Everywhere I go these days-as a pharmacist and director of continuing education, I run smack dab into the words "interprofessional" and "interdisciplinary"-especially in the worlds of healthcare, medicine, and pharmacy education. In the era of healthcare reform and the Affordable Care Act, all partners in the healthcare team-nurses, doctors, public health professionals, pharmacists, dentists and clinical exercise physiologists--are collaborating in order to work smarter and better with each other to provide optimal patient care.
The Interprofessional Education Collaborative (with member organizations from nursing, osteopathic medicine, pharmacy, dentistry, medicine and public health) developed the Core Competencies for Interprofessional Collaborative Practice in May, 2011. In that expert panel, four core interprofessional competency domains were named:
- Values/Ethics for Interprofessional Practice
- Roles/Responsibilities for Collaborative Practice
- Interprofessional Communication
- Interprofessional Teamwork and Team-based Care
What about ACSM-certified professionals and Registered Clinical Exercise Physiologists (RCEP)? They are part of the healthcare team too! Below are just three examples of these core values in action-ACSM-certified professionals who are not just educating their healthcare teams, but also making a difference in the lives of patients:
- Mark Patterson, M.Ed. and ACSM RCEP at Kaiser Permanente, in a region with many cyclists, often collaborates with primary care, specialty medicine (vascular surgery), and cycling coaches to determine whether or not patient surgery is necessary. The primary care physician sees patients initially, and refers some patients to the vascular surgeon. An ankle brachial index (ABI) and angiogram were performed in one case, which revealed nothing significant. Mark was then consulted and asked to have the patient bring in the bicycle in order to simulate the complaint. Abnormal post exercise ABI was found and a post-exercise angiogram with repositioning of the legs revealed the problem of abnormal vascular anatomy when in a cycling position. This proper diagnosis occurred with the appropriate team members collaborating with the patient to determine positive outcomes.
- Clinton Brawner, M.S. and ACSM-certified Clinical Exercise Specialist (CES) and RCEP, works in Preventive Cardiology Unit at Henry Ford Hospital in Detroit. The unit regularly hosts internal and external medical residents and fellows to learn about cardiopulmonary exercise testing. The physicians in training shadow Ph.D.-level clinical exercise physiologists working in the laboratory. Fellows and residents also receive information on cardiac rehabilitation, clinical weight management, and the Unit team educates patients about available resources, including Clinical Exercise Physiologists and Dietitians.
- David Seigneur, M.S., ACSM CES, FAACVPR, interacts with a cardiologists and surgeons on a regular basis. In one case, the team needed to address the clinical question: was a permanent pacemaker necessary for a patient with temporary external pacing due to underlying slow atrial fibrillation? Working along with the physicians, David and the team determined that the patient's intrinsic heart rhythm responded appropriately during exercise while the temporary pacemaker was turned off, suggesting a permanent pacemaker was not needed. A permanent pacemaker would have increased medical costs and the hospital stay for the patient-both unnecessary.
These three examples demonstrate the true value of care that is interprofessional and collaborative-improving patient care and producing positive patient outcomes. ACSM-certified professionals are answering the call on interprofessional care--are you?
Erin Albert is the community member of the Executive Committee for ACSM. She is also an entrepreneur, author, pharmacist, attorney and the Director of Continuing Education and Preceptor Development at the Butler University College of Pharmacy and Health Sciences in Indianapolis.