Improving Interprofessional Collaboration Between Social Work and Pharmacy Through Hybrid and Virtual Learning Experiences.

The professions of pharmacy and social work are not generally assumed to directly collaborate in patient care; however, these professions are complementary. Health and wellbeing outcomes are significantly improved when care is managed by an interprofessional team that communicates and collaborates to ensure all aspects of care are effectively managed. The creation of educational opportunities for students to practice working together provides enhanced educational experiences and leads to their success as professionals. Pharmacy and social work faculty developed an interprofessional education activity specifically aimed at integrative student learning. Faculty and students based on various islands throughout the state of Hawai'i and the US territory of Guam participated in the experience. The case study encouraged interprofessional teamwork and collaboration. The case study also challenged students to share profession-specific knowledge with each other. Mean evaluation scores were compared between hybrid and fully online platforms. Evaluation scores were high and at least as good or higher in the fully online exercise compared to the hybrid exercises. Using the 20-item pre-post format, Interprofessional Collaborative Competencies Attainment Survey, results indicated statistically significant improvements in scores for all questions and domains (all P<.001). When hybrid training and fully online training were compared, there were no significant differences in pre scores, but post domain scores were significantly higher in students who experienced fully online training. This interprofessional case-based activity successfully promoted interprofessional learning and collaboration. Introducing learners to this type of collaborative practice while in school is critical for future collaboration in the workforce.

Interprofessional Disaster Simulation During the COVID-19 Pandemic: Adapting to Fully Online Learning.

BACKGROUND: This paper describes the rapid conversion of a face-to-face interprofessional (IP) disaster simulation to an online format in response to COVID-19 campus closures. METHODS: The online disaster simulation utilized internet-based tools allowing real-time collaboration between IP students. Team exercises involved disaster triage, disease outbreak investigation, and disaster response. Surveys measuring self-assessment of various IP skills and simulation learning outcomes (SLOs) were compared with responses from previous face-to-face simulations. RESULTS: Results indicated mean scores for IP skills were higher for online students when compared with in-person simulations, and all SLOs were met. CONCLUSIONS: The online disaster simulation provided an effective, innovative IP educational opportunity.

Impact of COVID-19 on Hawai'i Community Agencies, Service Organizations, and the Individuals They Serve: A Snapshot from a Spring 2020 HI-EMA Survey.

Health and social service organizations across Hawai'i were surveyed between April 29 and May 11, 2020 by the Community Care Outreach Unit of the Hawai'i Emergency Management Agency. This article contextualizes and describes some of the major findings of that survey that reveal the impact of coronavirus disease 2019 (COVID-19) on Hawai'i community agencies, service organizations, and the individuals they serve. Major issues for individuals served by the responding organizations included securing basic needs such as food and housing as well as access to health services, mental health needs, and COVID-19 concerns (such as inadequate personal protective equipment, cleaning supplies, quarantine, and testing issues). Respondents reported that job loss and the resulting financial problems were a root cause of personal strain among clients served. Community-level stress was related to the distressed economy and store closures. Fulfilling immediate and future needs of health and social service agencies and the individuals they serve, as articulated in this report, could dampen the effect of COVID-19, promote population wellbeing, and support community resilience.

A Report on the Impact of the COVID-19 Pandemic on the Health and Social Welfare in the State of Hawai'i.

The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on the world. To address the impact of COVID-19 in the state of Hawai'i, the Hawai'i Emergency Management Agency (HI-EMA) Community Care Outreach Unit conducted an assessment survey to determine the impact of COVID-19 on the health and social welfare of individuals and their families across the state. This article presents key statewide findings from this assessment, including areas of need and community-based recommendations to help mitigate the impact of the pandemic, particularly for vulnerable groups. A total of 7927 participants responded to the assessment survey from across the state's counties. In all questions related to paying for essentials, the percentage of participants that expect to have problems in the future, as compared to now, almost doubled. Slightly higher than one-third reported that they would know how to care for a family member in the home with COVID-19, and half of the respondents reported a lack of space for isolation in their home. About half reported that if they got COVID-19, they would have someone available to care for them. Overall, Native Hawaiian, Pacific Islander, and Filipino groups reported greater burden in almost all areas surveyed. The results presented provide a baseline in understanding the impact, needs, and threats to the health and social welfare of individuals and their families across the state of Hawai'i. Local stakeholders can utilize this information when developing priorities, strategies, and programs to address current and future pandemics in the state.

A Report on the Impact of the COVID-19 Pandemic on the Health and Social Welfare in the City and County of Honolulu, Hawai'i.

To address the impact of COVID-19 in the state of Hawai'i, the Hawai'i Emergency Management Agency Medical Public Health Branch activated its' Community Care Outreach Unit (CCO Unit). A team from this unit developed a survey to assess the impact, needs, and threats to the health and social welfare of individuals and their families as they pertain to COVID-19. This article presents key findings for the City and County of Honolulu (CCH). A total of 5598 CCH residents responded. Approximately half of these respondents reported they or their household members experienced reduced work hours or lost their job as a result of COVID-19. In all questions related to paying for essential living costs, at the time of the survey, the percentage of participants who expected to have future problems nearly doubled. Those preparing for school in the fall school semester expected challenges centered on insufficient funds to purchase school supplies, lack of available face-coverings, and language barriers. Financial assistance, rental assistance, and food assistance seemed to be more difficult to apply for compared to health care services. The most common reasons for difficulty with applications noted by residents included that they could not figure out how to complete the form, did not have all the documents, or could not get through on the telephone. About one-half of CCH participants reported feeling nervous more than half of the days or nearly every day in the past 2 weeks. Most perceived the severity of COVID-19 to be moderate to very high. Less than half reported knowing how to provide care for someone in their family with COVID-19. Half of the CCH participants reported that they practice social distancing usually or all of the time, and the majority reported wearing a face-covering usually or always when outside of the home. A significant portion of respondents reported barriers for providing care for a household member exposed or infected with COVID-19. Such barriers included a lack of space in their home for isolation; not having enough cleaning supplies; no working thermometer in the home, or no family member available to care for them. The results presented may provide a baseline for understanding the impact, needs, and threats to the health and social welfare of individuals and their families in CCH and across the state of Hawai'i. Local stakeholders can utilize this information in developing priorities, strategies, and programs to address the pandemic as it continues to unfold and learn lessons for future pandemics.

A Report on the Impact of the COVID-19 Pandemic on the Health and Social Welfare in the County of Hawai'i, Hawai'i.

The Community Care Outreach Unit (CCO) of the Hawai'i Emergency Management Medical/Public Health Services Branch conducted a survey to gauge the impact of coronavirus disease 2019 (COVID-19) on the health and social welfare of individuals and families in the state of Hawai'i. A mixed-methods framework was utilized for survey distribution; 7927 respondents participated in the survey. This article presents key findings for the state's Hawai'i County (HC). It presents a descriptive analysis of the data to provide a basic overview of the impact of COVID-19 in HC, as assessed in August-September 2020. A total of 936 participants from HC responded to the survey. Approximately one-third reported that they or their family members experienced reduced work hours, and one-fifth lost their jobs because of COVID-19. Many reported difficulties paying for many types of living essentials and expected these difficulties to increase in the near future. Challenges for the fall school semester included lack of access to funds for school supplies and face-coverings. The majority perceived the severity of COVID-19 to be moderate/very high and most had at least a moderate level of knowledge about risks for developing severe COVID-19. Approximately half reported maintaining social distancing usually/all of the time, and about two-thirds reported wearing a face-covering usually/always when needed. Other barriers for COVID disease prevention and response included a lack of space for quarantine/isolation of family members, not having enough cleaning supplies, low knowledge of how to care for a household member with COVID disease and not having someone available to care for them if they contracted the virus. The results provide a baseline for understanding the impact, needs, and threats to the health and social welfare of individuals and their families as a result of COVID-19 in HC. Local stakeholders can utilize this information when developing priorities, strategies, and programs to address the pandemic where needed.

A Report on the Impact of the COVID-19 Pandemic on the Health and Social Welfare in the County of Kaua'i, Hawai'i.

The Hawai'i Emergency Management Agency Community Care Outreach Unit (CCO) conducted a survey to gauge the impact of coronavirus disease 2019 (COVID-19) on the health and social welfare of individuals and their families across the state of Hawai'i. A mixed-methods framework was utilized for survey distribution. This article presents a descriptive analysis of the data to provide a basic overview of the impact of COVID-19 in Kaua'i County (KC), as assessed in August/September 2020. A total of 420 participants in KC responded to the statewide survey. Approximately one-third reported that they or their family members experienced reduced work hours or lost their job because of COVID-19. Many reported difficulties paying for many types of living essentials and expected these difficulties to increase in the near future. Prevalent challenges for the fall school semester included access to funds for school supplies and face-coverings. About one-third reported feeling nervous more than half the time or nearly every day in the past 2 weeks, and one-fourth reported feeling worried more than half the time or nearly every day in the past 2 weeks. The majority perceived the severity of COVID-19 to be moderate/very high and most had at least a moderate level of knowledge about risks for contracting severe COVID-19. Less than half said they would know how to provide care for someone in their family with COVID-19. Half of the respondents in KC reported maintaining social distancing usually/all of the time, the majority reported wearing a face-covering usually/always when needed. The results provide a baseline for understanding the impact, needs, and threats to the health and social welfare of households and their families in KC as a result of COVID-19. Local stakeholders can utilize this information for developing priorities, strategies, and programs to address the pandemic where needed and also to assess progress in areas of need.

A Report on the Impact of the COVID-19 Pandemic on the Health and Social Welfare in the County of Maui, Hawai'i.

The Community Care Outreach Unit of the Hawai'i Emergency Management Agency (HI-EMA) Medical/Public Heath Branch conducted a survey to gauge the impact, needs, and threats to the health and social welfare of individuals and their families pertaining to coronavirus disease 2019 (COVID-19). This article presents key findings for the County of Maui (MC) in the state. A mixed-methods framework was utilized for survey distribution and recruitment of participants from across the state. Recruitment strategies included snowball sampling via website and social media, and paper surveys. Descriptive analysis of the data is presented to give a basic overview of the impact of COVID-19 in MC. A total of 883 participants in MC responded to the survey. Approximately one-third reported that they or family members experienced reduced work hours or lost their job because of COVID-19. In all questions related to paying for essential living needs, the percentage of participants who expected to have future problems was higher than the percentage who reported having current problems. Of those preparing for the fall 2020 school semester, expected challenges included lack of funds to purchase school supplies, lack of face coverings, and language barriers. Most participants in MC perceived the severity of COVID-19 to be moderate to very high, and there was a moderate level of knowledge about which groups are more at risk for contracting severe COVID-19. Less than half would know how to provide care for someone in their family with COVID-19. Several resource barriers for caring for a family member with COVID-19 were identified. The COVID-19 pandemic has had a more severe impact on Native Hawaiian and Pacific Islander groups compared to others in the county. The results may provide a baseline for understanding the impact, needs, and threats to the health and social welfare of individuals and their families in MC. Local stakeholders can utilize this information to develop priorities, strategies, and programs to address the COVID-19 pandemic response in MC.

Pathways to Social Work Licensure: An Examination of Hawai'i's Licensed Social Workers.

Few research studies have examined social work practitioners and their licensure practices and pathways, or how policies affect licensure choices. Pathways to licensure, particularly the process of movement from graduation to licensure, along with the type of license, and the length of time a license is held were analyzed using administrative data from a state agency responsible for professional licensure administration and two schools of social work in the same state. The analysis prioritized the review of individuals who have held or do hold multiple licenses. Results indicated (a) that the majority of people who pursue licensure do so shortly after graduation; (b) that once licensed, graduates maintain their licenses for long periods of time; (c) that the majority of graduates do not pursue licensure; and (d) that policy contexts and opportunities for licensure at different levels affect licensure decision making. The analysis resulted in detailed information regarding the decisions graduates are making to pursue their licenses, the impact of policy on licensure pathways, the intersection of jurisdictional policy and license mobility, and the process of how social workers move through various levels of licensure.

Evaluation of distance facilitation and technology in an interprofessional simulation exercise.

INTRODUCTION: This paper explores two objectives: (1) effectiveness of interprofessional education facilitators utilizing distance technology to facilitate and debrief an interprofessional exercise with students located on the islands Oahu and Hawai'i Island (Hilo), and (2) impact of technology on the simulation experience for facilitators and students. METHODS: Four disciplines participated in an interprofessional hospital discharge exercise for the same geriatric patient case. Two questions administered to facilitators and students after each session focused on: (1) satisfaction with the students' ability to work through the simulation, and (2) satisfaction with the use of distance technology. RESULTS: Results showed no significant differences when comparing students to facilitators for the students' ability to work through the simulation. Students gave significantly lower satisfaction scores with distance technology than faculty. There were no significant differences in scores among disciplines between either facilitators or students. Pharmacy distance students had significantly lower scores for satisfaction with the simulation exercise and for the role of distance technology compared to other students. Qualitative analyses showed trend improvements over five semesters in four technology areas; volume, noise, difficulty with clarity/understanding, and seating location/placement issues for the on-site group, but only significant improvement with clarity/understanding in the distance group. CONCLUSIONS: Interprofessional simulation exercises can be successfully facilitated from both on-site and distance site without compromising students' ability to work through the exercise. Satisfaction with distance technology was lower for distance student groups.

Engaging a Community Chaplaincy Resource for Interprofessional Health Care Provider Training in Facilitating Family Decision Making for Children at End-of-Life.

Coordinating the care of terminally ill children is difficult for both parents and the health care team. An underutilized resource is spiritual care, such as that provided by Pacific Health Ministry, a community-based nonprofit established to develop hospital ministry training programs in Hawai'i and provide chaplaincy services to local facilities. This paper describes a training exercise, called the Pediatric Interprofessional Program (PIPP), which is modeled after an adult program, the Hawai'i Interprofessional Training for End of Life Communication in the intensive care unit (HITEC-ICU). Both programs were developed to introduce teams of learners consisting of Pacific Health Ministry spiritual care residents, internal medicine or pediatric residents, undergraduate students in nursing, and graduate students in social work to techniques in delivering serious, life-altering information, and the dynamics of working as an interprofessional team through use of progressively unfolding clinical simulations. PIPP facilitators included chaplaincy instructors at Pacific Health Ministry, university faculty, and community practitioners in pediatrics, nursing, and social work. The simulations were conducted at the Translational Health Science Simulation Center (THSSC) of the University of Hawai'i at Manoa (UHM) School of Nursing and Dental Hygiene (SONDH), with simulated patients from the HealthCAST (Collaborative Acting Simulation Training) program, a collaborative agreement between SONDH and the UHM Department of Theatre and Dance. The training is ongoing, but has thus far demonstrated that interprofessional education programs are feasible across community, academic, and clinical lines, and benefit from the engagement of community resources.

An interprofessional team simulation exercise about a complex geriatric patient.

Interprofessional collaboration is an essential skill to optimize the care of older adults with complex problems. We successfully developed and evaluated an interprofessional teamwork simulation exercise for medical, nursing, pharmacy, and social work students. Pharmacy students participated via video conferencing. Before the simulation, students watched a teamwork video and reviewed the patient case. Following an icebreaker exercise, interdisciplinary faculty facilitated a discussion highlighting effective teamwork strategies. Students then collaborated to develop a discharge plan, followed by a simulated family meeting with a theater student. Interdisciplinary faculty again provided structured debriefing highlighting principles of effective teamwork. Students self-rated interprofessional practice core competencies were evaluated using a retrospective pre/post survey and analyzed using paired t-tests. We qualitatively examined the use of distance technology and assessed learner's satisfaction with the project. All core competency categories for all disciplines demonstrated significant improvements in mean scores. Students' qualitative comments demonstrated positive impact on learning interprofessional core competencies.

Financial Incentives for Medicaid Beneficiaries With Diabetes: Lessons Learned From HI-PRAISE, an Observational Study and Randomized Controlled Trial.

PURPOSE: The Hawaii Patient Reward and Incentives to Support Empowerment (HI-PRAISE) project examined the impact of financial incentives on Medicaid beneficiaries with diabetes. DESIGN: Observational pre-post study and randomized controlled trial (RCT). SETTING: Federally qualified health centers (FQHCs) and Hawaii Kaiser Permanente. PARTICIPANTS: The observational study included 2003 Medicaid beneficiaries with diabetes from FQHCs. The RCT included 320 participants from Kaiser Permanente. INTERVENTION: Participants could earn up to $320/year of financial incentives for a minimum of 1 year. MEASURES: (1) Clinical outcomes of change in hemoglobin A1c (HbA1c), blood pressure, and cholesterol; (2) compliance with American Diabetes Association (ADA) standards of diabetes care; and (3) cost effectiveness. ANALYSIS: Generalized estimating equation models were used to assess differences in clinical outcomes. General linear models were utilized to estimate the medical costs per patient/day. RESULTS: Changes in clinical outcomes in the observational study were statistically significant. Mean HbA1c decreased from 8.56% to 8.24% ( P < .0001) and low-density lipoprotein decreased from 106.17 mg/dL to 98.55 mg/dL ( P < .0001). No significant differences were found between groups in the RCT. Improved ADA compliance was observed. No reduction in total health cost during the project period was demonstrated. CONCLUSION: The HI-PRAISE found no conclusive evidence that financial incentives had beneficial effect on diabetes clinical outcomes or cost saving measures.