Today was one of my two half-days in the tuberculosis
(TB) clinic. In clinic today, the team
was comprised of a physician (today an Infectious Diseases specialist, other
times a Respirologist), a nurse practitioner, a nurse from Public Health, a
respiratory therapist who joined us for sputum inductions, and myself. There is a social worker who is a member of
the team here as well. The TB clinic started
in the year 2000 and they focus on diagnosing and managing both active TB
disease and latent TB infection.
One of the new patients I saw was referred because of
an abnormal chest X-ray finding on immigration into Canada from another country. Upon completion of the interview, it appeared
that the patient had been completely asymptomatic and otherwise healthy. What do we do in these cases? We contacted the respiratory therapist and in
between her other tasks, she came to clinic to help us obtain an induced sputum
so that we could test for acid-fast bacilli (AFB). If negative, the plan in this case would be
to follow-up with sputum cultures every 6 months for 2 years. If positive, this would warrant
treatment. Outside of clinic hours, the
nurse practitioners also serve as a contact point for these patients to notify
them of abnormal results and help to coordinate their follow-up. The Public Health nurse pointed out to me
that as a part of her work with Public Health, she often accompanies her
patients to their TB appointments. Many
of the patients that she works with may live in marginalized areas or are on
social assistance and she encourages them to follow-up and ensures that they
feel supported. It was fascinating to learn
about the scope of my colleagues’ roles in management of this complex disease.
A study from the University of California, San
Francisco demonstrated that designing an Interprofessional Patient Aligned Care
Team (iPACT) to provide interprofessional education (IPE) for internal medicine
residents had positive feedback from residents and interns. It was found that this collaboration created
a mutual understanding of the roles of the team members and was better for
patient care and safety. (Lo et al., 2017)
In a pilot curriculum study between the medical school
and pharmacy school at Marshall University, third year students attended
between two to four sessions during their rotations focusing on IPE topics. Students’ perception towards IPE had a
statistically significant improvement from this. (Gilkerson et al., 2017) These early experiences
in such settings have an impact on medical students’ appreciation of IPE teams. From my time in the outpatient TB clinic, this
multidisciplinary environment facilitated excellent patient care and was an
enriching learning experience. I’ll be
back in TB clinic on Thursday!
Bonne nuit,
SH
Resources:
Lo, D. et al. (2017). Changing Spaces and Learning
Environments to Improve Inpatient Interprofessional Education for Internal
Medicine Residents. Journal of Graduate
Medical Education, DOI: http://dx.doi.org/10.4300/JGME-D-16-00771.1
Gilkerson, C. L. et al. (2017). The Development of a
Novel Interprofessional Education Curriculum for third year medical students
and pharmacy students. Marshall Journal
of Medicine, 3(1): 80 – 89. DOI:
http://dx.doi.org/10.18590/mjm.2017.vol3.iss1.13
No comments:
Post a Comment