Malcolm Cox and Mary Naylor reflect on the inextricable linkage between education reform and practice redesign. The following is excerpted from proceedings (coming soon) of the 2013 Macy Conference, co-chaired by Cox and Naylor.
While islands of innovation persist, and some evenflourish, the past 40 years is littered with failed efforts to deploy interprofessional education throughout the health professions and across the learning continuum. Given this checkered history, how can we be sure that the current resurgence of interest in interprofessional education is not just another fad which will wither in the crucible of the health system reform?
We would argue that this time we have gotten it right, arguably for the first time, in part by emphasizing the linkage between workforce reform and delivery system redesign and in part by emphasizing the role of patients, families and communities in identifying the best path forward.
We believe that health professions education and clinical practice are linked in a positively reinforcing “learning/caring” feedback loop. In fact they are continuously interacting variables, so that changes in one inevitably influence the other. Efforts to enhance the U.S. health system by tackling either education or practice independently have been and will remain challenging. System-based improvements will only be fully realized when the potential impact of changing one or the other is given careful, proactive consideration.
Likewise, we believe that caring for and about patients, families and communities should be the primary arbiter of efforts to improve and sustain individual and population health. Not, you may notice “health care” but the much broader construct, “health.” Putting patients at the center of all we do as clinicians and educators plays to the professionalism so deeply rooted in all health disciplines. And it provides real meaning to efforts to reform the clinical workforce, enhances effective and efficient delivery of care, and promotes health.
The Conference opened with a vision of a future in which the patient is an integral member of a team dedicated to the provision of high quality and efficient services that match each individual’s and community’s health care goals.
What finally emerged were the central elements of a new vision for collaborative care and learning. Five major recommendations, each with several enabling strategies, support this vision… Each of the recommendations stands by itself, but all are unified by the overall goal of linking interprofessional education and delivery system redesign.