Before joining the Consortium, I spent about 20 years in academic medical education, working on medical school curriculum, faculty development, and residency training. Then in 2005 I shifted to the nonprofit association world, and joined the Consortium in late 2015. One of my colleagues from a previous nonprofit association introduced me to the concept of BFO – Blinding Flash of the Obvious. Now, I have frequent, and occasionally embarrassing, encounters with BFO’s. I would love to say that all my BFOs are the result of inspired synthesis of previously unrelated concepts. It’s a lovely aspiration; not necessarily reality…
My most recent set of BFOs occurred this past week. I was preparing to join a panel at the Veterans Health Administration’s conference given for the seven VA Centers of Excellence in Primary Care. The theme of the conference was interprofessional education, training and practice. I was asked to address the intersection of IPE and accreditation.
I did some research on the origins of interprofessional education/training/practice. In 2010, at least 3 major publications focused on the importance of interprofessional education, training and practice as a transformative approach to healthcare. The Lancet Commission, the Institute of Medicine (now known as the HMD or the Health and Medicine Division of the National Academies), and the World Health Organization were extolling the virtues of an interprofessional approach to healthcare. WHO defined Interprofessional education as: “When students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes.” Interprofessional collaborative practice was defined as: “When multiple health workers from different professional backgrounds work together with patients, families, carers [sic], and communities to deliver the highest quality of care”. More recently definitions have focused on the respect for, and collaboration with, the contributions of all participants in the health care process, including the patients.
I realized that the arc of the NP postgraduate training movement, beginning with the first NP postgraduate residency in 2007, coincided with the development of interprofessional education/training and its integration into healthcare practice. I knew that the NPs I’d met through my Consortium work inhabited and provided leadership in a safety net setting of interprofessional healthcare and postgraduate training. Although I hadn’t thought of it as uniquely “interprofessional.” I thought of their approach as incredibly effective, compassionate, and scalable. My first BFO: the FQCH model of care and the NP postgraduate training programs embedded in the FQHC’s (and other safety net settings) are steeped in interprofessionalism.
Then, I reread every word of the Consortium’s 8 accreditation standards, the 68 elements and too-many-to-count sub-elements. Turns out that the word ‘interprofessionalism’ is mentioned specifically in the elements of the Standard 2: Curriculum and Standard 3: Administration. In Curriculum, it is element 5: “Leadership and Professional Development, particularly in Interprofessional practice”; and then sub-element “7: Interprofessional Collaboration”. And so on throughout the Standards. As I steeped myself in the Standards, I came to a much richer appreciation of the role of interprofessional philosophy as the foundational principle in the Consortium’s accreditation process. Interprofessional characteristics are cited explicitly and implicitly on nearly every page, multiple times.
As I researched the term, read the literature, talked with various people, and reread the Standards, I had my second BFO moment. For NPs, the interprofessional approach to training and practice isn’t only philosophical, it is actually the heart and soul of the profession and of the accreditation process. Interprofessionalism is the DNA of the Standards and of the Accreditation process. It is more than the foundation – it is the material that is used to “build” the foundation.
Thinking of interprofessionalism as the DNA of our programmatic accreditation process continues to resonate with me. The two strands are training (mission, curriculum, evaluation, people) and environment (administration, organization, resources). Just as with DNA, the nucleotides (elements and sub-elements) are consistent, but each program organizes them in a unique pattern that best reflects their individual mission and vision. The possibilities for variation represent the opportunities for creativity and innovation.
BFOs can be a good thing!