Enhancing Interprofessional Collaboration through Interprofessional Collaboration through Remote Remote Consultation to Consultation to Provide Provide Comprehensive Care with Cerebral Palsy PatientsComprehensive Care with Cerebral Palsy Patients

Abstract

"Background: Cerebral Palsy is one of the most common motor disabilities in children affecting the ability to move, maintain balance, and posture. • As the disease progresses it is staged into 5 classes: stage 1 with mild mobility restrictions and Stage 5 being primarily wheelchair or bed bound. • In stages 4 and 5, common comorbidities include Aspiration Pneumonia, Gastric Reflux, Malnutrition and weight loss, Dental Caries and Gingival Hypertrophy, Decubitus Ulcers, and Seizures. • 68-90% of CP patients have Hip Subluxation and 60-75% Scoliosis, requiring surgical intervention. • Surgery is often delayed due to comorbidities, and various post-op complications often occur. • Large amount of health care professionals need to be involved to manage their care. Objective: The goal of this project is to apply the principles of IPE to develop communication & teamwork across disciplines involved in CP patient care to improve patient outcomes.

Learners: Biomedical Engineering Students, Nursing Students, Orthopedic Surgery Residents We expect the targeted learners to observe and develop an appreciation on the benefits of: i) working as part of an interprofessional team, ii) using whole patient problem solving.

The main IPE competencies to be addressed include: • Interprofessional Communication Practices • Interprofessional Teamwork and Team-Based Care • Roles/Responsibilities for Collaborative Practice • Values/Ethics for Interprofessional Practice

Methods: Students complete pre-quiz to determine level of understanding. • Students view two videos on inter-professional learning. • Students independently view video regarding Cerebral Palsy. • Students meet within their profession to discuss goals of care for the selected patient. • Students then independently listen to the recorded zoom sessions (x2) of the health care team collaboratively discussing the patient plan of care. • Students complete the Jefferson Observation Tool. • Lastly 2-3 students from each profession will meet to collaboratively discuss their designed plan of care. • Learners complete post-quiz and submit reflection.

Results: Two pre-op consultations were performed and have been recorded for use by IPE Learners. Good participation of over 15 different health professionals involved in the collaboration including Anesthesia, Dental, Dietician, ENT, GI, IT, Neurology, Nursing, Orthopedics, Surgeons, Pediatrics, Physical and Occupational Therapy, Social Work, PM&R, Pulmonary, and Urology. Pending are learners post surveys and reflections. Lessons Learned: Getting a large amount of health care professionals together at the same time can be challenging. • Some professionals feel their notes in the patient chart is sufficient and do not need to collaborate inter-professionally. • Patient surgery is often delayed more than once due to multiple health complications. • Had to select a different patient as the first one was not progressing toward surgical intervention. • Can be difficult for students from various professions to arrange a time to inter-professionally collaborate. • Obtaining HIPPA compliance for recorded zoom patient discussion.

Future Application and Next Steps: Students gather to discuss goals and their plan of care for the selected patient. • Patient goes in for scheduled surgery. • Learners to: • Evaluate patient outcomes. • Submit reflection. • Complete post-module survey.

Acknowledgements: Want to thank our selected patient and their caregivers for allowing us to use their challenging situation to examine and promote interprofessional learning. Also want to thank the various health professionals involved in the patients care for taking the time to collaborate inter-professionally and be recorded for student observation. Dr. Seymour (Zeke) Zimbler for his research contribution to Cerebral Palsy patient care."