Self-Management. Empowering the Person Living with Diabetes

Transcription

1 Self-Management Empowering the Person Living with Diabetes Monica Lowe Menecola (July 2009) Osteoporosis Canada for the North Simcoe Muskoka LHIN March 31, 2010

2 Context of the Project Spring of Implementation of a Regional Structure for Patient Self-Management Programs Proposal to the LHIN by the Self-Management Work Group- for CDSM Program expansion and support. Brief Clinical Intervention and Motivational Interviewing training- no funding available to implement regional program structure- however, recognition of the importance of self-management Diabetes Strategy announcement and one of the first initiatives- the Diabetes Registry

3 Secondment- spring/summer 2009 As a social worker and as a caregiver what is selfmanagement? Self-Management is more than a program Embedding self-management into what we do as professionals working with people living with chronic conditions Focus Self-management and diabetes

4 Diabetes Registry

5 Understanding and Believing in Self-Management Person living with the chronic disease Professionals working with people living with chronic conditions

6 Self-Management is an individual s ability to manage the symptoms, treatment, physical and psychological consequences and lifestyle changes inherent in living with a chronic condition. Kate Lorig, author of Living a Healthy Life with Chronic Conditions.

7 Self-Management Support is the systematic provision of education and supportive interventions by health care staff to increase individuals skills and confidence in managing their health problems, including regular assessment of progress and problems, goal setting, and problem-solving support. Patrick McGowan

8 Work during this time Contacted professionals in the diabetes field- selfmanagement supports (successes and challenges in their work and how it impacts patient self-management) Inventory of stakeholders in the diabetes field Started to develop a regional, integrated approach to embedding self-management into chronic disease prevention and management (specifically diabetes) Made recommendations and suggested next steps

9 Stanford Based Self-Management Programs in the LHIN BCHC offers the Chronic Disease Self-Management Program developed by Stanford University (Living a Healthy Life with Chronic Conditions) (open to anyone) FHTs are moving forward with having Stanford trainers to run programs (patients must be part of the FHT) Disease specific self-management programs such as the Arthritis Self-Management Program offered recently in Collingwood

10 Professionals within the Diabetes Field random selection of stakeholders were contacted in North Simcoe Muskoka LHIN 43 different stakeholders were contacted- not all contacts responded back Family physicians, specialists and pharmacists were not contacted 8 groups were interviewed, 16 individual interviews were conducted and 5 programs outside the LHIN were contacted

11 Difference between Patient Education and Self- Management Support (Mike Hindmarsh) Patient Education Information and skills are taught Usually disease-specific Assumes that knowledge creates behaviour change Goal is compliance Health care professionals are the teachers Self-Management Support Skills to solve patient identified problems are taught Skills are generalized Assumes that confidence yields better outcomes Goal is increased self-efficacy Teachers can be professionals or peers

12 Findings as of July 2009 All were committed individuals and extremely passionate about their work in diabetes Current model of funding for DECs create an environment where staff are stretched. Want to do more but the funding does not enable this. Some felt helpless and anxious over funding and the future of diabetes centres. Many of the providers were interested in learning more about self-management supports and implementing them

13 Findings continued Some form of self-management interventions With DECs- funding model restrictions- self-management often provided as patient education programs, goal setting and referrals FHTs- less restrictions with funding - were able to spend more time with patients and able to provide other components of self-management All provided literature, tools and resources as effective ways to reinforce self-management

14 Infrastructure of Diabetes in LHIN Development of a Regional Diabetes Network in the NSM LHIN with a Diabetes Collaborative in each subplanning area (similar to the Staying Independent, Falls Prevention Coalition of Simcoe Muskoka and the Dementia Network) Communication strategy to internal and external stakeholders review Thames Valley and Durham Region Diabetes Network Models

15 Next Steps in approaching Self-Management in the LHIN Diabetes as an example Integrated approach throughout the continuum of care will enable a multi-point access to embedding selfmanagement Using different interventions (CDSM program, BCI and Motivational Interviewing etc.) to engage people at the stage they are at within their chronic disease journey

16 Self-Management Work Group re-connect and review Regional Approach to Self-Management (expand group to include champions and local resource people) Develop a strategic plan with annual operating plans/budgets Investigate other funding opportunities to fund this work Quickly training and education opportunities on Self- Management Supports for professionals (North West LHIN, Stroke Network, South West LHIN Health Professional Toolkit)