Breaking down silos between specialties and hands-on training enable better health care delivery

Students at Humber College and BCIT are immersed in collaborative and hands-on learning environments. HIVES, Humber’s interactive learning spaces create environments that mirror paramedics, nurses, pharmacy techs and others working together (left). BCIT students (right) practise with life-size robots, which simulate symptoms such as plummeting blood pressure, cardiac arrest or uncontrolled bleeding. supplied

Health-care policy debates often begin with the assumption that meeting the challenge of unsustainable health-care spending means accepting less or lower quality patient care. But innovation at two Canadian post-secondary institutions – Humber College and British Columbia Institute of Technology (BCIT) – is upending that idea.

In fact, improving patient safety is one of the most effective ways to reduce health-care costs, says Jason Powell, the dean of the School of Health Sciences at Humber College Institute of Technology and Advanced Learning in Toronto. “Adverse events and near misses can be catastrophic for patients, and they also cost the system a significant amount of money,”

He uses a far-too-common story to illustrate: because of communication gaps between a care team that includes a pharmacist, surgeon and nursing team, Mrs. Smith is given a medication that causes an adverse reaction. Her expected three- or four-day hospitalization for a hip replacement turns into 28 days in hospital.

“When team members collaborate effectively, patients like Mrs. Smith get optimal care,” says Mr. Powell. “They’re home in three or four days and their bed is free. Costs and wait list times go down.”

A purposeful approach to collaborative practice education is an essential part of the solution, he says. In the traditional model, health-care professionals trained in isolated silos are expected to instantly understand the roles of other specialities the moment they begin their careers.

“Our aim here is to produce a workforce that’s ready to participate in collaborative, high-quality care.”

All Humber College School of Health Sciences, programs are designed to break down silos between specialties, and continuing education courses are available to equip health professionals already at work in their fields to collaborate more effectively with other specialists.

HIVES, Humber College’s interactive learning spaces, allows faculty to replicate the environments students are going to work in. A student paramedic, nurse, pharmacy tech, occupational therapist and emergency tele-communicator may be assigned to work together on a real-life case, Mr. Powell explains. “When students learn from, with and about each other; when they’re comfortable with and knowledgeable about other professions and know how to communicate with them effectively, the potential effect on patient safety is revolutionary.”

At BCIT, 22 computer-controlled robots allow critical care nursing students to learn how to save lives, often by making mistakes. As things go wrong, these sophisticated life-size robots may experience plummeting blood pressure, cardiac arrest or uncontrolled bleeding – and along the way, they may even swear at the nursing students trying to help them.

Rob Kruger, a member of BCIT’s Critical Care Nursing, Simulation and Innovation faculty, is the health-technology expert who programs the robots as part of his mission to integrate advanced technology into the institute’s health-care training. Working with the robots helps students bring their learning in the classroom into clinical practice, he says. “We use them for clinical decision-making and team practice, which translates to better health care delivery.”

BCIT’s emergency nursing department is currently beta-testing a virtual baby, and critical care nursing students – who would formerly have used textbooks that, when stacked, reached 42 inches high – now receive their entire curriculum on mini iPads. “With some help from Apple Canada, we created interactive books, with videos of actual clinical practice,” says Mr. Kruger.
Preliminary data shows that students immersed in this technology-driven experiential learning are much more prepared for clinical practise, he reports.

BCIT’s technology-driven training prepares students to access current guidelines and make the best decisions possible for patients, whether they’re in a hospital, a clinic or a home setting, says Bernice Budz, the dean of BCIT’s School of Health Sciences. “They are able to learn and practise in a safe setting, and when they go into clinical practice they’re already functioning at a high level, providing care with the least likelihood of creating error.”

A new BCIT health and life sciences building is in the planning stages, and the focus will be partnering with local health authorities to expand simulation opportunities, says Ms. Budz.

“We’re looking at research on how the brain learns and trying to really push the envelope, to design safe learning environments that encourage students to retain more information, which will continue to lead to better care,” says Mr. Kruger.

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