Self Management Learning Session 2

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Self Management Learning Session 2

• Co-facilitatorsDr. Frank Egan Esther Stevens
  MA, RD

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Real Agenda

• Why our plan crashed and burned
• How can we change it to make it useful for us
• Practice huddle to create Plan 2
• Relating this to supporting our patients
• Examples by Drs. Egan and Rollnick
• Personal application of Action Plans

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Ongoing Support
Getting Started
Sep 13
Prework
Ongoing
AP1
Aug 16
AP2
Oct 11
AP3
Jul 19
Month 0
Month 9-12
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SM Learning Objectives see flip chart

• Reflect on our own self management strategies and
  challenges 1 hour
• Develop an action plan to practice new skills in
  real time 1 hour
• Learn and practice patient empowerment, education
  and support skills 20-30 min

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Guiding Questions

• challenges you experienced?
• overcome barriers/challenges?
• Successes how did you know?

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Franks videos of 3 Qtns
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Another technical advantage?

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Summary of learning
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How we perceive change
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Learning and change
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PDSA Cycles (From Institute for Health
Improvement)
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Compare to Stages of Change
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CREATING CHANGE
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Parts of an Action Plan

• Something YOU want to do
• Reasonable
• Behaviour-specific
• Answers the questions
• What to change (activity)?
• How much?
• What time?
• How often?
• Confidence level of 7 or more

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1. Quality Culture is

• Non judgmental
• Patient/customer driven
• Data driven
• Evidence and experience driven
• Process driven any underlying problems are
  systems- and work-process related and not the
  fault of an individual
• Based on learning in small steps through planned
  experimentation

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2. In a Quality Culture

• Everyone learns everyone teaches.
• There are no experts. Everyone has expertise.
  Expertise must be shared for the best outcomes.
• Failures are just as important as successes.
  Celebrate the learning that results from
  failures.
• Success is Celebrated as a team.
• When in doubt always refer back to Understanding
  Quality Improvement.

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Self efficacy the key to positive behaviour
change

• Is my health behaviour worth changing
• How much will I benefit from the changed
  behaviour
• How difficult will it be for me to maintain the
  change
• How likely am I to relapse and if I do, what will
  happen
• Adapted From Patrick McGowan

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Ideas to involve our MOAs
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Possible MOA role

• determine the patients current level of physical
  activity, dietary consumption, or medication
  compliance
• help the patient set realistic self-management
  goals
• assist the patient in problem-solving barriers to
  goal accomplishment
• provide phone follow-up with patients, asking
  them about goal accomplishment and giving
  positive reinforcement or helping the patient
  revise the goal.

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Expanding the role of the MOA

• Barriers and challenges?
• Opportunities?
• Back to the practice Action Plan

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Planning for improvement

• What are we trying to accomplish? (specific,
  measurable, time-frame)
• How will we know a change is an improvement?
  (need definitions shared understanding and
  data)
• What change can we make that will result in an
  improvement?
• Understanding Quality Improvement
• http//www.impactbc.ca/pdfs/understand_qi.pdf

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Practice Action Plan

• Something YOU want to do
• Reasonable
• Behaviour-specific
• Answers the questions
• What to change (activity)?
• How much?
• What time?
• How often?
• Confidence level of 7 or more

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New ways to work
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Break AND PLANNING 1 hour
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A Menu of models

• The 3 questions approach
• Action Plan (Kate Lorig Model)
• Strength-based counselling strategies
• BCCFP Self management program
• The 5 As
• Stages of change
• Motivational interviewing
• Health literacy sensitivity/knowledge

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Back to Frank..
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Personal Action Plans 10 min

• Groups of 2
• Practice filling out parts of an Action Plan
  with each other 5 min each.
• Help each other design action plans that are
  acheivable and measurable.

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Optional Activities

• DVD discussion
• Tracking Frank
• ?

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4 Key words for our shift in approach

• Humility
• Graciousness
• Hope
• Partnership

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Action Period

• Next Learning Session is September 13, same time
  and place.

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Tools and Resources

• Rollnick S, Mason P, Butler C, Health Behavior
  ChangeA Guide For Practitioners, Churchill
  Livingstone Press, 1999
• Connie Sixta Manual BC College of FP from
  http//www.impactbc.ca/pdfs/bccfp_studymanual.doc
  
• Prochaska, James O. Norcross, John C. (2001)
  Stages of Change.
• www.practicesupport.bc.ca

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CME Info

• MAINPRO- M1 Verbal confirmation, Liza Kalstrom,
  3.5 credits per LS
• C level accreditation still pending

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Payment for session
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Patient Self Management LS Billing
Action Periods x 3
Potential Total 3,586.65
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Please hand in

• Name tags so we can redistribute them next
  session
• Evaluations - we need and appreciate your input