Gerri Lamb and Barbara Brandt, Co-Chairs
January 15, 2019
The Nexus Summit 2019 marks an important step in the evolution of interprofessional health care practice and education – to purposefully engage the full range of stakeholders in health care in dialogue and action. Recognizing that everyone in health care shares a common goal of improving quality and value, we also understood that the needs of each stakeholder group would vary. So we went out and talked to lots of people – from every sector of health care to learn what mattered to them. We listened carefully to the words they used – and then tried to capture them in one compelling title.
The title of the Nexus Summit 2019 is “Optimizing Interprofessional Clinical Learning Environments: Better Care, Better Value, Better Education.” Each word is intentional – and connected to the power and potential of collaborative practice and education to improve health care, deliver higher value and assure that we prepare the workforce for the work today and ahead.
We are colleagues who have worked in and studied IPE for quite a while, leading large systems implementations and change. We have both served as chairs of the American Interprofessional Health Collaborative and are committed to advancing the IPE field and developing leaders to navigate today’s rough waters of system change. Because we are in many national meetings and consultancies across sectors, we observe current trends and disconnects. For some time now, we have shared with each other our concerns about both the fragile U.S. health care system and the future of health professions education. As co-chairs of the Nexus Summit 2019, we embarked on a journey to not only plan for the meeting but also to figure out how to solve wicked problems while seizing new opportunities. We were stimulated to action during the November 2018 Strengthening the Connection Between Education and Practice Joint Workshop offered by the National Academy of Medicine Global Forum on Innovation in Health Professional Education and the National Center for Interprofessional Practice and Education. During that meeting, a respected colleague turned to us and said:
“We are educating students for a health care system that isn’t here today and certainly will not be tomorrow!
We have been talking about the same problems for decades – It’s time for real action.”
To make a real difference, we are approaching the Nexus Summit 2019 as more than a meeting and building upon our track record of hosting “Conversation Cafes” to discuss common issues and make recommendations to stimulate new thinking and action on a variety of wicked problems of IPE. For example, during the Nexus Summit 2016, we hosted a Café on perceived barriers of pre-professional accreditation for IPE implementation. By identifying the issues and working with a champion, the Café empowered the Health Professions Accreditors Collaborative, a group of 24 accreditors to collaborate on and release a guidance document on quality IPE across health professions education in February 2019. This is truly historic!
Stimulated by our colleague’s urging, we began conducting extensive dialogues and seeking input from multiple sectors: workforce planners, payers, academic faculty, physician leaders and health systems leaders. We also sent out a survey to over 35 colleagues with a request for a quick turnaround to test our ideas not only for a title but also to guide our decisions about the 2019 Nexus Summit design. People who do not have spare time on their hands began responding within an hour; some asking to speak with us. These conversations are yielding rich insights with participants sharing their opinions, how they are leading in their areas, as well as concerns and opportunities for new solutions for health care.
Here are our initial impressions:
- Although committed to “patient-centered care and quality”, various sectors are not aware of or understand what is happening in other sectors. Different but related issues are keeping people up at night. Sectors are operating in silos yet decisions in any one have significant impact in others.
- We use different words for the same thing.
- U.S. not-for-profit health system margins are down 60% since 2016. Health system leaders were emphatic that new programs or models will not be adopted, or even considered, unless it can be demonstrated that they add real value to health care.
- Even in the face of major technological change, “education,” “learning,” and “workforce development” are still thought of as very traditional models of curriculum, education and training rather than adopting newer workplace learning models currently used in the corporate world.
We started our thinking about the Nexus Summit 2019 with the concept of “interprofessional clinical learning environments” (IP-CLE). We have been testing what people know and understand about CLEs and improving learning and performance in practice as the focal point of the efforts of IPE. We admire the evolving work of the National Collaborative on Improving Clinical Learning Environments (NCICLE) initiated by the Accreditation Council on Graduate Medical Education in convening over 40 national organizations around this issue. We have the advantage of reviewing their soon-to-be-released report that makes bold observations and recommendations for learning in the continuum of health care organizations. Ninety percent of our colleagues with whom we have had conversations understand and support the term IP-CLE. With our commitment to NCICLE’s work, we decided to adopt the term “interprofessional clinical learning environments” and use the Nexus Summit 2019 as a means to promote, advocate for, and accelerate actionable next steps.
Why Optimizing? We received strong feedback that most prefer this term over others such as “transforming,” “rapid change,” “accelerating,” “advancing,” etc. But more than this, we believe the definition of optimizing, or making the best or most effective use of (a situation, opportunity, or resource) communicates leveraging what we have and engaging all learners for value.
Finally, we owe much to our colleague, Stuart Gilman, Director of Advanced Fellowships and the Centers of Excellence in Primary Care in the Office of Academic Affiliations, Veterans Health Administration who recommended the elegant tag line: “Better Care, Better Value, Better Education.” It succinctly sums up what we are learning and thinking. By rolling up our sleeves to optimize interprofessional clinical learning environments, we are confident that we will realize the “Three Bs.”
As we stitch together the Nexus Summit 2019, we will continue sharing what we are learning, how we are using your input to design both the meeting and new ways to break the cycle of the same conversations. We look forward to seeing you at the Nexus Summit 2019!