“There’s No Room for Silos.” Interprofessional Education in Hospital-to-Home Integrated Care Programs.

Introduction: Preparing current and future health care providers to work in integrated care models requires interprofessional learning about working in teams across health sectors and integrated care concepts/principles. Evidence indicates that Interprofessional education (IPE) is essential for training health and social care providers and building workforce capacity for new models of integrated care. Yet how we are preparing current and future health care professionals (HCPs) to work in these models of care is unclear. Therefore, we sought to understand how IPE is implemented in existing hospital-to- home integrated care. We report key informants’ descriptions of IPE in training existing HCPs to work in hospital-to-home integrated care programs in Ontario Canada. Method: Utilizing a qualitative descriptive approach, interviews were conducted with 15 leaders of hospital-to-home integrated care programs across the province. Interviews were audio-recorded and transcribed verbatim. Data analysis employed a thematic analysis approach. Findings were interpreted through the lens of an interprofessional learning continuum model (Institute of Medicine, 2015) and competencies for integrated care (Langins and Borgermans, 2015). Findings: Formal and informal IPE through staff orientation and team processes within the integrated care programs can support competency development (e.g., role clarity, communication, and teamwork) for interprofessional practice within hospital-to-home integrated care programs. Key informants acknowledged the importance of cross sector IPE to understand patient care trajectories and provider roles more fully. Conclusions: The findings provide examples of the need for both formal and informal IPE in these hospital-to-home integrated care programs. Interprofessional teamwork, learning together, and having no room for silos reinforced the importance of continuing interprofessional learning for existing HCPs in the context of hospital-to-home integrated care programs. IPE in integrated care programs is required to meet the changing needs of patient populations, shifting roles of health care providers, and evolving health care systems. Implications for Education and Practice: This work has direct implications for preparing current and future health care professionals to work in new models of integrated care such as hospital-to-home programs where collaborative approaches are critical to support safe, quality patient care within and across health and social care sectors. Education content should include concepts and principles related to IPE, collaborative teamwork, and fundamentals of integrated care. Training should begin in formal academic programs and continue in practice settings. Student placements for health professionals should be considered as a mechanism to develop knowledge and competencies for integrated care. Cross-sector training can help health and social care providers understand the focus of the integrated care program (e.g., patient pathways, referrals) and the roles and responsibilities of various team members. Next steps: We are currently engaging academic and practice leaders to explore the feasibility of creating new nursing student placement opportunities within hospital to home integrated care programs with the aim of building knowledge and competencies for integrated care.

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