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Continuing Education Credit (CEU)

We are pleased to offer 1 hour of CNE or CME* credit at no cost to participants.   

Migrant Clinicians Network is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.  

*Application for CME credit has been filed with the American Academy of Family Physicians. Determination of credit is pending.

American Nurses Credentialing Center

Webinars

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MCN is committed to providing high quality continuing education to health care providers serving migrant farmworkers. MCN's comprehensive clinical education program helps to develop excellence in practice, clinical leadership, and the dissemination of best models and practices.

 

MCN IPV Learning Collaborative Banner

Addressing Intimate Partner Violence

Next Session: May 1, 2019 @ 10am (PST) / 1pm (EST)

Description:  Intimate partner violence (IPV) occurs in all segments of our society, but vulnerable populations like migrant women may encounter additional disparities and barriers to care that make intervention and treatment of IPV more complex. Language barriers, economic hardship, and isolation from their communities, support networks, and cultures of origin make it increasingly difficult to come forward and report IPV. Those affected often suffer in silence for fear of losing their jobs or enduring legal ramifications like being reported to immigration by a citizen partner. In addition, immigrant and migrant women can have less access to social and medical services increasing their negative health outcomes. Health centers can make significant strides in reducing IPV in the community through culturally sensitive tactics both in the exam room and in the community.

In these two sessions, Migrant Clinicians Network provides specific and effective action items to better serve women who have experienced IPV in the exam room, and to make our communities safer by engaging men in the community.

 

Learning Collaborative Structure

Session 1: CREATING A SUPPORTIVE CLINICAL ENVIRONMENT TO ADDRESS INTIMATE PARTNER VIOLENCE
Date: April 17, 2019
This Learning Collaborative will explore ways in which clinicians can address IPV in a primary care setting. The first session will build on MCN’s decades of experience in supporting clinicians ability to use the exam room as a safe space to speak to women potentially affected by IPV. MCN worked with clinicians to identify a method to initiate dialogue through a brief low-literacy assessment tool that relied on icons to identify types of abuse. Through this training, we will prepare clinicians to understand exit plan development including critical items/documents, sources for financial support, and how to identify a trusted network. We will also discuss how to engage local and regional resources to provide resources and support for women experiencing IPV.

Session 2: PROVIDING ESSENTIAL TOOLS FOR MEN TO ACT ON PREVENTING INTIMATE PARTNER VIOLENCE
Date: May 01, 2019
Primary prevention of intimate physical and sexual violence is defined as preventing violence before it occurs. In this session, we will discuss strategies to engage in primary prevention among immigrant and migrant men. Research and programmatic experience conducted by MCN over the last two decades has shown the need to provide men with the skills and the lexicon/language to address stress, fear, and anger effectively in order for them to employ primary prevention strategies. Faculty will provide an understanding of the processes and outcomes, and enhancing sustainability for programs that focus on the prevention of intimate partner violence in immigrant and refugee communities. The discussion will also include information about videos and other materials for use in multiple settings that can be employed to engage men in conversation about primary prevention.

 

Lead Faculty

Deliana Garcia 

Deliana Garcia, MA, Director, International Projects and Emerging Issues

As the Director of International Projects, Research, and Development for Migrant Clinicians Network, Deliana Garcia has dedicated more than twenty-five years to the health and wellness needs of migrant and other underserved populations. Throughout her career she has worked in the areas of reproductive health, sexual and intimate partner violence, access to primary care, and infectious disease control and prevention. Ms. Garcia is responsible for the development and expansion of Health Network, an international bridge case management and patient navigation system to make available across international borders the health records of migrants diagnosed with infectious and chronic diseases. She has served as the Principal Investigator or member of the research team for a number of studies addressing topics, such as sexual and intimate partner violence prevention among Latino migrant and immigrant families, trauma in transit for migrants crossing international borders, and emotionally-charged dialogue between patients and health care providers.

 

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image of clinicians working together to treat a patient

Team-Based Diabetes Care for Federally Funded Health Centers

Next Session: April 25

Description:  Diabetes kills. It’s the seventh leading cause of death in the US, and it greatly increases the risk of heart disease, the biggest killer of them all.  Hundreds of thousands of patients at our federally funded health centers struggle with diabetes -- and that’s why well-implemented team-based care is so critical.  Team-based care can be more comprehensive, coordinated, and efficient -- and more effective. Plus, both patients and providers have rated team-based care as more satisfying.

But how do you implement it among special or vulnerable populations, such as those experiencing homelessness, migrant and farmworker patients, and those in public housing?  In this six-part learning series, participants will explore how to develop truly effective care teams to utilize the skills and expertise of different team members. Faculty will engage participants in discussions about team-based care specifically to address key elements of diabetes prevention, management, and control including obesity screen and prevention, the use of motivational interviewing for patient goal setting, as well as depression screening and management. Our expert faculty will work with 10-15 health center clinical teams comprised of community health workers (CHWs), clinicians, and other social support personnel to improve diabetes care for some of the most vulnerable adult and school-aged patients.

For special and vulnerable populations, it is especially critical to involve CHWs in the clinical team to most effectively engage and motivate patients to change health behavior and better manage their diabetes. CHWs typically work in their own communities, share cultural, economic, linguistic and other characteristics with the patients they work with (including in some cases diabetes), and are able to build close, trusting relationships with communities because of a deep knowledge of that community. Building an effective team that includes clinicians, CHWs and other support staff is critical to fulling addressing the needs of diabetic patients. Consequently, you must participate in this learning series as a team with at least three members of your clinic staff including at least one CHW or outreach worker. Each session will build on the previous one, so each team is expected to participate in all six sessions.

 

Learning Collaborative Structure

Session 1: Building an Effective Collaborative Care Team to Address Diabetes in Special and Vulnerable Populations
Date: April 18
This session will focus on the necessary elements to develop a high functioning patient-centered team for diabetes prevention, management, and treatment in primary care. The session will address the roles of all members of the team including the critical role of leadership and clinical champions to building an effective collaborative team. Faculty will include frontline staff from health centers to lead a discussion about evidence based team development practices from across the country. Participants and faculty will discuss the role of decision support tools, communication strategies, and care coordination in a team-based model.

Learning Objectives

  • Identify the role of different professionals in team-based care for diabetes.
  • Discuss evidence-based models of team-based care shown to be effective in primary care for special and vulnerable population.
  • Highlight tools and resources to assist in the development of highly functioning teams for diabetes care in federally funded health centers.

Session 2: Developing the Role of Community Health Workers and other Support Staff in Diabetes Prevention, Treatment, and Follow-Up
Date: April 25
Community Health Workers (CHW) have been shown to be especially successful reaching hard to access populations such as agricultural workers and their families as well as the homeless and residents of public housing. In this session, participants and faculty will explore the role of CHWs in the diabetes care team. Case studies and real world discussion will provide examples of both effective and ineffective integration of CHWs into the clinical care team. Participants will discuss the scope of practice and most effective roles for CHWs within the diabetes care team as well as the role of clinical champions and leaders in effectively mobilizing the skills of CHWs and other team members.

Learning Objectives

  • Discuss the scope of practice and most effective roles for CHWs within the diabetes care team.
  • Identify areas in which CHWs have been shown to be a significant asset to the diabetes care team.
  • Highlight tools and resources to assist in the integration of CWs into highly functioning teams for diabetes care for special and vulnerable patient populations.

Session 3: Patient Engagement Strategies for the Collaborative Care Team: Motivational Interviewing I
Date: May 2
This session will lead participants through the key elements of motivational interviewing, with a particular focus on how to engage socially and ethnically diverse patient populations. The session will examine the key elements of motivational interviewing including the four general principles of: (1) express empathy, (2) develop discrepancy, (3) roll with resistance, and (4) support self-efficacy. The session will emphasize specific skills and tools used to create a systematic approach to engaging patients that can be utilized by all members of the clinical team. The faculty will discuss using OARS (open ended questions, affirmations, summaries, and reflective listening) to draw patients into conversations about their health that lead to real change.

Learning Objectives

  • Participants will explore the “righting reflex” and determine one situation in which the righting reflex was not effective.
  • Participants will identify 2 OARS skills to be used in the next 30 days.
  • Participants will discuss specific case studies that use of motivational interviewing in a team-based setting for agricultural workers and/or homeless patients.

Session 4: Patient Engagement Strategies and Goal Setting for the Collaborative Care Team
Date: May 9
Patients with chronic diseases make day-to-day decisions about their health. The key to better health is for the health center team to engage with patients in the process of self-management so that the health center can fully support patients for better health outcomes. Patient self-management can be particularly challenging for vulnerable patients such as agricultural workers, the homeless, or residents of public housing. In this session, we will discuss some of the key strategies that have been proved effective in engaging patients in self-management. In particular, we will focus on tools to improve goal setting and on strategies to support patients in reaching their health goals. Particular emphasis will be placed on the role of CHWs in encouraging patient engagement and effective goal setting.

Learning Objectives

  • Participants will explore evidence based goal setting strategies for patients with diabetes. 
  • Participants will identify at least two tools that be used in a team-based care environment to help patients set realistic and manageable goals. 
  • Participants will discuss the role of CHWs in working with patients to set realistic and manageable health goals.

Session 5: Patient Engagement Strategies for the Collaborative Care Team: Pre-Visit Planning
Date: May 16
Pre-visit planning includes scheduling patients for future appointments at the conclusion of each visit, arranging for pre-visit lab testing, gathering the necessary information for upcoming visits and spending a few minutes to huddle and handoff patients. This can be particularly challenging for vulnerable populations such as agricultural workers, the homeless and residents of public housing. This session will explore strategies and tools for diabetes pre-visit planning that can be successful for vulnerable populations. Participants and faculty will bring case studies and real life scenarios to the discussion in order to facilitate problem-solving conversations about how to address challenging scenarios. The session will also address how to best incorporate pre-visit planning into a team-based setting that includes CHWs.

Learning Objectives

  • Participants will discuss the role of pre-visit planning in effective diabetes management for vulnerable populations. 
  • Participants will explore strategies to incorporate effective pre-visit planning for vulnerable populations such as agricultural workers, the homeless, and residents of public housing. 
  • Participants will assess the role of CHWs in effective pre-visit planning for vulnerable populations.

Session 6: Patient Intervention Strategies for the Collaborative Care Team: Group Visits
Date: May 23
Group visits have been shown to be an effective strategy to address diabetes management in a number of health settings. During group visits participants have a greater opportunity to ask questions, run the discussion and provide one another with peer support. CHWs can be particularly effective in setting up and helping run group visits at health centers. During this session, participants will discuss different models for group visit and explore best practices used in health centers. The session will rely on case studies and real life scenarios to discuss challenges and successes using group visits with vulnerable populations.

Learning Objectives

  • Participants will explore different models for group visits in health center settings.
  • Participants will examine the role of CHWs in developing and managing group visits. 
  • Participants will identify at least two tools that can be applied to develop group visits in a health center setting for vulnerable populations.

 

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Doctor looks at injury on patient's back

A Team-Based Approach to Improving Opioid Management in Primary Care for Vulnerable Populations

April 30, 2019 @ 10am (PST) / 1pm (EST)

Description:  Prescription opioid use and misuse have reached a crisis level in the U.S., with roughly 58 opioid prescriptions for every 100 residents in 2017 and more than 46 people dying daily from overdoses involving prescription opioids. (Source: Centers for Disease Control Opioid Prescribing Rate Maps). Although treatment plans and improved support options for managing opioid medications for individuals with chronic pain are being developed, implementing these evidence-based strategies in real world primary care settings can be challenging. Community and healthcare centers that treat patients who use opioids long-term for their chronic pain struggle with this issue and need tools and structured guidance in order to make meaningful change. This session will introduce the Six Building Blocks program which provides an evidence-based quality improvement roadmap to help primary care teams implement effective, guideline-driven care for their chronic pain and long-term opioid therapy patients. The session will discuss lessons learned during the implementation of this program and address key elements needed to transform systems of care. Faculty will also discuss upcoming opportunities for more in depth training and resource development designed to address pain management and opioid misuse in the primary care setting.

Speaker 

Michael Parchman
Michael Parchman, MD, MPH

Senior Investigator Michael Parchman, MD, MPH, is a nationally recognized scholar in chronic illness care research at Kaiser Permanente Washington Health Research Institute’s MacColl Center for Health Care Innovation. A family practitioner and health services researcher, Dr. Parchman previously served as the director of the Agency for Healthcare Research and Quality’s Practice-Based Research Network Initiative and senior advisor for primary care.

Dr. Parchman’s research focuses on using complexity science to explore how diverse health care teams can work together to achieve high-quality care. He leads Healthy Hearts Northwest, a three-year project for primary care practices in Washington, Oregon, and Idaho that is funded as part of the Agency for Healthcare Research and Quality (AHRQ)’s EvidenceNOW initiative. The project aims to help practices improve their patients’ cardiovascular health by expanding their existing quality improvement capacity.

Learning Objectives:  

  • Participants will be able to describe current challenges to managing opioid medications for individuals with chronic pain in a primary care setting. 

  • Participants will examine the six building blocks needed to build a quality improvement roadmaps to help primary care teams become effective.

  • Participants will identify at least 2 tools or strategies that can be applied in a primary care setting to address opioid use for long-term pain management.


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Clinician talking with patient

Stepping into the Cost of Care Conversation

May 15, 2019 @ 10am (PST) / 1pm (EST)

Description:  Clinic staff and clinicians typically assumed that others on the care team are addressing Cost of Care (CoC) concerns of patients, and expected that simply confirming insurance status is sufficient to address patients’ cost conversation needs. Both patients and providers report discomfort with conversations about healthcare costs and there are frequent instances of misunderstanding by patients of their financial responsibility for certain costs. Patients’ trust levels for staff and clinicians varied. Clinic workflow prioritized patient throughput rather than proactively exploring patient understanding of costs of copayments and deductibles, out-of-pocket costs for care or medications. Assessment of indirect costs of illness such as lost work time or transportation for treatments is often minimal. Additionally, the communication of patients’ CoC issues between staff across the steps of the medical visit is minimal.

The current state of cost-of-care conversations at many clinics leads to frequent misunderstandings and unmet CoC needs, which may ultimately increase the work and costs for both patients and their healthcare providers. Clinicians can play a larger role in facilitating conversations about costs with patients, especially those with low health literacy and their patients trust their insights. More frequent discussion of CoC concerns may improve adherence, and thereby outcomes. To assist with practice level improvement, administrators and staff can document CoC issues and better support patients’ understanding.

 

Learning Objectives

  • Participants will better understand the need for systematic, patient-friendly, culturally relevant CoC tools for patients, and for insightful CoC staff training that encourages and enables proactive exploration of CoC concerns
  • Participants will understand the principles of shared decision making and patient-centered care.
  • Participants will explore current and best practices for conducting cost-of-care (CoC) conversations in primary care among vulnerable patients, and optimal methods for training FQHC staff members on this emerging CoC issue.

 

Lead Faculty

Deliana Garcia 

Deliana Garcia, MA, Director, International Projects and Emerging Issues

As the Director of International Projects, Research, and Development for Migrant Clinicians Network, Deliana Garcia has dedicated more than twenty-five years to the health and wellness needs of migrant and other underserved populations. Throughout her career she has worked in the areas of reproductive health, sexual and intimate partner violence, access to primary care, and infectious disease control and prevention. Ms. Garcia is responsible for the development and expansion of Health Network, an international bridge case management and patient navigation system to make available across international borders the health records of migrants diagnosed with infectious and chronic diseases. She has served as the Principal Investigator or member of the research team for a number of studies addressing topics, such as sexual and intimate partner violence prevention among Latino migrant and immigrant families, trauma in transit for migrants crossing international borders, and emotionally-charged dialogue between patients and health care providers.

 

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Doctor takes blood pressure of agricultural worker

Working with the HRSA Diabetes Quality Improvement Initiative — making it work for your mobile and agricultural worker populations.

May 22, 2019 @ 10am (PST) / 1pm (EST)

Speaker 

Candace Kugel
Candace Kugel, CNM, CRNP, RN

Description:  The HRSA Diabetes Quality Improvement Initiative is an agency-wide effort to improve diabetes outcomes and lower health care costs.  MCN is working in support of the Improvement Initiative by assisting you to access resources and develop performance improvement skills that will enable you to address diabetes care in your mobile and agricultural worker populations. Diabetes care is a complex mix that includes medication, as well as education, self-care behaviors and continuity of care. Adding the factors of mobility, immigration status and culture takes the challenge to another level.

This webinar will include the following:  

  • Overview of the HRSA Diabetes Quality Improvement Initiative goals
  • Description of the elements Diabetes Performance Analysis process that is part of HRSA’s Operational Site Visit (OSV) process—root cause analysis, restricting and contributing factors, action steps
  • Relevant approaches to diabetes care for mobile populations and agricultural workers
  • Relevant data metrics for monitoring diabetes performance
  • Resources available for diabetes performance improvement

 

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Patient Engagement and Activation for
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ARCHIVED WEBINARS

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For any questions or additional information about MCN Sponsored Webinars, please email our Continuing Education Assistant at contedu@migrantclinician.org

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