Lynne Nemeth, PhD, RN, FAAN - The Medical …academicdepartments.musc.edu/PPRNet/Network_Meetings/2014...Lynne Nemeth, PhD, RN, FAAN Define the concepts of a virtual learning collaborative

Lynne Nemeth, PhD, RN, FAAN

Define the concepts of a virtual learning

collaborative and community of practice

Review previous PPRNet experience with

Alcohol-TRIP projects

Discuss current NIAAA proposal /opportunity

Develop a relevant set of recommendations

to embed in proposal based upon YOUR input

Meets the needs of its members through facilitation of peer-to-peer learning

Use social networking and computer-mediated communication to achieve a shared learning objective

Members share knowledge through text discussions, audio, video, blogs, etc. and propose goals and learning objectives

“Groups of people who share a concern, a set of problems, or a passion about a topic, and who deepen their knowledge and expertise by interacting on an ongoing basis”(Wenger, 2002)

COP differs from work groups or teams Voluntary membership

Goals are less specific/more adaptable

Community exists as long as members participate

Deep PPRNet experience

Operationalized through site

visits, network meetings and

performance reports

PPRNet must continue to

evolve to meet ongoing

advances in evidence, and

practice development to

sustain excellence

USPSTF (2013) recommends that clinicians

screen adults aged 18 and older for alcohol

misuse and provide persons engaged in risky

or hazardous behavior with behavioral

counseling to reduce misuse. (B)

Primary care is ideal for the early detection

and secondary prevention of alcohol-related

problems, due to its high contact-exposure

to the population

14.6% of people with AUD receive treatment (NIAAA, 2011)

Engaging people in primary care where

treatment and coordination of other medical

conditions occurs is an opportunity to

improve

Medications approved by FDA include:

Disulfaram

Oral naltrexone

Extended release naltrexone

Acamprosate

Use note templates

Nursing staff screening first 2 questions

Clinician f/u BI with identified HRD patients

Prescribe medications for patients receptive

to brief intervention

Use “Rethinking Drinking” materials to

educate patients (website, handouts)

(Ornstein et al, 2013)

Practices self-organized to adopt specific

approaches to incorporating alcohol screening,

intervention and medical management into

practice

Screening was readily adopted by nursing staff

with a consistent, practice-based approach

Clinicians embraced a willingness to address

alcohol use in the context of primary care,

gaining experience with some medication use

Most patients were receptive to SBI discussion

Ornstein et al, 2013; Wessell et al, 2014

Proposal: virtual learning collaborative (VLC)

in PPRNet submitted to NIAAA in Sept

Open to all practices (even if you have

participated in a previous study)

Random assignment to VLC or control

All practice clinical staff /providers eligible

CME and nursing CE would be provided for

participation

Develop and implement ALC-TRIP, a multi-component virtual learning community for primary care staff and providers.

Compare the effectiveness of participation in ALC-TRIP on alcohol screening, brief intervention and use of alcohol medications to practices that have not participated in this learning community, in a nationwide sample of 15 practices in each group.

Conduct a process evaluation of this learning community to examine the strengths, weaknesses, opportunities and threats related to this approach from the perspective of the stakeholders.

This R25 requires the input of stakeholders in

planning this intervention and an Advisory

Board to guide the process and evaluation

Need: Letters of support

Need: Practices in AA-TRIP and AM-TRIP

studies as advisors--clinicians and staff

Need: your wisdom and experience in

expanding practice team roles

What are the qualities of site visits and

network meetings that are important to

replicate in an on-line community?

Initial site visits seemed like a huge request

and time burden for some practices—what

concerns arise for this request for

participation?

Monthly webinars?

Checking discussions weekly and contributing

your ideas, experiences?

12-18 months for program duration?

Any questions?

Letters of support to [email protected]