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Roger Beech, Faye Foster, Rosie Piggott Institute of Primary Care and Health Sciences

The role of targeted training and “patient power” in promoting integrated evidence based care for COPD. Roger Beech, Faye Foster, Rosie Piggott Institute of Primary Care and Health Sciences Keele University. PLAN OF THE SESSION.

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Roger Beech, Faye Foster, Rosie Piggott Institute of Primary Care and Health Sciences

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  1. The role of targeted training and “patient power” in promoting integrated evidence based care for COPD Roger Beech, Faye Foster, Rosie Piggott Institute of Primary Care and Health Sciences Keele University

  2. PLAN OF THE SESSION • A Chronic Obstructive Pulmonary Disease (COPD) training initiative for primary care staff. • Its role in promoting more integrated and patient centred care.

  3. BURDEN OF COPD • Progressive disease that affects around 900,000 individuals in England. • Individuals experience increased morbidity and reduced quality of life . • Second largest cause of hospital admissions in England. • Death rates from COPD in England are almost twice the EU average. • Costs the NHS in England around £800 million per year.

  4. BUT... • Estimated that burden for individuals and health services could be reduced by: • Greater adoption of evidence based practice for preventing, detecting and treating COPD. • Improved integration of services available for the care of patients with COPD.

  5. NETWORK OF CARE POTENTIALLY AVAILABLE FOR COPD PATIENTS Roberts JA., Maslin TH, Bakerly ND. Development of an integrated chronic obstructive pulmonary disease service model in an inner-city region in the UK: initial findings and 12 months results.  Prim Care Respir J 2010;19:390-7. http://dx.doi.org/10.4104/pcrj.2010.00071

  6. A TRAINING INITIATIVE TO PROMOTE IMPROVED CARE • Targeted at primary care practices with high prevalence and admission rates (12 recruited). • Goal is to increase awareness of evidence based practice and generate behavioural change amongst professionals. • Designed and delivered in collaboration with local health professionals and patient support groups. • Incorporates interactive taught sessions and local service delivery projects. • Linked evaluation activity assessed impacts of the initiative.

  7. LINKS TO INTEGRATED CARE AGENDA

  8. IMPACTS: INCREASING AWARENESS • Have gained a greater understanding of COPD and now feel able to take this back and share with the rest of the team. (GP) • It was a really good course. Nice to see such a variety of things – rehab, spirometry; breathe easy; so broad it was very good. (Practice nurse)

  9. IMPACTS: ENCOURAGING NETWORKING AND COORDINATION • Local speakers were invaluable; they speak the same local dialect and can say where things are being held and talked about local people. (Practice nurse) • You learnt from other people on the course, what other surgeries are doing, you pick prompts and ideas from other people. (GP)

  10. IMPACTS: PROMOTING PATIENT CENTRED CARE • Out of the 5 sessions, the Breathe Easy group stuck uppermost in my mind. I really enjoyed listening to the patients – thank you. • The session was really informative and has given me an insight to patients with breathing conditions which I can use in a positive way during my consultations. • A very humbling experience many thanks.

  11. IMPACTS: CHANGING SERVICE DELIVERY • We’ve improved our screening and our pick-up rate; our diagnosis and prevalence of COPD have improved. We also picked up ideas from other attendees such as, we now have rescue packs. (GP) • I now encourage more patients to think about pulmonary rehabilitation. I’d heard of PR but I’d only had one patient that had been, so it was good to see people {Breatheasy} who had been through it so I can now say “look, this is something to consider”…now I know what’s involved I can tell patients. (Practice nurse)

  12. IMPACTS: A CATALYST FOR FURTHER CHANGE • Training initiative demonstrated that pulmonary rehabilitation services for patients with COPD are: • Effective and cost-effective. • Available. • BUT under-used (16 out 168 eligible patients in one practice).

  13. INTEGRATING PULMONARY REHABILITATION SERVICES Pulmonary Rehabilitation Monitor Eligible Patients Re-Design Re-Design Current Practice Patients Staff Academics

  14. EVALUATION PHILOSOPHY • Increased service uptake and improved patient and staff experience are key measures of success. • The economic impacts of increased service integration can be projected.

  15. CONCLUSIONS • Ensuring timely patient access to available evidence based services remains a crucial element of the integrated care agenda. • Training initiatives facilitate service linkage/ coordination and the development of communities of practice. • Proactive “patient power” is a crucial lever for promoting service change and a more patient centred approach to care.

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