Focus, Health Care, and Higher Education

Cherry Street Services will test new health care model

WMIPEI develops plan to use student teams to augment services.

July 4, 2014
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Cherry Street Services will test new health care model
Jean Nagelkerk, vice provost for health at GVSU, said if the pilot program at Cherry Street Health Services proves effective, it will be implemented at other sites in Michigan. Photo by Johnny Quirin
Michigan’s largest federally qualified health center may be welcoming a pilot program this fall where students from different health care backgrounds and academic institutions will work as a team at the clinic.

Through the West Michigan Interprofessional Education Initiative, three academic institutions are implementing a nontraditional clinical and collaborative model of care program with Cherry Street Health Services’ family practice at 550 Cherry St. SE, Grand Rapids.

Grand Valley State University, Michigan State University College of Human Medicine and Ferris State University College of Pharmacy are participating with the National Center of Interprofessional Practice and Education in an incubator research project to pilot a team-based model of care in a family medicine practice setting.

According to WMIPEI’s impact statement, the organization partnered with the National Center in 2012 to serve as an incubator site to develop a program to discover if interprofessional education and collaborative practice results in better patient and administrative outcomes.

Jean Nagelkerk, vice provost for health at Grand Valley, said as an organization, WMIPEI’s goal is to infuse team-based care and collaborative practice into the community, and the nontraditional model of care is one way to prepare students to work in a team setting.

“We know that if you work in teams, you have less communication problems, and according to The Joint Commission, the majority of errors — deadly errors — are due to communication failures,” said Nagelkerk. 

“We will be looking at patient outcomes, productivity. … Our hypothesis is that it will improve care by improving health outcomes, we will maintain productivity or increase it because of the assistance of the students, and there will be better patient satisfaction.”

According to The Joint Commission’s news release in June 2012, roughly 80 percent of serious medical errors occur when there is miscommunication between care providers during patient transfers. The independent nonprofit organization was founded in 1951, and certifies and accredits health care organizations and programs in the United States.

The interprofessional collaborative practice program will group students from different health care backgrounds and academic institutions to work in a group within the family medicine practice at the Cherry Street health clinic. Nagelkerk said there will be a medical student from MSU’s College of Human Medicine, a physician’s assistant from GVSU and a pharmacy student from FSU working as a team at Cherry Street Health Services.

Students will go through four of the six modules in the online program developed by WMIPEI for faculty, staff and preceptors at the Cherry Street site. The student modules cover such topics as interprofessional education and collaborative practice, patient safety, team building and conflict resolution, and motivational interviewing and appreciative inquiry. 

Faculty and staff also receive an interprofessional preceptor manual and a module on faculty or staff development.

In addition to the online modules, students will receive daily huddle guidelines and collaborative care planning, and will work on case presentations. Nagelkerk said students will have discipline-specific visits with a single preceptor, but the program takes a nontraditional approach since students will work as a team in a clinical setting.

“They will take a medical chart that has multiple medications, they will review them and make a recommendation to the preceptor as a team,” said Nagelkerk. “They will do RN call-backs. They will do diabetic group teaching … and then they will go in and see one patient in the afternoon as a team.”

She said the benefits for students participating in the nontraditional clinical model include learning interprofessional skills necessary in the workplace and being exposed to different health disciplines.

“One of the great benefits for students is they get to practice together,” said Nagelkerk. “They get to interact with the different disciplines, learn more about their roles, learn how to communicate effectively in a team-based setting, and then when they get out, they will have better skills in that area.”

Cherry Street Health Services was selected as the participating clinic due to its long-time affiliation with WMIPEI as a member, and its designation as the largest federal-qualified health center in Michigan. The nonprofit organization was established in 1988, and when it merged with Touchstone Innovare and Proaction Behavioral Health Alliance in 2011, it expanded to have more than 25 locations across the state, according to its website.

The health care organization serves more than 70,000 individuals each year, including nearly 4,000 patients who are homeless. Roughly 55 percent are uninsured, according to WMIPEI’s impact statement.

“We reached out to them and they were very interested in looking at a new model of care to infuse into a family practice setting, so we chose them,” said Nagelkerk, in reference to the partnership with Cherry Street Health Services.

She said the program is currently being processed with the internal review board at GVSU and after receiving grant funding, the anticipated start date for the collaborative program is Aug. 1.

“In order for us to do this, we had to have some funding,” said Nagelkerk. “We just learned a few weeks ago Blue Cross Blue Shield Foundation of Michigan will be providing a grant award to do this research, and then the National Center for Interprofessional Practice and Education is giving us matching funds.”

Although the program only will be implemented at Cherry Street Health Services, Nagelkerk said the nonprofit is open to using it in other settings if the resulting outcomes are positive. 

As an incubator site, the collaborative practice model will be shared with all members within WMIPEI and has been presented to Mary Wakefield, administrator of Health Resources and Services within the U.S. Department of Health and Human Services.

WMIPEI was founded in 2007 by GVSU, MSU’s College of Human Medicine, and the Grand Rapids Medical Education Partners. In 2009, FSU’s College of Pharmacy and Optometry became the fourth university partner. The organization was developed to provide an inter-institutional framework to look at interprofessional education in practice and innovative initiatives. 

WMIPEI has grown to more than 25 organizations with 145 members, Nagelkerk said.

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