EPA 3A: Engage in Collaborative Care - Consult
SCOPE OF WORK: This activity includes engaging in collaborative care between oral health care providers (e.g., dental specialties) and other health care professionals (e.g., medicine, nursing, nutrition, social work, pharmacy). Conducting safe, timely, effective, efficient collaborative care, verbal and/ or written, within the dental team and with other health care providers is essential to providing optimal, person-centered, and equitable patient care. Identifying and obtaining consultations from appropriate health care providers helps to ensure that the patient will receive safe and appropriate treatment and optimize health care outcomes.
- Person-Centered Care
- Critical Thinking and Decision Making
- Team Based Care
- Biomedical Science Application
- Self-Assessment
- Roles and responsibilities of all members of the health care team (including all dental specialties)
- Capability, knowledge, and skill that dental/non-dental health care professionals can provide to dental patients
- Communication and collaboration with oral and other health care partners
- ISBAR framework to communicate essential information
- Criteria for determining if/when consultation and/or referral are needed
- Process of referral and consultation (including informed consent, communication, documentation, followup)
- Required documentation specific to referral/consult in electronic patient record (EPIC Wisdom)
- Recognize one’s limitations in scope of practice, skills, knowledge, and/or abilities
- Recognize when patient would benefit from consult or referral
- Identify when further information is needed from other professionals to make treatment planning decisions that optimize safety and treatment outcomes
- Engage dental and non-dental health care professionals to assess, coordinate, and provide care that aligns with patient’s values and is safe, timely, efficient, effective, and equitable
- Demonstrate teamwork and effective communication to facilitate collaboration
- Engage in collaborative decision-making with intra- and inter-professional partners to address patient needs
- Referral/consult, written and/or verbal, includes the elements of the ISBAR framework
- Properly document referral/consultation to facilitate an effective handoff in electronic patient record (Epic Wisdom)
| Consultation |
Meets Expectations of the Graduate
|
Progressing
|
Below Expectations
|
Critical Error
|
|---|---|---|---|---|
| Decision to Consult | Appropriately identifies need to consult and to which dental professional(s) and or other health care provider(s) | Recognizes value of consult but needs guidance to identify the appropriate health care professional(s) or discipline(s) | Does not recognize need to consult or suggests consult with an inappropriate discipline, neither of which compromises patient’s health | Omission of consult that could negatively affect patient’s health outcomes |
| Patient Communication | Explains information to be obtained, why it is needed, and its potential impact on plan of care; obtains consent for the consultation | May not clearly explain the reason for consult or how the findings may impact their plan of care | Does not explain the reason for consult or how the findings may impact their plan of care | Fails to obtain consent for the consultation in violation of the patient’s autonomy or right to privacy |
| Request for Consultation | Request for consult, written or verbal, includes the elements of the ISBAR* framework, and avoids using dental jargon when communicating with providers outside of dentistry | Request for consult, written or verbal, may be missing one of the elements of the ISBAR*, or request to other provider needs clarification | Request for consult is missing more than one element of ISBAR* framework, making the request difficult to understand and may lead to inefficiencies or delay in patient care | Communication to health care provider is incomplete or/and has inaccuracies that could negatively affect patient’s health |
| Documentation of Consultation and Integration Into Plan of Care | Documents all communication with the consultant in patient’s record; integrates consultant’s recommendations appropriately into the patient’s plan of care | Documentation in patient's record from consultant may be incomplete; integrates consultant’s recommendations appropriately into patient’s plan of care | Key findings/recommendations of the consultant not documented, applicable treatment recommendations from consultation not incorporated into the patient's plan of care | Fails to incorporate critical consult information in patient's plan of care that may compromise patient’s health |
*ISBAR – Introduction: Identify oneself and role in care. Situation: Reason for consult/referral. Background: Pertinent patient information (e.g., patient diagnosis). Assessment: Learner’s assessment of the situation. Request/Recommendation/Result: What information is needed; what is their recommendation; what you would like them to do; arrange follow-up (how and when). Rating on "Team-Based Care" for this encounter will be included for the assessment of this task.