WEBVTT 00:00:13.729 --> 00:00:16.769 Hello and welcome to Listen Up People, a podcast 00:00:16.769 --> 00:00:19.730 of the USC Suzanne Dworak-Peck School of Social Work. 00:00:19.870 --> 00:00:22.469 I'm Dr. Eric Rice, professor and associate dean 00:00:22.469 --> 00:00:27.339 for research. 58 million Americans are 65 years 00:00:27.339 --> 00:00:30.480 old or older. Over the past decade, as baby boomers 00:00:30.480 --> 00:00:33.399 have reached retirement age, we've seen a 40 00:00:33.399 --> 00:00:36.500 % increase in the number of aging adults. My 00:00:36.500 --> 00:00:39.240 guests today are part of the Interprofessional 00:00:39.240 --> 00:00:42.659 Education and Collaboration for Geriatrics, a 00:00:42.659 --> 00:00:45.299 USC program which is transforming the way that 00:00:45.299 --> 00:00:47.859 services are delivered to the older adult population. 00:00:48.159 --> 00:00:51.600 I'd like to welcome my colleague, Dr. Dawn Joosten- 00:00:51.600 --> 00:00:54.280 Hagye, teaching professor and coordinator of 00:00:54.280 --> 00:00:57.100 interprofessional and team -based education at 00:00:57.100 --> 00:00:59.679 the USC Suzanne Dworak-Peck School of Social 00:00:59.679 --> 00:01:02.579 Work. She's joined today by her colleague, Dr. 00:01:02.780 --> 00:01:05.900 Tatyana Gurvich, Associate Professor for Clinical 00:01:05.900 --> 00:01:09.079 Pharmacy at the USC Alfred E. Mann School of 00:01:09.079 --> 00:01:12.000 Pharmacy and Pharmaceutical Sciences, a geriatric 00:01:12.000 --> 00:01:15.060 clinical pharmacologist and clinical preceptor 00:01:15.060 --> 00:01:18.719 at USC Mann UCI Medical Center Senior Health 00:01:18.719 --> 00:01:20.780 Clinic. It's wonderful to have you both here 00:01:20.780 --> 00:01:24.319 today to talk about this important topic. I love 00:01:24.319 --> 00:01:28.140 to start these podcasts off by asking folks how 00:01:28.140 --> 00:01:30.599 they got involved in the work. So maybe we can 00:01:30.599 --> 00:01:33.239 turn to you first, Tatyana. How is it that you 00:01:33.239 --> 00:01:36.239 got involved in wanting to do this kind of work? 00:01:36.540 --> 00:01:40.040 I've been in geriatrics for over 30 years. And 00:01:40.040 --> 00:01:43.340 I trained at USC. And when I did that about 30 00:01:43.340 --> 00:01:46.859 years ago, interprofessional education was in 00:01:46.859 --> 00:01:51.909 its infancy. And so I received a very interprofessional 00:01:51.909 --> 00:01:54.709 training in my residency program. I worked in 00:01:54.709 --> 00:01:57.849 a similar group of people, physicians, social 00:01:57.849 --> 00:02:01.269 workers, psychologists, occupational and physical 00:02:01.269 --> 00:02:04.810 therapists. speech therapist. So I received my 00:02:04.810 --> 00:02:06.670 training in an interprofessional environment. 00:02:06.849 --> 00:02:09.750 And I've been lucky enough to work in that kind 00:02:09.750 --> 00:02:12.530 of environment. When I joined USC as faculty, 00:02:12.789 --> 00:02:15.689 and I realized this program existed, it was just 00:02:15.689 --> 00:02:18.389 such a natural transition into this. And so I 00:02:18.389 --> 00:02:20.930 bring all this experience and background into 00:02:20.930 --> 00:02:24.990 it. And I think all of us on our team are well 00:02:24.990 --> 00:02:27.969 versed in interprofessional care. And so that's 00:02:27.969 --> 00:02:31.129 why it's so much fun. That's great. That's great. 00:02:31.810 --> 00:02:33.330 Dawn, how about you? How did you get involved 00:02:33.330 --> 00:02:36.990 in this project? Yeah, so similar to Tatyana, 00:02:37.469 --> 00:02:41.330 I've got a little over 25 years of experience 00:02:41.330 --> 00:02:44.169 working as a medical social worker and in geriatrics. 00:02:44.389 --> 00:02:46.750 And when I was working on my doctoral degree 00:02:46.750 --> 00:02:52.830 over at UCLA, I started as a fellow in team based 00:02:52.830 --> 00:02:56.370 education in a freshman cluster called the Frontiers 00:02:56.370 --> 00:03:00.590 in Human Aging and fell in love with based in 00:03:00.590 --> 00:03:03.530 a professional education. And then once I came 00:03:03.530 --> 00:03:07.169 over to USC, I immediately started linking up 00:03:07.169 --> 00:03:09.650 with other colleagues across the health sciences 00:03:09.650 --> 00:03:14.449 and was introduced to the IECG program and IPE 00:03:14.449 --> 00:03:17.810 Day here at USC. I would imagine most of our 00:03:17.810 --> 00:03:20.969 listeners who tune in to hear about a variety 00:03:20.969 --> 00:03:23.469 of different topics probably don't have a lot 00:03:23.469 --> 00:03:27.569 of knowledge about the IECG program. Maybe the 00:03:27.569 --> 00:03:30.689 two of you could give us some of the highlights 00:03:30.689 --> 00:03:34.110 about what it is that you do, the mission, and 00:03:34.110 --> 00:03:36.530 who you serve. And maybe we'll start with you, 00:03:36.610 --> 00:03:38.729 Tatyana. Maybe you can give us a little bit of 00:03:38.729 --> 00:03:41.330 an overview and Dawn, you can also contribute 00:03:41.330 --> 00:03:43.770 to this as much as you feel. So this program 00:03:43.770 --> 00:03:48.030 has been in existence for over 10 years. It involves 00:03:48.030 --> 00:03:51.270 seven professional schools across USC, and we're 00:03:51.270 --> 00:03:54.530 really lucky to have this breadth of education 00:03:54.530 --> 00:03:57.539 at this institution. So we have... Pharmacy, 00:03:57.639 --> 00:04:00.620 social work, medicine, occupational therapy, 00:04:00.879 --> 00:04:04.520 physical therapy, psychology. We had dentistry 00:04:04.520 --> 00:04:07.539 at one point. It's a lot of schools. Yeah, all 00:04:07.539 --> 00:04:10.520 these schools get together and they provide students 00:04:10.520 --> 00:04:14.180 from each school. And it's a six month program 00:04:14.180 --> 00:04:18.060 that we teach where the students are broken up 00:04:18.060 --> 00:04:20.639 into interprofessional teams with each of them 00:04:20.639 --> 00:04:23.300 having a lead faculty person attached to them. 00:04:23.660 --> 00:04:29.420 And we go to seniors homes throughout Los Angeles 00:04:29.420 --> 00:04:33.019 and we visit them on a monthly basis over a six 00:04:33.019 --> 00:04:35.899 -month period and each time we do a home visit 00:04:35.899 --> 00:04:40.040 we explore different areas of what each discipline 00:04:40.040 --> 00:04:43.180 does. For example, we're actually having a session 00:04:43.180 --> 00:04:47.639 this afternoon and today's session in this program 00:04:47.639 --> 00:04:50.720 will involve a medication reconciliation and 00:04:50.720 --> 00:04:53.079 getting to know the older adult in their home 00:04:53.079 --> 00:04:55.720 for the first time. And then the next time we'll 00:04:55.720 --> 00:04:58.339 cover another topic and we kind of go through 00:04:58.339 --> 00:05:01.439 each discipline and talk about what each discipline 00:05:01.439 --> 00:05:04.860 will do with an older adult and they practice 00:05:04.860 --> 00:05:07.899 it on the home visit. When you go to do these 00:05:07.899 --> 00:05:10.819 home visits, do you have students from multiple 00:05:10.819 --> 00:05:13.660 disciplines that are a part of the educational, 00:05:13.660 --> 00:05:16.360 I guess, outreach moment in these folks' homes? 00:05:16.740 --> 00:05:20.660 So yeah, so each team, each student team has 00:05:20.660 --> 00:05:24.160 six or seven members. There's each profession 00:05:24.160 --> 00:05:26.990 represented in that. And then there's a faculty 00:05:26.990 --> 00:05:29.589 person attached to each team. And we each go 00:05:29.589 --> 00:05:33.490 into a patient's home and do these educational 00:05:33.490 --> 00:05:35.889 sessions and practice sessions with the older 00:05:35.889 --> 00:05:38.490 adult while we're getting to know them. Very 00:05:38.490 --> 00:05:40.870 cool. Very cool. Dawn, do you have anything that 00:05:40.870 --> 00:05:42.730 you wanted to add to that about your experience 00:05:42.730 --> 00:05:46.329 in this program so far? Yeah, I think Tatyana 00:05:46.329 --> 00:05:50.370 summarized it really well. So the program emphasizes 00:05:50.370 --> 00:05:53.410 these didactic interprofessional trainings. And 00:05:53.410 --> 00:05:56.379 then there's this experiential learning that 00:05:56.379 --> 00:05:58.800 happens when they go in these home visits with 00:05:58.800 --> 00:06:01.480 the older adults and low income housing units. 00:06:01.579 --> 00:06:03.519 And the beauty from the perspective of a social 00:06:03.519 --> 00:06:06.079 worker is we're seeing the person in the environment 00:06:06.079 --> 00:06:09.160 and we're able to see. what we learn, all of 00:06:09.160 --> 00:06:11.199 us learn about social determinants of health. 00:06:11.439 --> 00:06:13.379 And those become really apparent when you're 00:06:13.379 --> 00:06:17.160 in someone's home and you see the community in 00:06:17.160 --> 00:06:20.699 which they're residing and you see their level 00:06:20.699 --> 00:06:24.439 of functioning as well. So it creates this really 00:06:24.439 --> 00:06:28.300 unique opportunity for students to immerse themselves 00:06:28.300 --> 00:06:32.120 in the environment in which the individual resides. 00:06:32.199 --> 00:06:35.120 And that's a real strength of this program. Yeah, 00:06:35.120 --> 00:06:37.100 it sounds like it's a fantastic opportunity for 00:06:37.100 --> 00:06:39.639 people to to see a variety of different perspectives. 00:06:40.279 --> 00:06:43.019 And that actually makes me think of something. 00:06:43.500 --> 00:06:45.720 I've been told, Tatyana, that you like to refer 00:06:45.720 --> 00:06:49.000 to healthcare for older adults as a team sport. 00:06:49.379 --> 00:06:51.420 Can you tell us what you mean by that phrase? 00:06:51.759 --> 00:06:57.459 Sure. All older adults are fairly complex. psychosocially 00:06:57.459 --> 00:06:59.779 and medically. From a medical standpoint, they 00:06:59.779 --> 00:07:02.980 kind of accumulate medical problems over a lifetime. 00:07:03.540 --> 00:07:06.600 So it's not uncommon for them to have multiple 00:07:06.600 --> 00:07:12.220 comorbidities, multiple medical conditions, physical 00:07:12.220 --> 00:07:17.620 limitations, psychosocial issues. And so traditionally 00:07:17.620 --> 00:07:20.600 the care people receive primarily comes from 00:07:20.600 --> 00:07:23.459 a physician, right? Well, they can't possibly 00:07:23.459 --> 00:07:26.500 address all of these concerns in a single older 00:07:26.500 --> 00:07:29.680 adult. If one person is only taking care of that 00:07:29.680 --> 00:07:31.860 older patient, a lot of things fall through the 00:07:31.860 --> 00:07:34.819 cracks. So this is the opportunity for all of 00:07:34.819 --> 00:07:38.639 us to get together and kind of provide our expertise 00:07:38.639 --> 00:07:41.579 for each of the problems that present themselves. 00:07:41.959 --> 00:07:45.079 So it's very much a team sport and we need each 00:07:45.079 --> 00:07:48.220 other to provide better care. And the older adult 00:07:48.220 --> 00:07:51.199 needs of us to receive that care. Yeah, it seems 00:07:51.199 --> 00:07:53.740 like there's a, I suppose, a sort of humility 00:07:53.740 --> 00:07:56.759 in having different disciplines come together 00:07:56.759 --> 00:07:59.180 and acknowledge that they need one another in 00:07:59.180 --> 00:08:02.899 order to do this work and do right by any one 00:08:02.899 --> 00:08:06.339 older adult whose life is so complicated. I think 00:08:06.339 --> 00:08:10.240 one of the things I've been interested in interdisciplinary 00:08:10.240 --> 00:08:14.920 research for a long time myself, and I Definitely 00:08:14.920 --> 00:08:17.480 have seen similar sorts of dynamics play out 00:08:17.480 --> 00:08:20.360 where you have much more ability to address problems 00:08:20.360 --> 00:08:22.459 when you have these variety of perspectives. 00:08:22.800 --> 00:08:25.120 One thing I'm interested in picking your brain 00:08:25.120 --> 00:08:27.860 about Dawn a little bit is the role that social 00:08:27.860 --> 00:08:30.540 work plays in this, because I don't think that 00:08:30.540 --> 00:08:34.360 a lot of people think about social work as maybe 00:08:34.360 --> 00:08:37.980 being a part of health sciences or a part of 00:08:37.980 --> 00:08:40.799 maybe these interdisciplinary teams. Maybe you 00:08:40.799 --> 00:08:43.279 can address a little bit about how it is that 00:08:43.279 --> 00:08:45.740 you see social work fitting into this. Yeah, 00:08:45.740 --> 00:08:48.759 absolutely. Thank you for that. So social work 00:08:48.759 --> 00:08:51.480 is important to include in collaboration of health 00:08:51.480 --> 00:08:54.320 science professions because we have expertise 00:08:54.320 --> 00:08:57.519 in the micromezzo and the macro systems, as well 00:08:57.519 --> 00:08:59.299 as I mentioned, the person and the environment. 00:08:59.379 --> 00:09:02.679 So we are often the profession that health professionals 00:09:02.679 --> 00:09:05.600 will make referrals to when they recognize that 00:09:05.600 --> 00:09:09.870 they have an older adult who is you know, experiencing 00:09:09.870 --> 00:09:12.549 challenges like maybe with housing and finances 00:09:12.549 --> 00:09:16.669 and transportation or food insecurity that's 00:09:16.669 --> 00:09:21.210 interfering with their ability to manage their 00:09:21.210 --> 00:09:23.190 health conditions that they're being treated 00:09:23.190 --> 00:09:26.470 for, right? So, you know, with that piece of 00:09:26.470 --> 00:09:30.029 it being global assessors, we're really key in 00:09:30.029 --> 00:09:32.769 being able to address not only those, but also 00:09:32.769 --> 00:09:36.029 any kind of emotional types of needs so that 00:09:36.029 --> 00:09:38.879 the whole biopsychosocial spiritual cultural 00:09:38.879 --> 00:09:42.799 model, right? Advocacy and improving access, 00:09:43.000 --> 00:09:46.299 all of those types of things to really help improve 00:09:46.299 --> 00:09:48.879 any of the disparities that are being experienced, 00:09:48.919 --> 00:09:51.659 especially among vulnerable populations. Yeah, 00:09:51.659 --> 00:09:53.700 that's such an interesting thing for you to bring 00:09:53.700 --> 00:09:56.500 up. I think social work in some ways, and I think 00:09:56.500 --> 00:09:57.960 pharmacy too, and I'll get to this in just a 00:09:57.960 --> 00:10:01.019 second, are disciplines that people have very 00:10:01.019 --> 00:10:03.700 stereotypical ideas about what those disciplines 00:10:03.700 --> 00:10:07.159 might be about that may not reflect the richness 00:10:07.159 --> 00:10:09.899 of the experience of what the disciplines bring 00:10:09.899 --> 00:10:12.779 to the table and this idea of being this holistic 00:10:12.779 --> 00:10:15.659 assessor role that social work plays is such 00:10:15.659 --> 00:10:18.360 an important thing and you know our school for 00:10:18.360 --> 00:10:20.480 the last few years we've had an interim dean 00:10:20.480 --> 00:10:25.190 that is the also the dean of the School of Pharmacy, 00:10:25.389 --> 00:10:29.049 and he's made me much more aware, Tatiana, of 00:10:29.049 --> 00:10:31.950 the way in which I think we misinterpret pharmacy, 00:10:32.169 --> 00:10:34.769 right? That I think a lot of people have this 00:10:34.769 --> 00:10:37.629 very one -dimensional view of pharmacists as 00:10:37.629 --> 00:10:40.330 being the sort of person that you see at a chain 00:10:40.330 --> 00:10:42.490 drug store. But really, you know, when you are 00:10:42.490 --> 00:10:44.769 going out into the community like this, your 00:10:44.769 --> 00:10:46.409 role must be very different than that. Can you 00:10:46.409 --> 00:10:48.570 maybe tell our listeners that are maybe more 00:10:48.570 --> 00:10:51.830 in social work what it is that a pharmacist does 00:10:51.830 --> 00:10:55.110 in especially this kind of context? What I do 00:10:55.110 --> 00:10:58.169 is I go into a home and home visits are really 00:10:58.169 --> 00:11:01.009 important for for pharmacy as well because you 00:11:01.009 --> 00:11:04.399 get to see where all these medications are being 00:11:04.399 --> 00:11:10.419 stored. How many vials are there of prescriptions? 00:11:10.879 --> 00:11:13.179 You get to look at the medicine cabinet, the 00:11:13.179 --> 00:11:16.159 bedside to see what all the over the counter 00:11:16.159 --> 00:11:19.379 medications the patient is taking. One time we 00:11:19.379 --> 00:11:22.779 went into one of the senior housing apartments 00:11:22.779 --> 00:11:25.399 as part of this program. And we were actually 00:11:25.399 --> 00:11:27.559 talking to a patient about nutrition. It wasn't 00:11:27.559 --> 00:11:29.980 time to talk about meds. And he was saying, you 00:11:29.980 --> 00:11:31.539 know, he doesn't have enough money for food. 00:11:31.899 --> 00:11:34.299 And so we immediately went into his kitchen to 00:11:34.299 --> 00:11:36.970 see what he was taking. and opened up his pantry 00:11:36.970 --> 00:11:40.690 and found literally a pantry full of herbal products. 00:11:40.970 --> 00:11:44.210 There was no food in there. It was just herbs, 00:11:44.549 --> 00:11:47.350 supplements, thousands of dollars worth of supplements 00:11:47.350 --> 00:11:50.190 at that point. And so those kinds of surprises 00:11:50.190 --> 00:11:53.470 are really relevant to what I do. So when I collect 00:11:53.470 --> 00:11:57.090 all the stuff the patient takes, we have a conversation 00:11:57.090 --> 00:11:59.779 about each medication. how they take it, whether 00:11:59.779 --> 00:12:02.639 the patient knows what it's for. I ask about 00:12:02.639 --> 00:12:04.659 common side effects that these medicines can 00:12:04.659 --> 00:12:07.639 cause. I screen to see if the patient has them. 00:12:08.019 --> 00:12:11.659 Then I look at the medical condition, the dose, 00:12:11.960 --> 00:12:15.299 whether or not they're tolerating it okay. you 00:12:15.299 --> 00:12:17.419 know, depending on the setting, in this setting, 00:12:17.620 --> 00:12:19.860 I would just make recommendations for them to 00:12:19.860 --> 00:12:21.960 talk to their physician about some of this stuff. 00:12:22.259 --> 00:12:25.720 In my clinic, I actually implement changes to 00:12:25.720 --> 00:12:29.399 medication regimens and see patients over multiple 00:12:29.399 --> 00:12:32.940 visits to titrate medications up and down, start 00:12:32.940 --> 00:12:36.360 new ones. and kind of limit the polypharmacy 00:12:36.360 --> 00:12:38.940 that happens in the management of older adults. 00:12:39.120 --> 00:12:42.080 That's so interesting. I think most people don't 00:12:42.080 --> 00:12:45.460 have a sophisticated understanding of how much 00:12:45.460 --> 00:12:49.440 as we get older, there's this variety of medications 00:12:49.440 --> 00:12:51.700 that were being prescribed by a bunch of different 00:12:51.700 --> 00:12:56.220 providers and that there may not even be a person 00:12:56.220 --> 00:12:58.820 like you who's who rarely is actually showing 00:12:58.820 --> 00:13:01.590 up at someone's house to do this sort of this 00:13:01.590 --> 00:13:05.789 kind of look. I mean, do you have a sense of 00:13:05.789 --> 00:13:07.690 who the population of the folks that, I mean, 00:13:07.690 --> 00:13:09.610 I know they're aging, but who are the folks that 00:13:09.610 --> 00:13:12.830 you are going into the homes of when you're doing 00:13:12.830 --> 00:13:14.889 these visits and how do they get involved in 00:13:14.889 --> 00:13:18.070 this program that you all are working on? So 00:13:18.070 --> 00:13:21.529 these patients live in low -income housing. Over 00:13:21.529 --> 00:13:25.230 the years, Our program has developed relationships 00:13:25.230 --> 00:13:29.490 with these communities. Some are in West LA, 00:13:29.710 --> 00:13:33.250 some are in East LA, some are in LA in general, 00:13:33.370 --> 00:13:35.929 and so we communicate with them. We make sure 00:13:35.929 --> 00:13:39.629 that the housing management picks out seniors 00:13:39.629 --> 00:13:42.570 for us to speak to. These patients volunteer, 00:13:42.809 --> 00:13:46.000 or these clients volunteer their time. but I 00:13:46.000 --> 00:13:49.440 think we build relationships with them. And so 00:13:49.440 --> 00:13:52.419 what we found that even when our students leave 00:13:52.419 --> 00:13:55.799 this program, they maintain a relationship with 00:13:55.799 --> 00:13:59.519 some of these older adults over the years and 00:13:59.519 --> 00:14:02.039 become friends with them. So it's a relationship 00:14:02.039 --> 00:14:05.500 building activity as well as a learning opportunity 00:14:05.500 --> 00:14:10.419 for students. And the older adults that we interact 00:14:10.419 --> 00:14:13.019 with also get useful information about their 00:14:13.019 --> 00:14:16.440 health care and hopefully a road going forward 00:14:16.440 --> 00:14:19.659 to get better care out of their providers and 00:14:19.659 --> 00:14:22.620 out of their situation. Yeah. So, Don, I want 00:14:22.620 --> 00:14:25.620 to turn to you for a second as a follow -up to 00:14:25.620 --> 00:14:28.200 this last point, which is about these home visits. 00:14:28.419 --> 00:14:32.320 I know that home visits are sometimes more a 00:14:32.320 --> 00:14:34.600 common place in social work, but can you talk 00:14:34.600 --> 00:14:37.320 to us about the sort of the importance that home 00:14:37.320 --> 00:14:40.539 visits have and what the social work role in 00:14:40.539 --> 00:14:45.269 those home visits? is when you're coming into 00:14:45.269 --> 00:14:49.789 these seniors homes? Yes, absolutely. So as a 00:14:49.789 --> 00:14:52.690 member of this interprofessional team, the social 00:14:52.690 --> 00:14:55.730 worker is, along with the team, engaging and 00:14:55.730 --> 00:14:58.110 building rapport with the older adult, having 00:14:58.110 --> 00:15:01.509 conversations with them, noticing any kind of 00:15:01.509 --> 00:15:04.649 concerns with safety. So if there's a lot of 00:15:04.649 --> 00:15:07.230 medications and pills and those types of things, 00:15:07.549 --> 00:15:11.610 then we may work with the pharmacist and others 00:15:11.610 --> 00:15:14.149 in the team to be able to help with setting up 00:15:14.149 --> 00:15:17.269 some type of an organization. And in the past, 00:15:17.330 --> 00:15:20.830 when I did home health, I would get sheets and. 00:15:20.889 --> 00:15:23.529 have pictures of the medications and help them 00:15:23.529 --> 00:15:25.309 with writing those down and work with the nurse 00:15:25.309 --> 00:15:29.649 practitioner of setting that up. We do those 00:15:29.649 --> 00:15:32.850 types of things, but then if there's a need for 00:15:32.850 --> 00:15:36.870 any kind of equipment in the home. If physical 00:15:36.870 --> 00:15:40.110 therapist and occupational therapy are looking 00:15:40.110 --> 00:15:43.049 at the bathroom and they notice, boy, they really 00:15:43.049 --> 00:15:45.669 could use some grab bars or a detachable shower 00:15:45.669 --> 00:15:50.490 head or a grab bar next to the toilet. Social 00:15:50.490 --> 00:15:53.549 workers will help with identifying community 00:15:53.549 --> 00:15:56.389 -based resources to be able to come in and make 00:15:56.389 --> 00:15:58.950 those kinds of modifications, helping with food 00:15:58.950 --> 00:16:02.710 insecurity, screening and assessing for loneliness 00:16:02.710 --> 00:16:06.090 and depression and anxiety. And as it relates 00:16:06.090 --> 00:16:09.090 to medication, one of the common types of referrals 00:16:09.090 --> 00:16:12.210 that social workers get as medical social workers 00:16:12.210 --> 00:16:15.690 are referrals for addressing medication nonadherence. 00:16:16.049 --> 00:16:18.720 And that may mean - Oh, you're right. not having 00:16:18.720 --> 00:16:21.580 health insurance that covers the medications 00:16:21.580 --> 00:16:24.000 because it's non -formulary out of their network, 00:16:24.340 --> 00:16:26.779 not being able to make the co -payment or maybe 00:16:26.779 --> 00:16:30.120 needing to work with pharmacy and the primary 00:16:30.120 --> 00:16:32.940 care physician to look at other medications that 00:16:32.940 --> 00:16:35.620 might be in their network that they can actually 00:16:35.620 --> 00:16:38.539 afford to pay the co -payment for. A lot of times 00:16:38.539 --> 00:16:40.679 as social workers, we help with making sure they 00:16:40.679 --> 00:16:43.960 have access as well, any kind of supplies and 00:16:43.960 --> 00:16:47.769 testing strips and all those other things. just 00:16:47.769 --> 00:16:50.470 think of social work being there to really support 00:16:50.470 --> 00:16:54.090 all the members of the team. And then also, of 00:16:54.090 --> 00:16:57.110 course, having the older adult as the expert 00:16:57.110 --> 00:16:59.649 over their lived experience and making sure they're 00:16:59.649 --> 00:17:04.390 at the center and that we are partnering with 00:17:04.390 --> 00:17:06.750 the older adult based on their strengths, based 00:17:06.750 --> 00:17:09.869 on what matters with them, to address any unmet 00:17:09.869 --> 00:17:14.569 needs. So helping them to age in place and have 00:17:14.569 --> 00:17:18.220 all of their biopsychosocial. spiritual needs 00:17:18.220 --> 00:17:21.279 met. I want to maybe take this as an opportunity 00:17:21.279 --> 00:17:24.099 to then talk about the impact that all of this 00:17:24.099 --> 00:17:26.359 great work you just have described to me has. 00:17:26.400 --> 00:17:28.799 And I think one thing that's exciting for me 00:17:28.799 --> 00:17:31.099 as the associate dean for research and somebody 00:17:31.099 --> 00:17:33.319 who really cares about academic research is when 00:17:33.319 --> 00:17:36.539 I get to see programs like this evaluated and 00:17:36.539 --> 00:17:39.579 publications done on it. because I think that 00:17:39.579 --> 00:17:42.880 oftentimes the proof of the value of a practice 00:17:42.880 --> 00:17:45.759 -based program like this is how that education 00:17:45.759 --> 00:17:47.440 impacts the real world and how you're actually 00:17:47.440 --> 00:17:49.640 able to establish that. And I know that the two 00:17:49.640 --> 00:17:51.960 of you were the first and second authors on a 00:17:51.960 --> 00:17:54.299 study that was published last year in the Journal 00:17:54.299 --> 00:17:58.579 of Interprofessional Care. And I'd love to hear 00:17:58.579 --> 00:18:02.250 about what you... wrote about and maybe you could 00:18:02.250 --> 00:18:05.650 describe to our audience the main findings of 00:18:05.650 --> 00:18:08.470 this study that evaluated the program's impact. 00:18:08.509 --> 00:18:10.890 Maybe we can turn first to you, Tatyana, and 00:18:10.890 --> 00:18:14.490 then we'll have Dawn contribute to this conversation 00:18:14.490 --> 00:18:15.910 as well. But I'd love to hear about what you 00:18:15.910 --> 00:18:19.089 found. We basically surveyed participants of 00:18:19.089 --> 00:18:23.329 this program three years after they've graduated 00:18:23.329 --> 00:18:26.390 and collected the results. Like, how did this 00:18:26.390 --> 00:18:28.730 program that they participated in as students 00:18:28.730 --> 00:18:32.269 impact their current practice and the findings 00:18:32.269 --> 00:18:35.890 were really encouraging. I mean, 81 % of the 00:18:35.890 --> 00:18:39.789 graduates of the IECG program continue to work 00:18:39.789 --> 00:18:43.529 in interprofessional teams. 80 % reported that 00:18:43.529 --> 00:18:47.109 their experience in IEGC significantly impacted 00:18:47.109 --> 00:18:51.029 their practice and they routinely use the tools 00:18:51.029 --> 00:18:53.910 that we taught them to use in this program on 00:18:53.910 --> 00:18:57.349 their patients. We collected multiple really 00:18:57.349 --> 00:19:00.180 nice quotes about how impactful this program 00:19:00.180 --> 00:19:03.279 was, how much it taught participants about the 00:19:03.279 --> 00:19:07.000 other's professions and what they could do. And 00:19:07.000 --> 00:19:10.599 I think that it possibly makes their job easier. 00:19:10.990 --> 00:19:13.490 in the clinical world because they know what 00:19:13.490 --> 00:19:16.750 to expect from each discipline. I have to tell 00:19:16.750 --> 00:19:18.970 you these programs are really difficult to put 00:19:18.970 --> 00:19:22.329 together. I mean every school has their own requirements 00:19:22.329 --> 00:19:25.230 for things. Scheduling is different. Getting 00:19:25.230 --> 00:19:27.569 these students together like this year we have 00:19:27.569 --> 00:19:31.490 I think 130 students from different schools all 00:19:31.490 --> 00:19:34.509 in one place. That it's very challenging and 00:19:34.509 --> 00:19:38.269 every year Somehow we managed to do it and we 00:19:38.269 --> 00:19:41.109 run it pretty successfully. We did it, we started 00:19:41.109 --> 00:19:44.509 it pre -pandemic with a lot of years of experience 00:19:44.509 --> 00:19:46.970 there. Then the pandemic hit, we turned it into 00:19:46.970 --> 00:19:50.430 a completely virtual experience and then a hybrid 00:19:50.430 --> 00:19:54.289 one and now it's all in person again. So we've 00:19:54.289 --> 00:19:57.450 gone through these phases of history and time 00:19:57.450 --> 00:20:00.930 and we've managed to keep it together and it's 00:20:00.930 --> 00:20:03.930 grown actually. This is the largest class we've 00:20:03.930 --> 00:20:05.549 had. Well, that's really cool. That's really 00:20:05.549 --> 00:20:08.130 cool. Dawn, I know that Tatyana just gave us 00:20:08.130 --> 00:20:11.329 some of the high level findings. Maybe you could 00:20:11.329 --> 00:20:13.970 give us a sense of, from your perspective, what 00:20:13.970 --> 00:20:16.950 some of the take home messages from this research 00:20:16.950 --> 00:20:20.569 were from your perspective. Yeah, so we. engage 00:20:20.569 --> 00:20:23.390 in medical education into professional education, 00:20:23.509 --> 00:20:26.910 the whole goal of it is to prepare this collaborative 00:20:26.910 --> 00:20:30.069 practice ready workforce, right? So we want them 00:20:30.069 --> 00:20:33.390 to be able to take and learn about. So this is 00:20:33.390 --> 00:20:37.339 the. The IECG program and all IPE programs are 00:20:37.339 --> 00:20:40.400 competency based. So we have competencies from 00:20:40.400 --> 00:20:45.400 the IPEC and all health sciences programs are 00:20:45.400 --> 00:20:49.380 required to have IPE and we use these, it's competency 00:20:49.380 --> 00:20:52.619 based, right? So we're really preparing these 00:20:52.619 --> 00:20:55.140 students to understand the roles and responsibilities 00:20:55.140 --> 00:21:00.039 of professionals to be able to have, to engage 00:21:00.039 --> 00:21:02.480 with older adult partners and their families, 00:21:02.880 --> 00:21:07.019 organizations. and communities with these competencies 00:21:07.019 --> 00:21:10.380 of values and ethics and cultural humility and 00:21:10.380 --> 00:21:12.799 responsiveness. All of those things are really, 00:21:12.799 --> 00:21:15.700 really important. So preparing this workforce 00:21:15.700 --> 00:21:19.480 is like a real key piece of it. And what we found 00:21:19.480 --> 00:21:23.539 in our research is that a little over 79 percent 00:21:23.539 --> 00:21:27.400 say IPG really had an impact on their daily practice 00:21:27.400 --> 00:21:29.819 and that's what it's all about helping them while 00:21:29.819 --> 00:21:32.160 they're in the programs be prepared to enter 00:21:32.160 --> 00:21:36.039 the workforce to be able to be ready to have 00:21:36.039 --> 00:21:38.240 that impact their practice and there's not a 00:21:38.240 --> 00:21:40.579 lot of studies to date that have actually done 00:21:40.579 --> 00:21:42.460 that. I'm kind of surprised to hear that there 00:21:42.460 --> 00:21:44.480 hadn't been many other studies that did this 00:21:44.480 --> 00:21:47.099 is it because you're these kinds of programs 00:21:47.099 --> 00:21:50.599 are so rare? Or is it because there's just been 00:21:50.599 --> 00:21:53.839 a lack of attention paid to actually collecting 00:21:53.839 --> 00:21:56.599 evidence on their impact? Yeah, it's probably 00:21:56.599 --> 00:21:59.829 a combination of both. Okay. Yeah. You know, 00:21:59.930 --> 00:22:03.569 and like Tatiana said, you know, these programs, 00:22:03.769 --> 00:22:06.470 we spend a whole year planning this program before 00:22:06.470 --> 00:22:10.190 we launch it, right? So it's very time intensive. 00:22:11.630 --> 00:22:15.970 And the fact that we had so many of the graduates 00:22:15.970 --> 00:22:19.230 actually participate in this study, in our study, 00:22:19.670 --> 00:22:22.990 speaks to, you know, the relevance of it and 00:22:22.990 --> 00:22:26.869 how valuable it was to them also, right? So we 00:22:26.869 --> 00:22:31.130 had a, you know, a good, good percentage of respondents 00:22:31.130 --> 00:22:35.630 that actually participated. The value of the 00:22:35.630 --> 00:22:40.230 program, I think, helps also because we had almost 00:22:40.230 --> 00:22:43.809 a 59 percent response rate, which is pretty high 00:22:43.809 --> 00:22:48.210 for 247 graduates that we sent the survey. That's 00:22:48.210 --> 00:22:50.589 amazing. It certainly speaks to the power of 00:22:50.589 --> 00:22:52.549 the program that you've got that kind of voluntary 00:22:52.549 --> 00:22:55.579 response rate. I want to make sure that we get 00:22:55.579 --> 00:22:58.779 a chance to ask you, Don, about a follow up to 00:22:58.779 --> 00:23:00.480 this, which is that I know that you're involved 00:23:00.480 --> 00:23:03.940 in an interprofessional certificate program at 00:23:03.940 --> 00:23:05.779 the School of Social Work as well. How is that 00:23:05.779 --> 00:23:07.880 connected to this and what is that about too? 00:23:08.039 --> 00:23:12.559 The IECG program is actually separate from the 00:23:12.559 --> 00:23:16.119 interprofessional certificate. So both are open 00:23:16.119 --> 00:23:20.099 to all graduate health profession students. IECG 00:23:20.099 --> 00:23:23.579 is a zero unit credit, no credit course. So that 00:23:23.579 --> 00:23:26.099 occurs like Tatyana mentioned on six Fridays 00:23:26.099 --> 00:23:29.839 between fall and spring semesters. The IPE caregiving 00:23:29.839 --> 00:23:33.440 certificate requires completion of four three 00:23:33.440 --> 00:23:36.200 -unit courses, one of which is a course that 00:23:36.200 --> 00:23:39.480 emphasizes interprofessional education and trauma 00:23:39.480 --> 00:23:42.160 -informed evidence -based team interventions, 00:23:42.680 --> 00:23:45.579 specifically focusing on diverse caregivers through 00:23:45.579 --> 00:23:49.140 a social justice and intercultural lens. So while 00:23:49.140 --> 00:23:52.200 both provide social work and health affairs students 00:23:52.200 --> 00:23:56.319 with IPE and team -based care and didactic and 00:23:56.319 --> 00:23:59.279 experiential experiences, experiences, the certificate 00:23:59.279 --> 00:24:02.200 is tailored to better prepare them for working 00:24:02.200 --> 00:24:04.900 with diverse caregivers versus older adults. 00:24:05.140 --> 00:24:07.380 Oh, I see. So it's a slightly different focus 00:24:07.380 --> 00:24:09.900 in terms of the work that you're training people 00:24:09.900 --> 00:24:12.299 for, but it's got a very similar character in 00:24:12.299 --> 00:24:15.519 terms of this interprofessional focus. Exactly. 00:24:16.200 --> 00:24:18.900 Go ahead, Tatiana, please. I think the other 00:24:18.900 --> 00:24:22.160 unique piece of this program is that for most 00:24:22.160 --> 00:24:25.299 of the students participating, this happens in 00:24:25.299 --> 00:24:28.960 their preclinical years. So I think there's always 00:24:28.960 --> 00:24:31.940 some interprofessional collaboration when students 00:24:31.940 --> 00:24:34.960 go on rotation to hospitals, to clinics, because 00:24:34.960 --> 00:24:37.480 they get together with other health professionals 00:24:37.480 --> 00:24:39.680 to take care of patients. I don't think that's 00:24:39.680 --> 00:24:43.210 that uncommon. But this is at least for pharmacy, 00:24:43.369 --> 00:24:47.230 for medicine, it's pre -clinical. But at the 00:24:47.230 --> 00:24:49.829 same time, it's not just didactic content. They're 00:24:49.829 --> 00:24:52.049 not in the classroom learning about this stuff 00:24:52.049 --> 00:24:55.809 without being able to practice it on a client 00:24:55.809 --> 00:24:58.690 or a patient. And so this is what's unique about 00:24:58.690 --> 00:25:01.849 it. It is six months long, which is very difficult 00:25:01.849 --> 00:25:05.250 to put together. So that's unique too. There 00:25:05.250 --> 00:25:07.250 are lots of interprofessional activities that 00:25:07.250 --> 00:25:11.869 are six weeks, one day. you know, a month. This 00:25:11.869 --> 00:25:15.089 is six months with the same person. You get, 00:25:15.089 --> 00:25:18.470 you really get impactful and meaningful interaction 00:25:18.470 --> 00:25:22.329 with the same older adult. And you, you know, 00:25:22.529 --> 00:25:25.150 over time, students learn from each other. Yeah. 00:25:25.170 --> 00:25:26.630 Well, it would sound like over six months, you 00:25:26.630 --> 00:25:28.130 would get a chance to learn from one another, 00:25:28.269 --> 00:25:30.289 as you said, but also I think you mentioned earlier 00:25:30.289 --> 00:25:33.130 that sometimes the students build relationships 00:25:33.130 --> 00:25:36.400 that endure past the training program with those 00:25:36.400 --> 00:25:38.920 older adults, which also makes a lot of sense. 00:25:39.160 --> 00:25:40.680 And I think it's interesting that you point out 00:25:40.680 --> 00:25:43.220 that some of the other programs that you know 00:25:43.220 --> 00:25:47.079 of are much shorter duration and probably, therefore, 00:25:47.599 --> 00:25:50.059 much less meaningful. I think it's also great 00:25:50.059 --> 00:25:52.539 to hear from both of you at the beginning of 00:25:52.539 --> 00:25:56.099 our conversation how you each had pretty profound 00:25:56.099 --> 00:25:59.539 interprofessional education experiences in your 00:25:59.539 --> 00:26:02.660 own training and that that has, it would seem 00:26:02.660 --> 00:26:06.559 to me, carried through in your career as now 00:26:06.559 --> 00:26:08.619 people who are training the next generation to 00:26:08.619 --> 00:26:11.519 do this kind of work that clearly you were inspired 00:26:11.519 --> 00:26:13.740 by when you were doing your training. I learned 00:26:13.740 --> 00:26:16.400 to talk to a patient from a social worker. When 00:26:16.400 --> 00:26:19.440 I was a student and a resident, I would go on 00:26:19.440 --> 00:26:22.269 home visits with a nurse, a social worker. and 00:26:22.269 --> 00:26:25.809 me. And I watched that social worker interact 00:26:25.809 --> 00:26:27.829 with a patient. And that's how I learned to talk 00:26:27.829 --> 00:26:30.309 to patients. I mean, it was an amazing experience 00:26:30.309 --> 00:26:32.490 that I carry with me. No, that's that's incredible. 00:26:32.509 --> 00:26:35.829 I mean, I love that I had a similar experience 00:26:35.829 --> 00:26:37.890 in my early training when I was a postdoc hanging 00:26:37.890 --> 00:26:40.049 out with social workers that they really changed 00:26:40.049 --> 00:26:42.210 the way that I interacted with people and thought 00:26:42.210 --> 00:26:45.529 about things to their social work. It has had 00:26:45.529 --> 00:26:47.750 some some pretty amazing tools for engaging with 00:26:47.750 --> 00:26:50.109 people. But I'm also sure that likewise, pharmacy 00:26:50.109 --> 00:26:53.210 has amazing tools for that social workers learn 00:26:53.210 --> 00:27:01.140 from as well. collaborative, reciprocal places 00:27:01.140 --> 00:27:05.079 where people learn. I think I want to close out 00:27:05.079 --> 00:27:07.460 with any last thoughts that you might have for 00:27:07.460 --> 00:27:10.200 our listeners about lessons learned from doing 00:27:10.200 --> 00:27:13.180 this interprofessional education or from your 00:27:13.180 --> 00:27:15.460 own experiences doing this kind of work that 00:27:15.460 --> 00:27:18.039 you think would be worthwhile sharing with folks. 00:27:18.160 --> 00:27:20.299 Maybe I'll start with Dawn and then let Tatiana, 00:27:20.299 --> 00:27:22.539 you close us out. Dawn, anything you want to 00:27:22.539 --> 00:27:24.900 share with our audience? Yeah, I think just in 00:27:24.900 --> 00:27:27.700 listening to both of you talk, you know, coming 00:27:27.700 --> 00:27:30.779 back to what interprofessional education is, 00:27:30.940 --> 00:27:34.299 it is learning from with and about others together, 00:27:34.299 --> 00:27:37.750 right? So. It's not coming in uniprofessionally, 00:27:37.750 --> 00:27:41.630 right? So this holistic lens is key. Going out 00:27:41.630 --> 00:27:44.130 into the community where our clients, where our 00:27:44.130 --> 00:27:46.789 patients, where people actually live and reside, 00:27:47.230 --> 00:27:49.809 that's going to become increasingly important 00:27:49.809 --> 00:27:53.230 in being able to really address population health 00:27:53.230 --> 00:27:56.400 in a meaningful way because Our clients don't 00:27:56.400 --> 00:27:58.500 live in the office. Our clients don't live in 00:27:58.500 --> 00:28:00.599 the hospital. They don't live in the clinic. 00:28:00.700 --> 00:28:03.500 They actually live out in the community. And 00:28:03.500 --> 00:28:05.960 when we're able to go out into the community, 00:28:06.839 --> 00:28:09.720 we're able to just see this. whole different 00:28:09.720 --> 00:28:13.599 type of perspective and really hear what's important 00:28:13.599 --> 00:28:15.480 to, especially when we're talking about older 00:28:15.480 --> 00:28:17.900 adults, what's important to them, what matters 00:28:17.900 --> 00:28:20.640 to them, and then to be able to meet them where 00:28:20.640 --> 00:28:23.799 they are and partner with them. So this is that 00:28:23.799 --> 00:28:28.859 partnership of us as clinicians and them as the 00:28:28.859 --> 00:28:31.640 person. And that's the important piece of it, 00:28:31.680 --> 00:28:33.940 is being able to listen, hearing what their narrative, 00:28:34.140 --> 00:28:35.980 what their needs, what their preferences are, 00:28:36.240 --> 00:28:40.220 and being able to have that culturally responsive 00:28:40.220 --> 00:28:45.200 types of approaches, especially in these diverse 00:28:45.200 --> 00:28:48.859 communities and populations surrounding our campus. 00:28:50.650 --> 00:28:53.710 parting thoughts for our audience? I think interprofessional 00:28:53.710 --> 00:28:57.630 education is part of every health professional 00:28:57.630 --> 00:29:01.230 program requirements. And a lot of this stuff 00:29:01.230 --> 00:29:05.309 is just a box to be checked off. So some of the 00:29:05.309 --> 00:29:07.529 some of the programs that are out there aren't 00:29:07.529 --> 00:29:10.730 as meaningful as I think this is. And so, you 00:29:10.730 --> 00:29:13.430 know, we have to continue to look for these long 00:29:13.430 --> 00:29:16.630 term, thorough, in depth kinds of programs that 00:29:16.630 --> 00:29:19.529 actually teach students something that they carry 00:29:19.529 --> 00:29:22.789 with them. One challenge we faced over at least 00:29:22.789 --> 00:29:25.470 the last couple of years is the lack of funding, 00:29:25.569 --> 00:29:29.240 you know, and so I think Health professional 00:29:29.240 --> 00:29:32.359 schools should really prioritize programs like 00:29:32.359 --> 00:29:35.400 this to see that they not only succeed but are 00:29:35.400 --> 00:29:38.680 able to continue. Having interprofessional centers 00:29:38.680 --> 00:29:41.539 or having an interprofessional center at USC 00:29:41.539 --> 00:29:44.759 would be wonderful because it could house a program 00:29:44.759 --> 00:29:47.960 like this and many others that haven't even been 00:29:47.960 --> 00:29:50.220 developed yet. If we're going to move our professions 00:29:50.220 --> 00:29:52.900 forward and education forward, we have to think. 00:29:53.579 --> 00:29:57.079 more globally, more interprofessionally. And 00:29:57.079 --> 00:30:00.319 I hope the right people are listening. I'm sure 00:30:00.319 --> 00:30:02.319 some of them are. I'm sure some of them are. 00:30:02.700 --> 00:30:05.420 Well, thank you so much, Dawn and Tatyana, for 00:30:05.420 --> 00:30:07.839 doing such incredible work out in the community 00:30:07.839 --> 00:30:10.460 and also taking the time to talk to me and our 00:30:10.460 --> 00:30:12.559 audience today about this work that you're doing. 00:30:13.200 --> 00:30:14.980 If you, the audience, would like to learn more 00:30:14.980 --> 00:30:18.019 about the IECG, as well as the research happening 00:30:18.019 --> 00:30:20.519 at the USC Suzanne Dworak-Peck School of Social 00:30:20.519 --> 00:30:26.299 Work, you can visit our school's website. And 00:30:26.299 --> 00:30:29.200 if you have questions for the guests on our show, 00:30:29.460 --> 00:30:31.880 or you want to support our transformative research 00:30:31.880 --> 00:30:36.140 and programs, you can email us at listenuppeople 00:30:36.140 --> 00:30:39.880 @usc.edu. And let me just say thank you one 00:30:39.880 --> 00:30:42.359 more time to both of you. It was absolutely fabulous 00:30:42.359 --> 00:30:44.460 to have you both here today. Thank you. Thank 00:30:44.460 --> 00:30:45.359 you for the invitation.