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Social Work, Social Development: Action and Impact World Conference in Stockholm, July 8- 12, 2012 Interprofessional Education in Health: Challenges of Health Inequality and Social Exclusion Florette Giasson, Université de St. Boniface, Canada [email protected] and Tuula Heinonen, University of Manitoba, Canada [email protected]

Interprofessional Education in Health: Challenges of Health Inequality and Social Exclusion Florette Giasson, Université de St. Boniface, Canada [email protected]

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Social Work, Social Development: Action and ImpactWorld Conference in Stockholm, July 8-12, 2012

Interprofessional Education in Health: Challenges of Health Inequality and Social Exclusion

Florette Giasson, Université de St. Boniface, Canada [email protected] and Tuula Heinonen, University of Manitoba, Canada [email protected]

Overview Introduction: Social work in interprofessional

practice in health Global Agenda for Social Work and Social

Development Commitment to Action and IFSW Statement on Health

The Canadian and Local Context of interprofessional health practice in Winnipeg, Manitoba, Canada: Some examples

Conclusions, Recommendations and Implications

Context of Interprofessional Education and Collaborative Practice

Growing awareness globally that interprofessional education (IPE) and collaborative practice (CP) can enhance health systems, address health workforce challenges (aging workforce, job dissatisfaction) and improve quality of service and outcomes

The foundation of IPE and CP is to ensure the health and wellbeing of individuals, their families and communities

The World Health Organization(2010) has stated, “Interprofessional education occurs when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes”. The outcome is a collaborative practice-ready workforce

IPE and CP requires that something must be exchanged that changes how the learner perceives themselves and others

Action on Interprofessional Education & Collaborative Practice call to action:

Since health systems differ internationally, policies and strategies need to be suited to local contexts with their own varied challenges and needs.

The Framework presents ideas for moving forward interprofessional education and collaboration with a range of partners and stakeholders in health care and is essentially, “a call for action to policy-makers, decision makers, educators, health workers, community leaders and global health advocates to take action and move towards embedding interprofessional education and collaborative practice in all of the services they deliver” (WHO, 2010. p. 10).

Social Work in Interprofessional Practice in Health Care

Historical aspects Social work situation in relation to other health

professions and in the health care system Roles and functions of social work in IPE Challenges and potential for social work Our local context is Winnipeg, Manitoba Canada:

Canada Health Act shapes the health system which is mainly biomedical and serviced by doctors and hospitals. Public health initiatives are also covered, but they focus mainly on primary care services.

Inequality and Determinants of Health: A Social Work and Social Development Perspective

(adapted from Heinonen, Metteri and Leach, 2009)

Material Well-Being & Social and Health Care Access and Entitlement

Behaviour and Lifestyle

Social and Physical Context

Health Beliefs and CultureBiology, Genetics,

Psychology and Identity

Societal-,Political and Structural Features

Global Agenda for Social Work and Social Development Commitment to Action: Key Areas (1)

Human rights Economic disparity, poor labour standards and

conditions and lack of corporate social responsibility leading to damaged health and well-being of individuals and communities and increasing inequality and poverty

Cultural diversity and right to seek redress for better speak out for “a more satisfactory intellectual, emotional, moral and spiritual existence.”

Global Agenda for Social Work and Social Development Commitment to Action: Key Areas (2)

Threats to community support for social development and well-being of people

Challenges imposed on health and well-being by unsustainable environments “related to climate change, pollutants, war, natural disasters and violence.”

“We commit ourselves to supporting, influencing and enabling structures and systems that positively address the root causes of oppression and inequality… with people who use services and with others who share our objectives and aspirations to create a more socially-just and fair world…” (IASSW, ICSW and ICSD, 2012, p.1)

IFSW Statement on Health (1)

• Health as a social work issue• Determinants related to health • Social work principles• Social work roles and responsibilities

Retrieved on line, June 30, 2012 at: www.ifsw.org

IFSW Statement on Health (2):Some implications for interprofessional practice in health care and health-concerned settings

Health is multi-dimensional Health is not just the absence of disease, also encompassing

wellness Promotion of social work activity as essential throughout

health services Promotion of a holistic understanding of health in policy

making and practice Advocacy and support of efforts of individuals, families and

communities to participate in decisions affecting their health

University of Manitoba Interprofessionnal Education Initiative

The University of Manitoba Interprofessional Education Initiative was formed in 2008 by the Deans of 13 health science academic units within the University of Manitoba (U of M);

The IPE website sets out the mission of IPE as follows: “to graduate health professionals prepared to manage and adapt processes in interprofessional teams necessary to achieve optimum person- and family- centred health and wellness outcomes.”

Research indicates that IPE is most effective when:• principles of adult learning are used. (e.g. problem-based

learning and action learning sets).• learning methods reflect the real world practice experiences of

students• interaction occurs between students.

Faculties are presently including components of IPE in Curricula

Faculty of Social WorkInterprofessionnal Education Initiative

The Faculty of Social Work was a pilot site for an interprofessional learning event that, grounded in adult learning theories, brought together small interprofessional groups of (8-10) students from social work, occupational therapy, nursing and kinesiology students to work on a health promotion case situation. The students were unanimous in recommending that this kind of interprofessional learning event be repeated in the future and with a greater number of student participants.

In 2012, a large interprofessional education event was held in which over 450 students and 48 facilitators in eight professional academic units took part. After the event, students evaluated their experiences. Social work students were highly appreciative of the event and felt they had gained valuable knowledge from it.

Manitoba Example 1:Transdisciplinary Project in

Community Health (1) Université de Saint-Boniface, Winnipeg, CANADA

(Team: Gisèle Lapointe, Nursing, Halimatou Ba, Social Work, Florette Giasson, Social Work, Janelle de Rocquiny, Research Assistant and Emanuel Zabre, Research Assistant)

Funded by Great-West Life Community Partners:

Centre Flavie Laurent: reduce poverty by offering support and physical goods (clothes, furniture, household items) to people in need

Accueil francophone: services for French-speaking new comers (immigrants & refugees)

Youville Centre: services focused on healthy living – from health care and wellness education to counselling and support

Centre de santé de Saint-Boniface: primary healthcare clinic that offers services in both French and English – offers community health programming outside the clinical setting

Manitoba Example 1:Transdisciplinary Project in

Community Health - Goals (2) Students to transcend their ideas – draw on team members’ best

skills/assets – develop a new way of thinking as a group Students to change their perceptions, attitudes and behaviours about

transdisciplinary work Tackle social inequalities at the prevention/community level Focus on “transdisciplinarity” & “community health”:

Collaborative practice works best when it is organized around the needs of the population being served (Framework for Action on Interprofessional Education & Collaborative Practice, p. 28).

Community Primary Tertiary Health Care Care

Trandisciplinary Multi or Interdisciplinary

Manitoba Example 2: WISH Clinic at Mt. Carmel Clinic

The WISH Clinic is an interprofessional, student-run clinic It provides non-judgmental, socially responsible, holistic

health care to a population that struggles with poorer health than the rest of the city.

Health and social care is provided by university students and licensed professional mentors from a broad range of disciplines that includes Dental Hygiene, Dentistry, Dietetics, Medical Rehabilitation, Medicine, Nursing, Pharmacy, Psychology, Social Work, and Spiritual Care.

The WISH clinic is open on Sundays and offers not only care services for clients, but also food for those who come to use its services.

Conclusions, Recommendations and Implications

Interprofessional health care practice is here to stay In Canada, intersectoral interprofessional strategies (beyond hospital

care) in promoting health and preventing health problems can be further developed (e.g., housing, child care, education and action to address violence, poverty and addictions and social exclusion)

Social work contributions in health care can be highlighted and promoted through interprofessional relationships and in practice settings

Social work roles in social advocacy and action can enhance interprofessional practice collaboration and health outcomes for clients

Social workers can play a greater role by researching and writing on interprofessional practice processes and outcomes

It is time to treat the client as a true partner in a system where the client is encouraged to take more responsibility for his or her health and where professionals are encouraged to practice in a collaborative process.

Questions and Comments

References http://umanitoba.ca/programs/interprofessional/ http://umanitoba.ca/programs/interprofessional/about_us/media/ www.umanitoba.ca/news/blogs/blog/improving-health-promotion-and-care-the-i

nterprofessional-way http://www.cihc.ca/World Health Organization (WHO) (2010). Framework for action on interprofessional

education & collaborative practice. Geneva: WHO. Heinonen, T., Metteri, A. & Leach, J. (2009). Applying health determinants and dimensions in social work practice. European Journal of Social Work, 12(2), 139-153.

WHO (2010). Framework for Action on Interprofessional Education & Collaborative Practice (WHO/HRH/HPN/10.3). Geneva: author.

Sargent, J. (2009). Theories to aid understanding and Implementation of Interprofessional education. Journal of Continuing Education in the Health Professions, 29(3), 178-184.

D’Amour, D., Ferrada-Videla, M., Rodriguez, L., & Beaulieu, M-D. (2005). The conceptual basis for interprofessional collaboration: Core concepts and theoretical frameworks. Journal of Interprofessional Care, 1, 116-131.