University of South Dakota
Report date
December 2021
What has been most instrumental to your progress?
1. Capacity Building
To gain access to training tools and resources that are made publicly available from similar projects around the world, three of our faculty members participated in ECHO Immersion Training sessions. In November and December of 2020, Anne Pithan, Cheryl Fischbach, Becky Heisinger and Sabina Kupershmidt participated in ECHO training (Project ECHO, ECHO Institute) where we learned effective telementoring facilitation and programming approaches in a 3-day training course. Participants are given access to the Project ECHO Resource Library (PERL) and even received CNE credits. The resources and the know-how that are needed to build palliative care capacity through telementoring in South Dakota are now at our fingertips.
To gain access to training tools and resources that are made publicly available from similar projects around the world, three of our faculty members participated in ECHO Immersion Training sessions. In November and December of 2020, Anne Pithan, Cheryl Fischbach, Becky Heisinger and Sabina Kupershmidt participated in ECHO training (Project ECHO, ECHO Institute) where we learned effective telementoring facilitation and programming approaches in a 3-day training course. Participants are given access to the Project ECHO Resource Library (PERL) and even received CNE credits. The resources and the know-how that are needed to build palliative care capacity through telementoring in South Dakota are now at our fingertips.
2. Coalition strengthening
Monthly leadership team meeting (10 participants) consisting of representatives from SDSU, SDAHO and Avera are held on Zoom. In addition, meetings are held with community partners with 27 names from nursing homes, churches, clinics, hospitals and other stakeholders. The primary partners in our Palliative Care coalition, USD, SDAHO, Monument Health and Avera were invited to an in-person conference at Arrowwood Resorts in Chamberlain, SD on June 10 & 11. Outcomes that resulted from the monthly Zoom meetings and from the in-person meetings are a Strategic Plan, a Logic Model and Workplan with a timeline was completed at the in person conference. Smaller teams were assigned to 1. Develop a Curriculum for the ECHO sessions, 2. Invite the speakers, and 3. Evaluate the teaching sessions.
Monthly leadership team meeting (10 participants) consisting of representatives from SDSU, SDAHO and Avera are held on Zoom. In addition, meetings are held with community partners with 27 names from nursing homes, churches, clinics, hospitals and other stakeholders. The primary partners in our Palliative Care coalition, USD, SDAHO, Monument Health and Avera were invited to an in-person conference at Arrowwood Resorts in Chamberlain, SD on June 10 & 11. Outcomes that resulted from the monthly Zoom meetings and from the in-person meetings are a Strategic Plan, a Logic Model and Workplan with a timeline was completed at the in person conference. Smaller teams were assigned to 1. Develop a Curriculum for the ECHO sessions, 2. Invite the speakers, and 3. Evaluate the teaching sessions.
3. Curriculum Design
At the in person conference in Chamberlain the team decided to implement the Clinical Practice Guidelines for Quality Palliative Care by the National Coalition for Hospice and Palliative Care. We designed a curriculum based on the domains identified by the guidelines. Eight sessions were planned that will cover these topics: 1. Structure and Processes of Care, 2. Physical Aspects of Care, 3. Psychological and Psychiatric Aspects of Care, 4. Social Aspects of Care, 5.Spriritual, Religious and Existential Aspects of Care, 6. Cultural Aspects of Care, 7. Care of the Patient Nearing the End of Life and 8. Ethical and Legal Aspects of Care. The telementoring sessions are scheduled to start in March of 2022 and will be run on a monthly basis with access for everyone.
At the in person conference in Chamberlain the team decided to implement the Clinical Practice Guidelines for Quality Palliative Care by the National Coalition for Hospice and Palliative Care. We designed a curriculum based on the domains identified by the guidelines. Eight sessions were planned that will cover these topics: 1. Structure and Processes of Care, 2. Physical Aspects of Care, 3. Psychological and Psychiatric Aspects of Care, 4. Social Aspects of Care, 5.Spriritual, Religious and Existential Aspects of Care, 6. Cultural Aspects of Care, 7. Care of the Patient Nearing the End of Life and 8. Ethical and Legal Aspects of Care. The telementoring sessions are scheduled to start in March of 2022 and will be run on a monthly basis with access for everyone.
Key lessons learned
We took a risk when we organized an in-person conference in Chamberlain while the pandemic was still ongoing and attendance was lower than expected. Only 10 people were able to attend. However, following the meeting, the response was overwhelmingly positive. The attendees felt that they understood the project much better than previously. Everyone felt that much more can be accomplished when we meet in person. There was a lot of energy and engagement with the project afterwards. Our partners worked very hard on the curriculum and we met all of the goals set at the in-person conference by the end of the year. In fact, the response was so good that we will try to hold another in-person conference in January if our funds permit.
A very exciting development happened when we realized that South Dakota is the recipients of 3 separate grants (Bush, HRSA and NIH) all working on palliative care-related issues. Through our community partners on this grant, we are now interacting with the leaders of the other 2 grant-funded palliative care efforts. We are sharing information and we are trying to avoid duplication of work by having regular meetings.
Reflections on inclusive, collaborative or resourceful problem-solving
It is impossible to say which of the three elements was most important. Our coalition is trying to keep a balance between all three. Resourceful may have been the most natural because everyone knows how to work with limited resources. The inclusive and collaborative parts were the most fun and engaging elements. Once we all realized that each had a personal story that drove us to work with palliative care, we became stakeholders. We shared our “why” and decided to provide solutions that would be helpful to our communities.
Other key elements of Community Innovation
Our team consists of several different professions, practice partners and service providers. Initially, there may have been some hesitation to speak freely because we know that our employers are in competition for scarce resources. Very soon we all realized that everyone was respectful of the others; we became very goal oriented and looked at the desired outcome – improved palliative care for our community. Respect for others was key.
Understanding the problem
The work we have done so far has actually reinforced our belief that our chosen approach of using Project ECHO, a validated remote-mentoring continuing education platform, to design and implement a learning curriculum for rural palliative care community health workers will be superior. Through the new learning environment created by the COVID pandemic, we have learned that remote learning is here to stay. Telementoring will be in even greater demand going forward than it appeared to be two years ago when we first formulated our plan for Palliative Care ECHO telementoring in South Dakota. In addition, health care is experiencing an attrition in the workforce and it will be ever more important to support each other through online learning communities. The curriculum we are building will be a model for others.
If you could do it all over again...
The most important lesson we learned from the results of our in-person conference in Chamberlain was that online meetings are not as productive and energizing as face-to-face meetings. In addition, we learned that it takes a very long time to build relationships with stakeholders. Hiccups and difficulties within the team are normal and predictable. Keep talking to each other and you will work through difficulties if you have a clear goal in mind.
One last thought
It is amazing to see how the pandemic has changed healthcare forever. Healthcare workers now have so many options for employment than before and we will need to show support for each other because everyone is affected by fatigue and stress.