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Learn important self-management support strategies to improve patient care. Explore SMS implementation ideas and key resources attached.
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Supporting Patients on their Journey Paul Kerston, Positive Living BC Kathy Reims, MD STOP HIV/AIDS Collaborative Learning Session Learning Session 2 May 25, 2011
Session OverviewSelf-Management Support (SMS) • Important SMS themes from a patient perspective • SMS implementation ideas • Time for dialogue • Key resources attached
If you are thinking about what to say next, you are not really listening.
What changes can we make that will result in improvement? • Emphasize the patient's central role • Use effective self-management support strategies that include: assessment, goal setting, action planning, problem-solving and follow-up • Organize resources to provide support
Trusting Relationships • Continuity • Interpersonal skill building • Strong systems support
Listening • Takes practice • Motivational Interviewing training • Role play • Office culture
Explain, then respect the patient choice • Information, but more than that • Evidence for shared-decision making • Respect for patient role and autonomy • Brief Action Planning – patient drives the goal
Keep it personal • Eye contact • Think through computer use – involve the patient • See what you are asking through the lens of the person • Document progress over time and follow up
Teams • Protocols • Prompts and reminders • Outreach • Case management assistance when needed • Decide what is always in the provider domain • Expanded multidisciplinary teams
See the person, not the disease • Social history • Prompts about key life events • Ask questions about impact of care and illness • Leverage strengths • Emphasize wellness • Tap into personal networks and community supports
SMS Resources: Core Training • Schaefer J, Miller D, Goldstein M, Simmons L. Partnering in Self-Management Support: A Toolkit for Clinicians. Cambridge, MA: Institute for Healthcare Improvement; 2009. Available at: www.IHI.org • Physician Tip Sheet for Self-Management Support. Chicago, IL: American Medical Association; 2008. AMA.org • Prochaska, JO; Norcross, JC; DiClemente, CC. Changing for good: the revolutionary program that explains the six stages of change and teaches you how to free yourself from bad habits. New York: W. Morrow; 1994. ISBN 0688112633.
SMS Resources: Advanced Training • Cole S. Ultra-Brief Personal Action Planning. Rochester, NY: Stony Brook University Medical Center; 2008. • California HealthCare foundation Website: http://www.chcf.org/publications/2005/06/helping-patients-manage-their-chronic-conditions • Weiss, Barry D., Mays, Mary Z., Martz, William, Castro, Kelley Merriam, DeWalt, Darren A., Pignone, Michael P., Mockbee, Joy, Hale, Frank A.Quick Assessment of Literacy in Primary Care: The Newest Vital SignAnn Fam Med 2005 3: 514-522
SMS Resources: Advanced Training • The Newest Vital Sign: A New Health Literacy Assessment Tool for Health Care Providershttp://www.pfizerhealthliteracy.com/physicians-providers/newest-vital-sign.html • The Macarthur Initiative on Depression and Primary Care http://www.depression-primarycare.org/clinicians/toolkits/materials/forms/phq9/ • Motivational Interviewing http://www.motivationalinterview.org/ • Motivational Interviewing in Health Care: Helping Patients Change Behavior (Applications of Motivational Interviewing) Stephen P Rollnick PhD, William R. Miller Phd, Christopher C. Butler MD, Guilford Press, New York, 2008.