NCOA Webinar Presentation May 21, 2013 PRESENTERS › wp-content › ... · NCOA Webinar...
Transcript of NCOA Webinar Presentation May 21, 2013 PRESENTERS › wp-content › ... · NCOA Webinar...
NCOA Webinar Presentation May 21, 2013
PRESENTERS
Kim Crilly, RN, MS Coordinator, Chronic Disease Self Management Program
Holy Cross Hospital, Silver Spring, MD
Sarah McKechnie, MA, AHFS
Manager, Community Fitness
Holy Cross Hospital, Silver Spring, MD
Judy Simon, MS, RD, LDN
Nutrition and Health Promotion Programs Manager Maryland Department of Aging
Baltimore MD
Department of Aging
Introduction to partnership with Holy Cross Hospital
Establishing grant deliverables with a new partner
Holy Cross Hospital
Why organization decided to invest in CDSMP
Impetus behind developing toolkit
Integration of the Toolkit into Holy Cross' day-to-day operations
Key portions of Toolkit from a hospital perspective
Referral processes and hospital staff education regarding program
Integration with readmissions and discharge planning
Towson University
State Agencies
(DHMH, Medicaid)
Advisory Committee
MDoA
AAA’s & Hospital
Local
Partners
Implementation
Sites
Interview
Four
Hospitals
Create
and
Consult
FINAL
Version
#1: Deliver CDSMP and DSMP Workshops
3/2010 3/2012
#2: Create Hospital Toolkit
9/2010 – 3/2011
3/2011-1/2012
Presentations 3/2012
Maryland: Regional Grantee Meetings & Advisory Council
National Forums: NCOA Webinars
NCOA Health Aging Library
Dorland Health, “The Case Manager’s Guide to Readmissions.”
Tools and Tips to Enhance
Hospital and Community Partner Adoption of CDSMP
History of CDSMP at Holy Cross Hospital
2007 - Two Faith Community nurses and Community Health’s Manager of Community Fitness became certified master trainers.
2007 – 2009 : Held 6 workshops with 306 encounters.
2010 (last quarter) : Provided 7 workshops with 310 encounters.
2010-2012 : Held 28 workshops with 1,599 encounters.
April 2012 – present : Held 8 workshops (one in session) with 298 encounters for seven of the workshops.
Total number of workshops held: 49 with 2,513 encounters.
Why Holy Cross Hospital Invested in CDSMP
To uphold the hospital mission to provide service to vulnerable communities
To establish partnerships with other organizations with similar goals
To offer CDSMP as a resource to other hospital depts. including discharge planning, seniors emergency, diabetes education, health clinics, etc.
To be part of a national network dedicated to improving chronic disease management
Impetus Behind the Toolkit
MDoA requested the development of the toolkit as part of a two-year (2010-2012) statewide grant.
Toolkit assists hospitals and community partners in the adoption and implementation of CDSMP.
Toolkit helps foster a relationship between hospitals and community partners.
Toolkit strengthens health promotion and prevention networks in Maryland.
Toolkit encourages hospitals and community partners to work collaboratively to help people living with chronic conditions.
Primary Questions Regarding Adoption of CDSMP
Time –Phase 1: Hosting a workshop
–Phase 2: Adoption and Implementation of CDSMP
Money
Outcomes
Integration of CDSMP into Daily Operations at Holy Cross Hospital
Preventing Readmissions Program
Faith Community Nurse Program
Community Health and Community Fitness Departments
Seniors Emergency Department
Holy Cross Health Centers
Key Portions of Toolkit: A Hospital’s Perspective
Integration with Readmissions and Discharge Planning
–Navigation Web (page 14)
–Prescription Pad (Appendix J)
Community Partnerships (page 20)
Timeline, Budget and Outcomes
How People are Identified for Referral
Education of Hospital Staff Regarding CDSMP Availability
Regular emails with a flyer listing the upcoming workshops are sent to the following: –Faith Community Nurse Program –Seniors Emergency Department
–Holy Cross Health Centers –Preventing Readmissions Program –Community Health and Fitness Departments
Working with Hospitals
Choose to partner with hospital that shares a similar mission and goals as your agency.
Schedule an appointment with the hospital’s Education Department or Community Health Department.
Provide the hospital staff with the quick reference sheets (timeline, budget and outcomes).
Present your own outcome data.
Helpful Appendices
Timeline (Appendices C and D)
Budget (Appendix E)
Outcomes (Appendices A and B)
Prescription Pad (Appendix J)
Recruitment Phone Script (Appendix M)
Timeline: Phase 1
Timeline: Phase 2
CDSMP Budget Worksheet
Personnel Part-time coordinator 0.5 FTE
$
$
$
Lay Leader 1 $ $ $
Lay Leader 2 $ $ $
Supplies/Equipment $ $ $
$ $ $
$ $ $
$ $ $
Travel $ $ $
Advertising $ $ $
Miscellaneous
$ $ $
Total Per participant: Per workshop: Per year:
Outcomes
Chronic Disease Self-Management Program (CDSMP)
Overview
Background
Developed at the Stanford University Patient Education Research Center as a collaborative research study between Stanford and the Northern California Kaiser Permanente Medical Center
Results of the five-year study showed that people who took the program, as opposed to people who did not take the program, improved their healthful behaviors and decreased their days in the hospital
The program is a six-week program, 2.5 hours per week
Healthful Behaviors Addressed by the CDSMP Exercise Nutrition Cognitive symptom management Coping skills Communication with physicians Stress management/relaxation
Outcomes
Why Adopt CDSMP?
This one page sheet was designed with the specific needs of hospitals in mind. It is a quick and effective way to provide an overview of the original Stanford study along with outcomes. (Results of follow-up studies are included in the appendix of this toolkit for further reference.) The Division of Family and Community Medicine in the School of Medicine at Stanford University received a five-year research grant from the Federal Agency for Health Care Research and Quality and the State of California Tobacco-Related Diseases office. Study was completed in 1996.
The purpose of the research was to develop and evaluate a community-based self-management program that assists people with chronic illness.
It was a randomized controlled trial.
Over 1,000 participants with heart disease, lung disease, stroke or arthritis participated in the study and were followed for up to three years.
Prescription Pad
Chronic Disease Prevention and Management Classes Patient/Participant name: ________________________________________________________
Diagnosis or at-risk for: __________________________________________________________
Holy Cross Hospital’s Community Health Department offers a variety of classes to help you prevent or manage chronic disease. For more
information on these classes including schedules, locations and fees, please call 301-754-8800 or visit www.holycrosshealth.org.
Please check the box for class referral(s).
Recruitment Phone Script
Phone Script for Calling Living Well Candidates
Candidate’s Name: _________________________ Date: ________________
Hello, my name is ___________________________. I’m calling from Holy Cross Hospital.
May I speak with Mr. /Ms. ____________________?
The reason for my call is that you have been identified by the hospital as a good candidate for a free six
program we offer called Living Well. The program helps participants manage their chronic disease(s).
Some examples of a chronic disease are heart disease, cancer, high blood pressure, diabetes, and
arthritis. There are other chronic diseases as well. The goals of the workshop are to improve health
behaviors and prevent hospital readmissions.
Questions? • Toolkit URL: www.ncoa.org/improve-health/center.../Hospital-Toolkit-MD-
2012.pdf
• Contact Information: – Judy Simon, MS, RD, LDN
• Nutrition and Health Promotion Programs Manager, MDoA
– Sarah McKechnie, MA, AHFS
• Manager, Community Fitness
– Kim Crilly, RN, MS
• Coordinator, Chronic Disease Self-Management Program
Thank You!