Transcript HealthChange® Methodology

HealthChange® Core Training for Managers
Implementing HealthChange® Methodology
in Clinical Practice and Programs
Presented by HealthChange Australia
Janette Gale, MD, Health Psychologist
www.healthchange.com
© 2014 HealthChange Australia
Slide 1
Workshop content
Review the nature and purpose of
HealthChange® Methodology from an
organisational perspective
Key HealthChange® tools and documents
to be integrated into existing systems
Program implementation considerations
and challenges
Discussion forum
© 2014 HealthChange Australia
Slide 2
Who is here today?
What do you want from this
workshop and forum?
© 2014 HealthChange Australia
Slide 3
Topic 1:
The nature and purpose of
HealthChange® Methodology
for health services
HealthChange® Methodology and workshops have
undergone significant changes since the start of the
NSW Connecting Care in the community CDMP
© 2014 HealthChange Australia
Slide 4
If we do what we always did then only 1 in 2 people can be expected to take
action to achieve better health and quality of life outcomes!
66%
Patients with hypertension who have poor BP
control due to non-adherence
50%
Patients who act on GP referrals to other
practitioners and services
50%
Overall adherence to chronic conditions treatment
25%
Maintenance of new exercise behaviours after
rehabilitation in the general population, and
following cardiac rehabilitation
50%
50%
Acute care presentations that receive best practice
care
(WHO 2003; GP clinic audit; Dishman 1988; Oldridge 1991)
© 2014 HealthChange Australia
Slide 5
Client Reflections
Video - Geoff
• Back injury (medical discharge from Navy)
• Chronic pain
• PTSD, depression & other psychosocial
• Diabetes type 2
• Prostate cancer previously
• High cholesterol
• Weight management issues
• Resistance from previous experiences
© 2014 HealthChange Australia
Slide 6
What is ‘Best Practice’
• Evidence-based clinical assessment, diagnosis and
treatment recommendations
• Patient-centred care:
• Respectful and responsive to patient preferences, needs
and values*
• Incl. client engagement in decision making, health care
team approach, behaviour change support, consideration of
patient beliefs, cognitions, social and cultural contexts **
• Includes promotion of health literacy and self-management
But, is Best Practice happening in Usual Practice?
* Patient centred care, Aust Commission on Safety and quality in Healthcare 2011 ** Bauman et al. 2003
© 2014 HealthChange Australia
Slide 7
HealthChange® Methodology
A health service practice methodology
used to deliver patient-centred care,
promote health literacy and support
adherence to evidence-based
recommendations for improved
patient outcomes
See healthchange.com to view short videos
on HealthChange® Methodology
© 2014 HealthChange Australia
Slide 8
HealthChange® Methodology:
Within organisations
Provides a systematic, practical and evidence-informed
methodology for delivering health services in a time-efficient,
clinically effective and measureable manner
Creates a common language, consistent approach and
consistency of treatment advice across clinicians and across
agencies and services
Actively promotes evidence-based best practice and integrated
care
Requires micro-systems and documentation adaptation
© 2014 HealthChange Australia
Slide 9
HealthChange® Methodology:
Within client interactions
Integrates client-centred information exchange and behaviour
change support into consultations to promote patient and carer
engagement and adherence to treatment recommendations
Uses a clinical practice decision framework to guide frontline
staff in conducting their consultations effectively and efficiently
Promotes patient health literacy, motivation and confidence and
documents agreed patient actions
Requires practice change (it is not an ‘add on’ process or tool)
© 2014 HealthChange Australia
Slide 10
HCM is founded on three evidence-based sets of
processes required to facilitate behaviour change:
1. Person-centred, non-judgemental therapeutic
approach that respects client autonomy
2. Processes required to form a behavioural goal
intention
(health literacy, motivation, importance, priorities)
3. Processes required to convert that goal intention
into action and maintenance
(planning, barriers, enablers, confidence)
From: Gale & Skouteris (2013)
© 2014 HealthChange Australia
Slide 11
HealthChange® integrated suite of tools to improve clinician and
client adherence to evidence-based treatment recommendations
PSMP
Decision
Framework
Essential Behaviour
Change Techniques
BEST Barriers & Facilitators
Behaviours
Emotions
Situations
Thinking
Client-Centred Practice Principles
Behaviour Change Pathway – Client Needs
© 2014 HealthChange Australia
Slide 12
For clinicians, HealthChange® Methodology is
like an ice cream cone!
© 2014 HealthChange Australia
Slide 13
Australian and overseas programs and services
Primary Care
•
•
Prevention
•
•
•
GP & Allied Health consultations
ACT Health/Medicare Local/Heart Foundation
HeartLink Program
NSW Get Healthy
NSW Live Life Well Diabetes Prevention
VIC WorkSafe WorkHealth Coach
Program
Clinical Research
•
•
•
•
Chronic Condition Management
•
•
•
•
•
•
•
•
•
•
NSW CDM Connecting Care
Home & Community Care (HACC)
VIC Early Intervention (EICD)
VIC HARP programs
Heart failure & Cardiac rehab
Diabetes, HIV, Disability, Aged Care
Mental health
QLD Health Call Centre Cardiac Triage
QLD Disease Management Services
TAS Diabetes services
Deakin University – HIPP/Healthy Pregnancy Study
Melbourne University – Knee Osteoarthritis, Diabetic Retinopathy, physiotherapy clinical practice
Wollongong University – Practice Nurse Care Planning Pilot
Monash University – Positive Ageing with HIV
Ottawa Regional
Cancer Foundation
•
Survivorship support
coaching
Alberta Health Services
•
Chronic Disease
Management Services
© 2014 HealthChange Australia
Denmark - Copenhagen
•
Metropolitan University College
Slide 14
Typical results using HealthChange® Methodology
Fewer ‘fail to show’ clients
Diabetes prevention group program: retention at week 5 80% v. 36%
Exercise physiologist group program: wait list reduced to zero, higher
participation rates
Diabetes risk reduction program: 18 of 1st 400 recruited elected not to attend
group education
Community-based healthy lifestyle programs: improved clinical outcomes,
decreased negative affect
Osteoarthritis chronic care service (OACCP) tracked the changes in outcomes
pre and post implementation of HealthChange® Methodology:
• Jan-Mar 2011: 51% of patients had surgery deferred due to poor selfmanagement after being on waitlist for 12 months
• Jan-Mar 2012: 34% of patients were deferred. Cardiac-related deferrals
alone declined from 29% to 10%
© 2014 HealthChange Australia
Slide 15
E-mail received from Alberta Health Services HealthChange® Trainer:
RN in chronic disease services
“as a result of [learning HealthChange Methodology] I am now a much more
efficient and effective practitioner. It has also greatly influenced my personal
life and I have seen tremendous growth in my family’s and my own health.
I am so appreciative of the opportunities HealthChange [Methodology] has
offered and even more appreciative of the impact this can and will have on
our health system.
I have seen with my own eyes, patients that we never thought could or would
change, start changing.
And I have seen practitioners embrace the model and redefine how we do
our work and as a result they are seeing success daily. It is stunning to see
these changes and be a part of it!”
© 2014 HealthChange Australia
Slide 16
The Big Challenges!
HealthChange Methodology requires:
• Top down direction
• Staff engagement and attitude
change
• Bottom up practice change
• Microsystems change
• Quality control / Accountability
© 2014 HealthChange Australia
Slide 17
Topic 2: Key HealthChange® tools and
documents to be integrated into existing
systems for successful implementation
© 2014 HealthChange Australia
Slide 18
HealthChange® Behaviour Change Pathway
(What patients need in order to take action)
Knowledge & Understanding
Motivation & Expectations
Decision & Commitment
Decision Line
Macro view
Ready to take action
Micro view
Planning
Action
Self-regulation
Build Importance
© 2014 HealthChange Australia
Build Confidence
See healthchange.com
to view video
Slide 19
What clinicians need to ask themselves to be able to help patients
Does the patient know and understand their health issues and clinical
targets and the broad lifestyle and treatment categories applicable to these?
Have they been assisted to collaboratively prioritise these categories?
Are they ready, willing, able and committed to taking action?
Decision Line
Macro view
Ready to take action
Micro view
What options do they have for taking action in particular categories?
What are their personalised goals/plans for achieving category goals?
Are they confident they can do these things? What might stop them?
Will I review the patient? What other support might they need?
Build Importance
© 2014 HealthChange Australia
Build
Confidence
Build
Confidence
Slide 20
Four Aspects of Goal
Setting required for
health interventions

Clinical
Targets
(Physiological)

Motivational
Drivers

Referral,
Lifestyle &
Treatment
Categories
© 2014 HealthChange Australia

Specific
Personalised
Health Goals
Slide 21
Patient experience of micro advice from multiple sources
Manage Chronic
Health Condition/s
Hospital-based
Procedure
Receive home
nursing visits
Have pathology
and other tests as
required
Visit General
Practitioner
Recognise and
act on signs of
Speak with Care
improvement
Coordinator
Recognise and
act on signs of
Know and
deterioration
Other...
understand own
medications
Use accurate
dose and timing
Identify and
manage triggers
Manage alcohol
consumption
Do specific
rehabilitation
activities
Manage nutrition
and eating
Avoid infections
and illnesses
Visit medical
Recognise and
specialist/s
act on side effects
Use bracing,
supports and aids
Monitor and
effectively
manage pain
Take care of
Know and use
equipment
emergency action
plan/s
Manage wounds
and dressings
effectively
Use nutritional
supplements
effectively
Seek a
medications
review
© 2014 HealthChange Australia
Manage weight
Other...
and waist
Manage physical circumference
Address
activity
recreational drug
use
See Diabetes
Manage stress
Educator
and mood
Manage fatigue
effectively
and energy
Engage social
support
Go to physio clinic
Reduce or quit
smoking
Monitor and
Receive Social
manage other
Services
symptoms
Attend education
Arrange transport
or assistance
and other access
program/s
to services
Slide 22
HealthChange® generic menu of options for
health conditions – to support health literacy
Manage Health
Condition/s
Manage
Medications
Effectively
Engage in Specific
Treatment
Activities
Monitor and Act
on Symptoms
Attend Services
and Appointments
Manage Triggers
and Risk Factors
Manage Healthy
Lifestyle Factors
Grouping patient tasks into overarching behavioural
categories rather than specific diseases and clinical areas
in order to create a patient action plan
© 2014 HealthChange Australia
Slide 23
HealthChange®
Menu of Options
Manage
Medications
Effectively
Manage Health
Condition/s
Engage in Specific
Treatment
Activities
Monitor and Act
on Symptoms
Attend Services
and
Appointments
Manage Triggers
and Risk Factors
Manage Healthy
Lifestyle Factors
Know and
understand own
medications
Do specific
rehabilitation
activities
Know and use
emergency action
plan/s
Have pathology
and other tests as
required
Identify and
manage triggers
Manage nutrition
and eating
Use accurate
dose and timing
Avoid infections
and illnesses
Recognise and
act on signs of
improvement
Visit General
Practitioner
Manage alcohol
consumption
Manage physical
activity
Recognise and
act on side effects
Manage wounds
and dressings
effectively
Recognise and
act on signs of
deterioration
Visit medical
specialist/s
Address
recreational drug
use
Manage stress
and mood
effectively
Take care of
equipment
Use bracing,
supports and aids
effectively
Monitor and
manage pain
Attend education
or assistance
program/s
Reduce or quit
smoking
Manage fatigue
and energy
Seek a
medications
review
Use nutritional
supplements
effectively
Monitor and
manage other
symptoms
Arrange transport
and other access
to services
Manage weight
and waist
circumference
Engage social
support
Other...
Other...
Other...
Other...
Other...
Other...
©2014 HealthChange Australia
www.healthchange.com
How do the four aspects of goal setting relate to
the HealthChange® behaviour change pathway?

Clinical
Targets

2
Decision
Line

Motivational
Drivers
Lifestyle
Referral,&
Treatment
Lifestyle
&
Categories
Treatment
Categories
Macro view

Micro view
Specific
Personalised
Health Goals
© 2014 HealthChange Australia
Slide 25
What clinicians need to ask themselves above the decision line
to facilitate patient action and adherence to recommendations
Does the patient know and understand their health issues and clinical
targets and the broad lifestyle and treatment categories applicable to these?
Have they been assisted to collaboratively prioritise these categories?
Are they ready, willing, able and committed to taking action?
Decision Line
Macro view
Ready to take action
Micro view
Build Importance
© 2014 HealthChange Australia
Slide 26
Step 1: Identify & discuss clinical issues and broad
lifestyle & treatment categories
1a) Identify/assess and discuss clinical issues:
– Gather clinical data and/or conduct clinical assessment
– What are the clinical issues? Summarise the issues for the
patient and check their knowledge and understanding
– Why are these clinical issues a problem for the patient?
First ask, then offer!
© 2014 HealthChange Australia
Slide 27
Step 1: Identify & discuss clinical issues & broad
lifestyle & treatment categories
1b) Identify/assess and discuss referral, lifestyle and
treatment categories:
– What does someone with these clinical issues need
to do over time to get the best results?
– Summarise the recommendations for the patient
and check their knowledge and understanding
– Why would taking action on these recommendations
be beneficial?
– What are they already doing?
First ask, then offer!
© 2014 HealthChange Australia
Slide 28
Do the first step right and the rest will follow!
© 2014 HealthChange Australia
Slide 29
Step 2: Prioritise and choose categories to work on in
this consultation
•
•
•
•
•
Prevent the client from becoming overwhelmed
Prioritise broad lifestyle and treatment categories
Balance duty of care with client fully-informed choice
Clarify what the client is already doing to manage their health
Set the agenda for the current consultation
Messy Head Syndrome
© 2014 HealthChange Australia
Relief
Slide 30
Step 3: Check RICk
Readiness, Importance, Confidence, knowledge
Use your RICk radar (intuition), but when in doubt, ask the client:
• How important is it to you personally to work on this issue
(given all the other priorities currently in your life)?
• How confident are you that you will make some
manageable and sustainable behaviour changes in relation
to this issue?
© 2014 HealthChange Australia
Slide 31
Step 4: Make a decision
Client’s decision:
a) ‘yes’
b) ‘no’
c)
‘maybe’
Clinician’s decision:
a) Client 'yes'
b) Client 'no'
c) Client ‘maybe’
© 2014 HealthChange Australia
Proceed below the decision line
Revisit Step 2 or invite them to opt out
Check if the client needs more
information to make a decision
[you could also use RICk-focused
decisional balance]
Slide 32
Beware the Motivation Trap!
Motivation to
reduce pain
lose weight
retain independence
etc.
© 2014 HealthChange Australia
≠
Motivation to engage in
actions or tasks
required to reduce pain,
lose weight, retain
independence etc.
Slide 33
Client case demonstration
Video – Darren low back pain
Promoting health literacy and prioritising long
and short-term areas for patient action
© 2014 HealthChange Australia
Slide 34
What clinicians need to ask themselves below the decision line to
facilitate patient action and adherence to recommendations
Decision Line
Macro view
Ready to take action
Micro view
What options do they have for taking action in particular categories?
What are their personalised goals/plans for achieving category goals?
Are they confident they can do these things? What might stop them?
Will I review the patient? What other support might they need?
Build Confidence
© 2014 HealthChange Australia
Slide 35
Client case demonstration
Video – Darren low back pain
Identifying and addressing potential barriers
and documenting patient self-management
information and intended actions
© 2014 HealthChange Australia
Slide 36
HealthChange®
Patient’s Plan to
complement
Care Plans and
Treatment Plans

Clinical
Targets
(Physiological)

Motivational
Drivers

Referral,
Lifestyle &
Treatment
Categories
© 2014 HealthChange Australia

Specific
Personalised
Health Goals
Slide 37
HealthChange® Personal Self-Management Plan
The Patient’s or Client’s Personal Plan
Referral, Treatment,
Lifestyle
Recommendations
Priority
Patient’s
Decision
Action Time
Frame
Patient’s
Agreed Actions
Comments
Agree
Disagree
Unsure
NA
Agree
Disagree
Unsure
NA
Agree
Disagree
Unsure
NA
Agree
Disagree
Unsure
NA
Step 1b
Step 2
© 2014 HealthChange Australia
Steps 3 - 4
Steps 5-10
Slide 38
Using the HealthChange® Personal Self-Management
Plan to document long-term recommendations, client
priorities and agreed short-term actions
• I have a form here that we can use to write down the broad
areas that you can take action in to get better results for
yourself, and then together we can prioritise them in a way
that suits you, your body and your situation.
• You can take a copy of the form as a reminder and I can keep a
copy for my records and to share with your (other team
member/s). Is that okay with you?
© 2014 HealthChange Australia
Slide 39
Using care plans to inform behaviour change
Client problems, needs &
relevant conditions
Clinical goals
Required
treatment &
services
Provider for
treatment & services
Type 2 Diabetes
HbA1c < 7%
3 monthly checks
Diabetes Education
Exercise Program
Foot care
Physician/Nurse
D. Educator/Dietitian
Ex. Physiologist
Podiatrist
Hypercholesterolaemia
TC: < 4mmol/L
LDL < 2.5mmol/L
HDL> 1.0mmol/L
TG < 2.0 mmol/L
Cholesterol meds
10mg
Low saturated fat
diet
Physician/Nurse
Dietitian
Obesity
BMI < 25
Maintain a healthy
diet
Physician/Nurse
Dietitian
Back pain
Reduce pain &
improve mobility
Physiotherapy
Bone density scan
Physiotherapist
Nuclear imaging
© 2014 HealthChange Australia
Slide 40
Personal Self-Management Plan: Managing Osteoarthritis
Referral, Treatment,
Lifestyle
Recommendations
1. Medications
Priority
-
Client’s
Decision
Action
Time
Frame
Comments
Good
understanding of
medications
Agree
Taking
action
Continue current
regime
4 weeks
then
review
Strength exercises
Minimum required
3 x per week
to have an effect
minimum
2. Specific
exercises
1
Agree
3. General activity
2
Not yet 4 weeks
Revisit in
4. Pain management
1
Agree
5. Weight
management
3
Unsure
© 2014 HealthChange Australia
Client’s Agreed
Actions
Get pain under
control first
Plan and pace
Ongoing
Discussed pain and
activity, more rests
from now
how to manage it
in the day
See how pain and
activity goes
Slide 41
Personal Self-Management Plan: Case management
Referral & Treatment
Recommendations
1. Medications
(see Physician)
Priority
2
Client’s
Decision
Agree
2. Rehabilitation
exercises
(already provided)
2
Unsure
3. Wound care
1
Agree
4. Dietary changes
(see Dietitian)
3
Not yet
5. Tests (bone density
scan & bloods)
4
NA
6. Home assessment
(see OT)
2
© 2014 HealthChange Australia
Agree
Action Time
Frame
1 Week
Client’s Agreed
Actions
Call to make
appointment by
Friday
Comments
Discuss
medications
Discuss next
appointment
2 weeks
Elevate leg for 20 Link to TV
min 3 x per day
programs
Revisit in 2
weeks
Conducted
recently
Within 3
weeks
Call service if not
contacted
Referral made.
Ask daughter to
be there
Slide 42
How HealthChange® Methodology saves time
1. Clean, targeted assessment
2. Targeted and individualised education
3. Targeted questions
4. Quickly identifying and addressing barriers to adherence to
referral, treatment and lifestyle recommendations
Quickly builds
rapport and trust
Avoids discussing things that other
clinicians have already covered
Avoids irrelevant and nonproductive conversations
Avoids discussing things the
client does not want to do
Avoids discussing things
the client is already doing
Keeps the conversation
focused & on track
© 2014 HealthChange Australia
Slide 43
Topic 3:
Program implementation
considerations and challenges
HealthChange® Methodology requires:
•
•
•
•
•
Top down direction
Staff engagement and attitude change
Bottom up practice change
Microsystems change
Quality control / Accountability
© 2014 HealthChange Australia
Slide 44
Reasons practitioners say they aren’t changing
practice following training
• Low knowledge, motivation, confidence and/or perceived authority to
change they way they practise (face to face, telephone and groups)
Commonly cited barriers:
• Lack of actual or perceived authority to change practice in the workplace:
amount of nature of assessment, education and documentation
• Perception that their role doesn’t include health literacy and/or selfmanagement support (it’s someone else’s responsibility)
• Lack of time to plan and enact practice change and perceived or actual
lack of line management and/or higher management support
• Non-alignment with clinical documentation
• Inconsistency of practice and approach by team members
© 2014 HealthChange Australia
Slide 45
What is required for clinician success?
Without behaviour change
Exposure to
new
information
Passive
Learning
Cycle
Short term improvement
of practice
© 2014 HealthChange Australia
With behaviour change
Active
Learning
Cycle
Long term improvement of
practice and integration of
new knowledge
Slide 46
The Bottom Line
• To be successful, top down integration requires bottom up
practice change
• Current clinical practice is delivered in a way that can add to
the problem of poor patient adherence and undermine the
potential effectiveness of care management and care
coordination outcomes
• Clinicians are risk averse and/or unable to change their
practice due to perceived and real organisational factors
• Support and guidance for frontline staff accompanied by
micro systems change is required to create practice change
• Line managers need to understand the methodology to
support frontline practice change
© 2014 HealthChange Australia
Slide 47
HealthChange® Integration Pathway
HealthChange® core
training for clinicians
and frontline staff
HealthChange® Core Training
Part 1 (2-day workshop)
Methodology Basics &
Decision Framework
Organisational
capacity building
options
HealthChange® Core Training
Part 2 (1-day workshop)
Application &
Troubleshooting
Entire package
HealthChange® Core Training
and Forum for Managers
(½-day workshop and forum)
HealthChange® Practice
Leader Support Program
(Planning & mentoring)
HealthChange® Integration
Support Package for Program
Managers and Health Services
Program Development
Package
(Design or redevelopment)
© 2014 HealthChange Australia
Slide 48
Training needs hierarchy
Practice
Leaders
(Skills devt, planning
workshop + teleconferences)
Clinicians & Case Managers
(Core Training Part 1 and Part 2 and/or
shorter formats with integration support package)
(Plus in-house skills development support)
Program Managers
(½ day workshop +
implementation support)
© 2014 HealthChange Australia
Referring Clinicians
(Overview presentation or briefing)
Slide 49
Topic 4: Discussion Forum
Given your experience in implementing change in
teams, programs or organisations:
1. What are the challenges that you foresee in training staff
and/or implementing this methodology into your teams and
programs?
2. What solutions can you propose to address the challenges?
3. What are the potential benefits and opportunities for your
organisation, services or programs in adopting
HealthChange® Methodology?
© 2014 HealthChange Australia
Slide 50
Organisational change considerations
• Designation of responsibility for systems change and practice change
• Role redefinition and attitudinal shift: from viewing health systems staff as
information and service providers to one that views them as facilitators
and supporters of client self-management and behaviour change
• Changes to the nature and amount of assessment conducted within intake
and consultations
• Changes to the way that information and education is provided and the
amount of education provided within consultations and programs
• Adaptation of clinical documentation and/or data collection systems to
reflect the different structure of interviews or consultations when using
HealthChange® Methodology and to collect process and outcome data for
reporting
• Communication and sharing of data with other staff or services within the
client’s multidisciplinary care team
© 2014 HealthChange Australia
Slide 51
Organisational change considerations cont’d
• Development of program-specific behaviour change support tools
• Changes to recruitment and/or marketing messages delivered to end
users/consumers
• Changes in recruitment and/or marketing messages to referring services
or health care providers
• Time allocation for planning the above changes
• Time allocation for health care providers to adapt to the new systems and
to develop their HealthChange® Methodology skills
• Development of an organisational culture that allows for the open
examination of what health care providers do in their consultations
• Development of quality assurance processes to verify that practice change
and systems change is happening
• Changes to KPIs and performance reviews to support all of the above
© 2014 HealthChange Australia
Slide 52
Bottom up clinical practice & system factors adding to
the adherence problem:
• Duplicated and excessive paperwork that is contra to patient-centred consultations
• Duplicated and unnecessary assessment
• Provision of clinical services in an isolationist or siloed manner (even within teams)
• Didactic, non patient-centred delivery of treatment advice and education
• Lack of consistency of advice across clinicians and services
System and
practice factors • Lack of a common framework to discuss patient behavioural health goals and actions (as opposed to
clinical goals)
Patient and
carer
disengagement
Poorer patient
outcomes
•Health system fatigue (the ‘here we go again’ factor)
•Information overload
•Poor knowledge and understanding (health literacy) and confusion regarding treatment
recommendations
•Disengagement, poor motivation and ability to adhere to recommendations
•Reduced trust in the health system and clinicians within it, feeling devalued
•‘Doctor shopping’ and search for answers outside of evidence-based care
• Unnecessary ED admissions and hospitalisations
• Unnecessary or unhelpful treatments and appointments
• Unnecessary time and resources spent seeking help
• Poorer health service experience
• Poorer health and quality of life outcomes
© 2014 HealthChange Australia
Slide 53
Client exit surveys
• What was the client’s experience of the consultation approach?
• Are they aware of how their condition/s might impact on them personally and why they might
take action to improve their outcomes?
• Do they know the overall treatment and lifestyle categories that are appropriate for effective
management of their condition/s over time. I.e. are they aware of the range of evidence-based
treatment recommendations?
• Do they feel that the clinician engaged in collaborative decision-making? Were they given
choice or simply advised what they must do in a prescriptive way? Were they treated in a
client-centred, non-judgemental and considerate way?
• Where they assisted to consider what might stop them from engaging in the recommended
treatment options?
• Were they invited to take notes in the consultation?
• Were they asked to what extent they think they can do the tasks that were agreed upon, within
the agreed time frame?
• Are they aware of other support mechanisms/services that might be available to them?
© 2014 HealthChange Australia
Slide 54
© 2014 HealthChange Australia
(Workbook Section 9)
Slide 55
© 2014 HealthChange Australia
(Workbook Section 9)
Slide 56
Understanding how people need to be thinking
People will not take action unless they believe:
I have a problem
k
The problem is serious
enough to consider action k
It could adversely affect
things or people that are
important to me
There is an effective course
of action open to me
I am able to pursue this
course of action
I can’t put off making a
decision
I
Weigh up
expected
costs and
benefits
Decide to
take action
or not
k
C
R
Adapted from the Health Belief Model (Becker & Rosenstock, 1984)
© 2014 HealthChange Australia
Slide 57
Ongoing support from HealthChange Australia
• Skills development toolkit for frontline staff
• Website downloads: case studies, documentation, client
resources, videos
• HealthChange® Core Training Text and Workbook
• HealthChange® Online: Online Learning Environment
• Ongoing support for HealthChange® Practice Leaders and
Managers
• HealthChange® Integration Support Package
© 2014 HealthChange Australia
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Thank
you
for
your
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participation!
HealthChange® tools can be used freely in clinical practice
and programs as long as Health Change Australia intellectual property
is visibly acknowledged by displaying the HealthChange® Inspired logo
Contact us for more information
© 2014 HealthChange Australia
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Return
© 2014 HealthChange Australia
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© 2014 HealthChange Australia
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© 2014 HealthChange Australia
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© 2014 HealthChange Australia
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© 2014 HealthChange Australia
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Training alone is not enough:
• Practice change takes time
• Health care provider importance and confidence
to change practice is generally low
• Systems change, documentation change, quality
control and accountability are required
• Frontline managers need to understand the
methodology – in order to identify and address
challenges, convince staff of the need for practice
change and keep clinicians and teams accountable
© 2014 HealthChange Australia
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