a funding opportunity announcement was made on July 20 to determine where the center would be housed and who would direct it. Applications were sent for competitive review in mid-August, and an announcement regarding the site of the new center is expected by the end of September.

The hopes for the new center include:

• Developing, managing and evaluating programs to enhance interprofessional collaboration in education and practice to provide health professionals with the competencies they need to effectively deliver care as part of a team;
• Engaging leaders in education, practice and policy communities;
• Contributing to the research and dissemination of best practices and evaluation parameters to ensure the most effective innovations are utilized;
• Connecting innovators and encouraging partnerships; and
• Developing successful funding streams to ensure sustainability.
  • “Our hope is this coordinating center will provide the infrastructure for collecting the information on best practices in the classroom, as well as the practice setting,” Heinrich said.

Ladden noted the United States could learn from other countries including Canada, the United Kingdom, Australia and Sweden, which have integrated collaboration into their basic healthcare education for a number of years. “We have to look to international models to learn what it takes and how to do it better,” she said, adding the Institute of Medicine has a new committee on global healthcare education to study effective international models of care.

As crucial as the health profession education component is, those behind the center said it requires more than just training the next generation of providers to think collaboratively. The broader concepts must also work their way into today’s practice setting. Heinrich said she envisions convening groups of thought leaders to identify best practices and conduct trainings at a variety of levels. Equally important, she continued, would be a research component and a strong evaluation process to ensure evidence supports concepts.

Ladden said, to borrow an old phrase, that it truly does take a village to deliver effective healthcare today. “If you’re a patient … or you’re a healthcare provider … or you’re a caregiver, you know healthcare is incredibly complex.”

In the face of a patient population that is older, sicker and coping with more chronic diseases and comorbid conditions, she continued, “No one type of provider and no one provider can do it alone anymore.” She added, “You want to be able to be sure patients and families get the best care when and where they need it by the people who are best equipped to give them the best care.” To do that Ladden continued, “You need a group of healthcare providers who really work collaboratively because no one person has all of the knowledge and skills and competencies.”

Ultimately, Heinrich concluded, “I don’t think we can do too much to help people affiliated with our academic medical centers understand how important it is to begin rethinking how we educate and collaborate if we’re gong to make our delivery systems for healthcare be as efficient as they need to be as access expands for both preventive and curative healthcare.”

“The center comes at a really key time for healthcare,” Ladden added. “It’s a really exciting time because of the work we’re doing in primary care to look at how to use the workforce more creatively to improve access and quality and control cost and to help them understand how to work together.”

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