New Models to Transform

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New Models to Transform Heal throughCollaborati
on Relationships The Spiritual Focus
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Meeting each other..
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Fear and depression are a part of life. In
illness there are no negative emotions, only
experiences that have to be lived through. What
is needed in these moments is not denial but
recognition. The ill persons suffering should be
affirmed, whether or not it can be treated. What
I wanted when I was most ill was the response,
Yes, we see your pain we accept your fear.
Arthur W. Frank, At the will of the body.
Houghton-Mifflin, 2001.
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Objectives

• 1) Appreciate spirituality as a component of
  holistic care
• 2) Begin to engage in transformative dialogue
  with others to foster healing wholeness
• 3) Explore relationships as a basis for IP
  collaborative care model
• 4) Receive a number of tools (your Toolkit)
  provided to enhance personal and professional
  growth and,
• 5) Develop a more clear understanding of
  integrating healing presence at the core of the
  care.

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Your expectations?
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The skeleton woman
Tamsin Williams performing in Skeleton Woman.
Photogaph Nick Sayers.
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Reflections.

• With your neighbour
• With all of us

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Use of narrative our experiences

• University of Ottawa HSS4100 -
• Death Made Visible
• An Interdisciplinary exploration of death dying
  in literature

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HSS 4100 Death Made Visible An
Interdisciplinary Exploration of Death Dying in
Literature

• Course Participants
• 2002 2006 2007 2008
• 1st or 2nd year medical students 3 8
  3 0
• 4th year RN /or post-RN 4 3 (1) 6
  4
• Pastoral Care Counseling 1 2(1) 0
  1
• Health Sciences
  20 15 25
• Total 8 33 24 30
• F/M 8/0 27/6 21/3 21/9

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we are expected to work as a team in society
but, unfortunately, we are segregated throughout
our education. We lack knowledge about each
others roles how to work together
NS the course has helped mebetter
understand the perspectives of nursing medicine
how spiritual care forms part of the health
care team PC
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I feel a strong sense of gratitude for the
labyrinth-like path that has brought me tothis
interprofessional learning experience of Death
Made Visiblethe people, the various groupings,
the learning activities, all seeming to combine
in a rich tapestryDeath Made Visible provided a
wealth of opportunitiestouching me in ways I had
not anticipatedBringing our experiences,
personal and professional, a strong sense of
cohesiveness and trust developed amazingly
quickly
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..I loved the byplay and interaction between
the professors and the different specialties. I
absolutely loved the course and the ideas on how
to deal with palliative care. The course
covered a variety of topics that we typically
never discuss We discussed ethics, dealing with
other people, interactions with other
professional groups, we discussed a lot of
things, it wasnt just only death. Were so much
more ready for that world
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Interactive theatre

• Collaboration with the Theatre Department,
  University of Ottawa
• CPD Suffering
• UOttawa 1st year Medical Students Health Care
  Theatre Evening
• The power of the story.

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Learning in Action - On-line
How can I be truly present to someonewho is
suffering?
What am I learning about myself when I listen to
someone who is suffering?
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The Design
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Learning in Action
How can I be truly present to someonewho is
suffering?
What am I learning about myself when I listen to
someone who is suffering?
Meet Neil
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Read your bubble

• Share what you know about Neil
• What are you learning about yourself as you learn
  about Neils story?
• How can you be truly present to someone who is
  suffering?

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Results Participants

• No answer n2 Pilots 1-3 all female
• Pilot 4 2 male / 3 females
• Overall-Female 90

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Knowledge Case Study (n11) Pilots 1-3
PRE-
IP approach n2
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Navigation
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Our Challenge to Health Care

• Can we articulate our relationships with
  patients, families and each other with a model
  that inspires transformation and healing?

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We are each made whole by these parts we are
each affected differently, but all domains are
touched..
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Each profession has a cognitive map
Each person has a unique cognitive map
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Profession
Discipline
There can be several disciplines within one
profession
Professions have different roles, functions,
training
MEDICINE
NURSING
Family Doctor
Surgeon
Oncologist
MEDICINE
VOLUNTEER
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Tools Signs
Sense Meaning Action
Rules
Division of Labour
Community
Engström 2004
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Knotworking.
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Traditional model of care
Assumptions in this model Boundaries are very
clear Power is clearly delineated Relationship is
centred on the illness and fixing the patient
Health Care Professional
Patient
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Often results in
Team members work in parallel, responsible for
their own professional tasks
Each team member may feel this is my patient!
Communication is often minimal, through chart and
leader
Leader is often the physician
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Patient Centred Care
Assumptions in this model It adopts the
patient's perspective. What is it about their
interaction with providers, systems, and
institutions that patients say matters to them
and affects them, either positively
or negatively. The health care professional is at
the service of the patient.
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This has resulted in Collaborative
Interprofessional Patient-Centred Models of Care
Team members collaborate together, and include
patient as a team member Roles blur ,but each
member has unique skills. See the 7 elements of
collaboration
Communication is frequent, through chart,
meetings, shared decision making processes which
include the patient, working toward the same goal
Leadership changes as issues change
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This has resulted inCollaborative
Interprofessional Patient-Centred Models of Care
Hall Weaver 200135867-75 Choi 2006

• Team members collaborate together
• Roles blur/are shared, but each member has
  unique skills.
• Communication is frequent, through chart,
  meetings, shared decision making processes which
  include the patient, working toward the same goal
• Leadership changes as issues change

Interprofessional
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Relational Responsibility
Assumptions Health Care Professional and Patient
are both human beings and this is the connector
between them. Both retain their role as health
care provider and patient but are not defined by
this relationship
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HC provider
HC provider
HC provider
HC provider
Patient
Family
Changing knots of relationships how can we do
this? Being human connects us all.
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Choi, 2006
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Martin Buber
Martin Buber speaks of the I-Thou relationship
as a reverent being-with the other through which
ones own humanity is confirmed. The primary
word I-Thou can be spoken only withconcentration
and fusion into whole being which can never
take place alone, nor can it take place without
me. I become through my relation to the Thou as
I become I, I say Thou. - Buber, 1958
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'Withness'