Placement: Rutgers University, Robert Wood Johnson Medical School
Mentor: Benjamin Crabtree, Ph.D., Professor, Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School
Project: Diffusing the Barriers to Achieving Integrated Care at a Professions Level Using Policy Levers
Martin Chadwick, D.H.Sc., M.H.S., is a 2019–20 New Zealand Harkness Fellow in Health Care Policy and Practice. As the chief allied health professions officer at New Zealand’s Ministry of Health, Chadwick works closely with the chief medical officer and chief nursing officer to provide transdisciplinary clinical leadership, supporting clinicians, programs, and projects across the ministry. Chadwick is currently developing a work program around what he has identified as the five challenges facing allied health, which include demonstrating the value add of the allied health professions to population health and the transdisciplinary provision of health care services. Prior to his appointment in the ministry, he was executive director of allied health at the Bay of Plenty District Health Board, and before that was director of allied health at Counties Manukau District Health Board. Chadwick recently completed his Ph.D., examining health work force change. His M.H.S. is from the University of Indianapolis and he trained as a physiotherapist at Otago Polytechnic. He is chair of the National Directors of Allied Health Group and is passionate about the untapped potential that allied health professions can bring to improving quality of care and promoting health equity at the population level.
Project Overview: The delivery of healthcare services has become increasing complex with an ageing population and the proliferation of lifestyle associated health issues. Internationally, there have been attempts to implement models of healthcare delivery that focus on how teams work together, including the collaboration that occurs between health professionals in producing integrated care across the patient journey. In the United States, the Patient-Centered Medical Home, a model for primary care practice redesign, has led to the identification of common themes that enable successful implementation of practice changes. These include an enhanced focus on the population being served, the use of technology to improve linkages and coordination of services, the changing of traditional staff roles and how they interact in service delivery.
This research aims to examine a working hypothesis that integrated care is achieved at a system level by minimizing conflict and competition around professional jurisdictions through the implementation of transdisciplinary care models. In addition, it seeks to examine how these care models allow health professionals to maximize their expertise and associated skill sets to better meet population health needs. Exemplar sites will be selected for inclusion based on evidence of having worked past barriers to enable new models of care or working across traditional professional jurisdictions.
In-depth study of exemplar sites will include review of publicly accessible documentation, initial phone interviews with clinical leads from the medical, nursing and ancillary professional groups, subsequent in-person interviews with clinical leads, and direct observation of select teams demonstrating transdisciplinary working. The results of this research will be used to develop guidelines for policy audiences that can be applied to health care settings in the U.S., New Zealand, and elsewhere around the world.