RESUMO
Background: No Place Like Home is a clinical interprofessional education (IPE) activity whereby pharmacy and medical students conduct home visits under the guidance and supervision of a clinical preceptor to homebound patients. Purpose: We examined pharmacy and medical student perceptions of mastery of interprofessional competencies during an in-person clinical home visit pre-COVID-19 pandemic versus a virtual IPE learning activity consisting of didactic and case discussions in response to the global COVID-19 pandemic. Methods: We administered the same modified Interprofessional Collaborative Competency Attainment Survey (ICCAS) instrument, which uses a five-point Likert scale, to both the in-person and the virtual IPE students following their learning activity. Results: We received a total of 459 completed survey responses with an overall response rate of 84%. For both groups of students, the in-person format was preferred, however, to our surprise, the results indicated that students in the virtual group reported greater perceived gain in interprofessional skills than students in the in-person group. In addition, pharmacy students perceived greater gain from the interprofessional activity and offered more thoughtful reflections about their experience. Conclusions: Even though both groups of students preferred the in-person visit, the IPE objectives were equally (for medical students) or better (for pharmacy students) absorbed in the virtual environment than the in-person clinical home visit.
RESUMO
BACKGROUND/OBJECTIVES: There is significant literature on the development and validation of quality measures, but comparably less on their implementation into learning health systems. Electronic Health Records (EHRs) have made vast amounts of data available for quality improvement purposes. In this paper we describe a conceptual model for EHR implementation of quality measures. DESIGN: The model involves five steps: (1) select a measure; (2) define measure criteria; (3) validate criteria and measurement process; (4) improve recording of measure-related activity; and (5) engage quality improvement processes. The model was used to develop and implement a quality measure in the Home-Based Medical Care (HBMC) setting. SETTING: Harris Health House Call Program (HHHC) provides primary medical and palliative care for homebound patients in Houston. PARTICIPANTS: Four-hundred twenty-four primary care patients followed in the HHHC. MEASUREMENT: Completion rate of the 9-item Patient Health Questionnaire (PHQ-9) within the Electronic Health Record of newly enrolled HHHC patients. RESULTS: Use of the conceptual model to guide implementation of a quality measure of depression screening in a HMBC practice was successful. Additional components of early leadership and clinician buy-in were required, as well as strong relationships with IT to ease implementation and limit disruptions in clinicians' work-flow. CONCLUSION: This conceptual model was feasible for guiding implementation of a quality measure for depression care of HBMC patients, and it can guide broader implementation of EHR-based quality measures in the future.