ORIENTATION SESSION - PowerPoint PPT Presentation

Strengthening Chronic Disease

Prevention & Management

Why the Tool is being introduced

How it may be helpful to your group/committee

Goals of the meeting

Regional Context

How and Why the Tool was Developed

What the Tool Looks Like

Basic Concepts

Critical Success Factors for Strengthening Chronic Disease Prevention & Management

How the Tool Might Be Used

Add in appropriate info for your region:

Regional strategies or goals for preventing chronic disease, risk factors and underlying determinants

Framework or model guiding regional chronic disease prevention and/or management efforts

Relevant stats or targets

Eg. reducing number of new cases of type 2 diabetes by x %

Eg. increasing % of population eating recommended daily fruits and vegetables

Eg. increasing access to diabetes education and self-management program for high risk population group(s)

HOW AND WHY THE TOOL WAS DEVELOPED

The importance of reorienting health services towards health promotion, disease prevention, community-based care and chronic disease management has been repeated in every major health report and consultation in the past 10 years, including the Health Council of Canada’s 2006 annual report*

*Health Council of Canada. 2006 Annual Report “Health Care Renewal in Canada: Clearing

the Road to Quality.” Available online at: http://www.healthcouncilcanada.ca

Moving toward Integrated System for Chronic Disease Prevention and Management

Addressing common risk factors

Individual and population health approaches

Intersectoral policy, building environments that support health

Reducing inequities

Improving system integration (policy, planning and program delivery levels)

Changing environment

Wide range of disease-specific, risk factor-specific and age-specific strategies

Efforts are underway to better align and better coordinate strategies and services along the full continuum

to improve health outcomes

to sustain health system

“What are the critical success factors for integration of chronic disease prevention and management?”

The Tool was developed through:

Extensive multi-disciplinary research

Peer-reviewed, indexed journal articles

Grey literature (websites)

Key Informants

Focus Groups

Four pilots

Limitations in:

Infrastructure and capacity for both areas

Interface: integration, coordination, communication

Opportunities through renewal efforts in primary health care towards

Disease prevention

Health promotion

Chronic disease management

A collaborative planning and assessment tool

Eight Critical Success Factors

Guiding Questions for each

THE TOOL

Engage planners and policy-makers in dialogue

Promote information exchange

Assess current policy, planning and practice

Identify actions, roles and shared responsibilities for strengthening prevention and management of chronic disease

Policy-makers and planners

With shared responsibility for preventing and/or managing chronic disease

Working in:

public health

primary care

home care and acute care

non-governmental

non-health sectors

NOT an accreditation-style tool

NOT a prescriptive tool detailing what should be in place

IS a resource to stimulate thinking about what better or promising practices “MIGHT” look like

WHAT DOES IT LOOK LIKE?

Assessment tool, including worksheets and rating scales

How-To Guide

Case Studies

Purpose and Use of the Tool

Ideas about who could use it

Basic Concepts

Intro to Critical Success Factors

Worksheets with Guiding Questions

CDPM Framework

Building prevention into the health system

Integration of CDPM

Collaborative Action

Capacity-building

COMMUNITY

Build Healthy Public Policy

HEALTH SYSTEM

Self Management/ Develop Personal Skills

Information Systems

Create Supportive Environment

Delivery System Design/ Re-orient Health Services

Decision Support

Strengthen Community Action

Informed Activated Patient/ Family

Prepared Proactive Community Partners

Prepared Proactive Practice Team

Activated Community

Productive Interactions & Relationships

Functional & Clinical Outcomes

Population Health

Determinants of Health

TertiaryPrevention

Prevent progression

to complications and/or

hospitalizations

Prevent movement

to at-risk group

Prevent progression

To established disease

Better aligning strategies, vision and goals

Linking individual & population-level approaches

Shared planning to coordinate efforts and/or resources

Mechanisms to support information-sharing, communication and coordination

Service-level integration to improve comprehensiveness, continuity of care

Shared responsibility for CDPM

Range of stakeholders

Building system capacity for CDPM requires collaborative action

Organizational development

Workforce development

Resource allocation

Leadership

Partnership development

Reference: A Framework for Building Capacity to Improve Health, NSW Health, 2001.

CRITICAL SUCCESS FACTORS

Common Values and Shared Goals

Focus on Determinants of Health

Public Health Capacity and Infrastructure

Primary Care Capacity and Infrastructure

Community Capacity and Infrastructure

Integration of Chronic Disease Prevention and Management

Monitoring, Evaluation and Learning

Leadership, Partnership and Investment

Common Values and Goals

Public Health Capacity/ Infrastructure

Evaluation

Monitoring

Clinical-based Prevention

(Primary Care)

Population-based

Prevention

(Public Health)

Integration

Community Capacity/ Infrastructure

Chronic Disease Management

(1°, 2°, 3° care)

Primary Care Capacity/ Infrastructure

Focus on Determinants of Health

Leadership,

Partnership and Investment

Learning

Cues to help assess current capacity in the Critical Success Factors

Where are we now in our practice?

What opportunities are there to build capacity/improve practice?

The assessment questions are also presented in worksheet format. The questions include a rating scale that outlines a possible range of practice for this component of the Critical Success Factor

 Additional resources and a more complete description of each Factor is also provided in these sections of the Tool.

HOW MIGHT THE TOOL BE USED?

No one right way to use the Tool

Keep it manageable, e.g.

Do an assessment of all eight critical success factors, but focus in on a particular risk factor, e.g. obesity

Choose a few critical success factors to focus on

Focus on a setting, e.g. workplace and choose the appropriate factors

The Tool is meant to initiate and guide a process of engagement – it is neither a one-time event, nor an end it itself. To assist in this process, a series of how-to supports have been developed.

Includes case studies