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Implementing Self Management Support

Implementing Self Management Support. What is encompassed by the term Self-Management Support?. Self-Management Support could be:. Stanford Workshops Group Medical A ppointments Health Coaching Motivational Interviewing Peer Support Community Health Workers Panel Management.

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Implementing Self Management Support

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  1. Implementing Self Management Support www.livinghealthychamplain.ca

  2. What is encompassed by the term Self-Management Support?

  3. Self-Management Support could be: • Stanford Workshops • Group Medical Appointments • Health Coaching • Motivational Interviewing • Peer Support • Community Health Workers • Panel Management

  4. Self-Management Support could be • Patient Education • Group Education • Care Plans • Telephone Coaching • On-line Forums • Shared Medical Records

  5. Self-Management Support could be • Support Groups • Training patients to be participants in their medical care • Community Resources • Family-based programs • School based programs • Community Associations and Neighbourhood Plans

  6. Self-Management Support Do we have to wait until a patient has a chronic condition?

  7. What are we trying to do?

  8. What are we trying to do? • Improve patient outcomes • Improve patient quality of life • Provide a service that meets the needs of clients • Improve our work satisfaction • Keep long term health spending within reasonable limits

  9. Implementation Stage 1 Patient ready to make a plan Trained health care professional Behaviour change

  10. Implementation Stage 2 Patient ready to make a plan Follow up with patient Record goals Trained health care professional Behaviour change

  11. Implementation Stage 3 Endocrinologist Social Worker Stanford Workshop at practice Health Coach Other specialists Diabetes Educator Dietitian Physician Optometrist Foot nurse Physician

  12. Implementation- Health Care Organization Ministry of Health Health Authorities Family Physicians Federal Government Employers Provincial Programs Individuals undertaking tasks to live well with their chronic health conditions and includes having to deal with medical management, role management and emotional management of these conditions Media Community Groups Researchers Universities Professional Associations Non-Governmental Organizations Health Care Professionals From Self-Management Support: A Health Care Intervention, BC Ministry of Health

  13. Implementation- Community Supportive Care Team Employment Combatting food deserts Patient Safe recreational space Affordable fresh food Family Adequate housing Affordable community resources

  14. Survey Time

  15. Where are we at? >3 : “ I feel like the lone voice crying in the wilderness” 4-7: “We’re doing OK but I’m not sure about the rest of them” 8-10: “ Everyone in the organization thinks SMS is a good idea, but in practical terms, we can’t always put it into operation” 11-13: “ Our organization is doing everything it can to integrate SMS into routine care” 14-16: “ I think I’m in the wrong workshop”

  16. Planning Next Steps Where do you realistically want to be next spring, in terms of implementing SMS?

  17. Action Planning

  18. Practical tips about change • You can’t be too specific • You can’t start too small • Timing is important • Adaptability is key • Change needs to become as easy to do as not to do • Evaluation builds confidence

  19. Lessons from the Field: California Health Foundation Institutional change……lays the groundwork for other changes All aspects of the Chronic Care Model are necessary to improve Chronic Illness Care

  20. System Design and Patient Flow Think about team composition and workflow Clinical and administrative champions are needed at each site Doctors’ participation is essential

  21. Training On-site training, hands on experience and regular booster sessions Providers and patients need to build confidence

  22. Measurement Measurement and reporting are critical for the organization, the providers and the patients Organizations need to think about appropriate measures Feedback to providers is critical, to close the loop Keep action plans short term 6-8 weeks

  23. Celebrate Success

  24. Support is available Kate Nash: Training Facilitator lhcconnect@bruyere.org 613-562-6262 x 1622

  25. Resources and References Self-Management Support: A study and Implementation Guide, Fraser Health Authority 2008 Self-Management Support: A Healthcare Intervention, BC Ministry of Health, June 10th 2011 Promoting Effective Self-Management Approaches to Improve Chronic Disease Care: Lessons Learned California Healthcare Foundation, April 2008 Strategies to Support Self-Management in Chronic Conditions: Collaboration with Clients RNAO, September 2010

  26. Thank you

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