Theme 3. Transforming patients’ and caregivers’ experience and health
Presentation Materials (members only)
HERSTORY Peer Directed Group Exercise Programs Improving Clinical Outcomes Group medical visits, including peer-led and peer-facilitated exercise groups, and care-based focus groups, are emerging as an efficient and effective way to care for patients with complex needs. Four teams describe how they have implemented group visits and share their results.
(I) HERSTORY: An Innovative Group Model for Mental Health Care Using Peer Facilitation and Patient Co-design
Learning Objectives
WHAT MAKES A PATIENT COMPLEX? The Bridgepoint FHT would like to present an approach for dealing with a complex and underserved population- those with a past history of sexual childhood trauma. In this interactive presentation you will learn about the impact of this model, be provided with the tools to spread this model to your FHT and hear directly from the voice of patients and peer facilitator.
Summary
The Bridgepoint FHT in partnership with our patients have developed a cutting edge women's trauma program entitled "HERSTORY". The current community wait times for referral to trauma therapy are measured in YEARS. In order to respond better to our patient needs we developed an inter professional group model of care using focus groups, peer leadership and ongoing patient and provider feedback. This presentation will illustrate our process, review our outcomes both qualitative and quantitative, provide insights into the challenges and victories of this unique group and allow the audience to hear directly from our patient representative and peer facilitator.
Presenters
- Bridgepoint FHT
- Lora Judge, MSW,RSW
- Lora Cruise, Medical Director
Authors and Contributors
- Christine Gordon
(II) Shared Medical Appointments: The Why, the How, the Impact
Presentation Materials (members only)
- Materials will be posted following the 2015 Conference.
Learning Objectives
- Summarize SMAs - what they are, evidence for their use.
- Describe our process to initiating and adapting SMAs in busy practices -listen to/hear experiences of SMA participants (practitioners and patients).
Summary
Shared Medical Appointments are an exciting and innovative way to provide care to patients with chronic diseases. Our interdisciplinary teams introduced Shared Medical Appointments (SMAs) to patients living with diabetes in 2012. An SMA is a 90 min appointment held simultaneously with 5-10 patients and 2 providers in an interactive visit. All parameters of diabetic care are monitored as with any individual diabetic visit, patient questions are addressed by both peers and providers and true collaboration is encouraged between patient and health care professionals. Participants (providers and patients) experiences will be highlighted in this presentation.
Presenters
- Hamilton FHT:
- Anneli Kaethler, MSc, RD, CDE
- Cornelia Mielke, BSc, MD, CCFP
Authors and Contributors
- Hamilton FHT:
- Catherine Bednarowski, Clinical Pharmacist, CDE, Hamilton FHT
- Sheilah Lamb, MD
- Barbara Teal, MD
- Robert Kerr, MD
(III) Peer-Directed Group Exercise Programs Improving Clinical Outcomes
Learning Objectives
Attendees will learn about how building group exercise programs with peer co-leaders and patient directed educational discussions not only cn affect A1c, BMI, BP and MaxMETs in a population with metabolic syndrome or diabetes, but also improves patient attitude towards being physically active. The program leaves participants confident and prepared to maintain activity levels after completion. This model increases patient independence and thrives off of group cohesion and the support of peer co-leaders. In addition, attendees will learn how to implement similar programs with varying resources in their own community.
Summary
Supervised group exercise programs have been proven effective in improving outcomes in patients with diabetes. At the Guelph FHT we have implemented group exercises classes that incorporate peer co-leadership and patient directed educational discussions. The program runs on a rotating basis twice per week for 12 weeks. Participants complete cardio, strength, balance, and flexibility activities during each session. Upon completion, patients have the option of undergoing training to become peer co-leaders. The program’s goal is to improve outcomes (a1c, BP, BMI, WC, lipids, MaxMET) for people with diabetes and metabolic syndrome and increase physical activity levels and leave patients confident with their ability to maintain after program completion. Results are collected and analyzed in an ongoing basis. As of April 2015, average days completing cardio exercises increased from 1.8 to 4.5 and resistance training from <1 to 3.5 days. Perception of exercise improved during the program and 90% of graduates believed they had attained the necessary confidence, skills, and strategies to maintain their activity levels. Average a1c decreased 0.3%. Estimated MaxMETs increased approximately 20%. Both WC and BMI showed decreasing trends. Using a highly peer directed group exercise program can increase physical activity levels and improve outcomes. Similar programs could be created using partnerships with community gym facilities or with minimal equipment. This model also places the focus on the patient and empowers them make positive and hopefully lifelong changes in their perception of and motivation to be physically active.
Presenters
- Krista Crozier, R.Kin, CDE Diabetes Care Guelph, Guelph FHT
(IV) Group Medical Visits (GMV) for Primary Care Diabetes: The McMaster Family Health Team Experience
Learning Objectives
- To gain knowledge about how to organize and implement a group medical visit
- To learn the value of using group medical visits effectively within primary care
- To hear positive patient accounts about their experience with group medical visits
Summary
The increasing prevalence of diabetes poses a threat to the sustainability of Canada’s health care system. Group medical visits (GMVs) are emerging as an efficient strategy to deliver care to multiple patients and have been shown to improve glycemic control, patient satisfaction and patient self-efficacy in disease management. The purpose of this study was to examine a number of process and quality of care outcomes measures to compare GMVs to traditional care and a diabetes clinic model that existed within the McMaster Family Health Team. This was a cohort study comparing GMVs to traditional care and a diabetes clinic model over the period 2008-2012. During each visit, patients saw a family physician and registered practical nurse with foot care certification and one of the following diabetes educators: nurse practitioner, dietitian or pharmacist. Group visit content included physical exam, medication review, group diabetes education review, question and answer time and goal setting. The numbers in each group were small so data was analyzed descriptively. The benefits and challenges of GMVs as compared to conventional care will be highlighted during this presentation and suggestions on how GMVs can be used effectively for diabetes care within primary care will be provided.
Presenters
- McMaster FHT:
- Inge Schabort, MB ChB CCFP FCFP
- Michele MacDonald Werstuck, RD MSc CDE
Authors and Contributors
- Kalpana Nair, PhD, McMaster University
- Christie Tasch, BA, McMaster University