Transcript Making Every Contact Count and Optimising Outcomes

Making Every Contact
Count
(MECC)
and
Optimising Outcomes
Dr Siân Griffiths
Consultant in Public Health Medicine
Lifestyle and disease
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Lifestyle behaviour plays an important role in
people's health.
Smoking, excessive drinking, poor diet, lack of
exercise and immunisation are major
preventable causes of ill health and death.
Increase the risk of Heart disease, Stroke,
Dementia (vascular), Cancers, Type 2 diabetes,
and many more diseases.
Small changes to lifestyle will improve health.
Immunisation important for health - the most
effective way to prevent infectious disease.
All 5 are priorities of local partners.
Lifestyle behaviours in Cardiff
and Vale
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21% of adults smoke
46% of adults drink alcohol over recommended
levels
73% of adults do not meet recommended
guidelines for physical activity
66% of adults do not eat 5 portions of fruit &
vegetables per day
Only 6% of adults have all 4 healthy
behaviours
Welsh Health Survey 2010+2011
People in deprived areas have
shorter lives and are in poorer
health for longer
In Cardiff and the Vale:
• Men in deprived areas live almost 12 years less
than men in more affluent areas (10 years less
for women)
• Men in deprived areas spend an extra 23 years of
their lives in poor health compared to men in
more affluent areas (21 years for women)
Wider determinants of health
Lifestyle choices are not the only factors
that influence health.
• Social and economic conditions affect
health e.g. Income, education,
employment, housing....
• MECC is one of a number of interventions
to address the determinants of health and
is one we can all do something about.
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What is MECC?
•Systematically
promoting the benefits of healthy
living
• Asking individuals about their lifestyle and
changes they may wish to make
• Responding appropriately to the lifestyle issue/s
once raised
• Taking the appropriate action to either give
information, signpost or refer service users to the
support they need.
What MECC is not
It is not about…
• adding another job to an already busy
working day
• becoming a specialist in a certain lifestyle
area
• becoming a counsellor or providing
ongoing support
• telling somebody what to do and how to
live their life
An example of MECC Impact
In Cardiff & Vale University Health Board
• 14,500 staff (approximately)
• Millions of patient contacts a year
• If staff MECC with just ten people
Less than one hour a year for each staff member
= 140, 000 opportunities to influence behaviour
change.
MECC topics
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Smoking
Alcohol
Food
Physical activity
Immunisations
Progress to date
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Pilot completed
 Training package
 Key messages
Training now to be offered more
widely (training the trainer)
Embedding
National links
Optimising Outcomes
Policy Statements
(OOPS)
Background
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Optimising Outcome Policy Statement
proposed by the University Health Board
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Aim – to reduce post operative complications
by offering smoking cessation and weight
management support.
Why?
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Stopping smoking eight weeks before elective
surgery leads to improved recovery and
outcomes
 Reduced complications
 Quicker wound healing
 Shorter hospital stay
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People who are obese have poorer outcomes
 More wound infections
 Higher rate of thrombosis
 Respiratory problems
Optimising Outcomes Policy
Statement(s)
These statements must be applied in the context of a patient’s
individual clinical need which is ultimately to be determined
by the clinician responsible for the patient’s care.
Policy Statement - Smoking
Anyone to be listed for an elective intervention who is
recorded as a smoker must have been offered, accepted
and completed smoking cessation support prior to their
listing
Policy Statement - Weight management
Anyone to be listed for an elective intervention who has
recorded a BMI of 40 or above must have been offered,
accepted and completed weight management support prior
to their listing.
Exclusions
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Patients requiring emergency surgery
Patients receiving surgery for the treatment of
cancer
Patients referred for bariatric surgery (weight
management exclusion only)
Patients who have a BMI of 40 and above with
specific endocrine conditions which make them
medically unsuitable for this pathway (weight
management exclusion only)
People who smoke and have BMI of 40 or above will
need to complete both pathways
How can this be done best?
Contact details
Dr Sian Griffiths
Tel: 02920 336201
E-mail: [email protected]