The South Eastern Sydney PAM Experience. Tom Chapman A/ Integrated Care Manager Brendon McDougall Integrated Care Program Manager

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1 The South Eastern Sydney PAM Experience Tom Chapman A/ Integrated Care Manager Brendon McDougall Integrated Care Program Manager

2 ed_care_strategy.pdf

3 Strategy areas for action Engage with people and communities through person centred planning and evaluation Develop a Health Intelligence system Use innovative models to target areas of need Utilise central support structures to evaluate, transfer and spread successful models

4 Strategies Engage with people and communities through person centred planning and evaluation Strategy 1: Spread motivational interviewing and health coaching techniques to support collaborative care planning, as adopted by SESLHD including general practice, by working with selected, motivated primary health care services Strategy 2: Test use of patient activation, outcome and experience measures and sharing of outcomes across all providers as a tool to improve quality of care.

5 Measuring person centred care and an increase in ability to self-manage How? Looking for something that would measure how active a patient is in their own care A lot of measures assess the delivery of care components not the actual level of patient activation (e.g. Patient Assessment of Chronic Illness Care - PACIC) How could we measure and act on a patients level of activation to increase their ability to self-manage

6 Measuring person centred care Measuring components of person centred care Holistic concept of person centred care Patient experience Empowerment Empathy Communication Self-management Shared decision making

7 First trial of PAM Student Led Clinic Goals: Provide person centred health education and coaching for clients educate students in health coaching and interdisciplinary team working increase clinical placements Clinic now known as SHIRES (South Eastern Health Information Referral and Education Service)

8 Measuring PAM in South Eastern Sydney Aim to evaluate the efficiency and effectiveness of the Patient Activation Measure (PAM13 ) tool in an Australian setting, and determine the level of patient engagement in their health care CI%20PAM%20Project%20Final%20Report%20April% pdf

9 Measuring PAM in South Eastern Sydney 1522 completed surveys average population Activation Level of 3

10 Measuring PAM in South Eastern Sydney Private health insurance This finding suggests that those with Private Health Insurance are more likely to have higher activation in their health.

11 Measuring PAM in South Eastern Sydney Mental health This finding suggests that those who have seen a mental health professional in the past 12 months are less likely to have high health activation.

12 Measuring PAM in South Eastern Sydney Self-reported current health status This finding suggests that there is a relationship between an individual s self-rating of their health and activation level. Further analysis needs to occur in order to determine an association between self-rating of health and activation level.

13 Measuring PAM in South Eastern Sydney Regular GP/Dr This finding suggests that those with a regular GP/Family Doctor are more likely to sit at the extremes of the PAM levels (i.e. levels 1 and 4).

14 Measuring PAM in South Eastern Sydney Language used This finding suggests that those who speak a language other than English at home have a lower health activation than those who do not.

15 Current PAM use in SESLHD Cardiac Rehabilitation (POW) Integrated Rehabilitation and Enablement Program (ireap, WMH) Pulmonary Rehabilitation (POW, TSH) Respiratory Coordinated Care Program (RCCP, POW) Student-led health coaching clinic (SHIRES, TSH)

16 Barriers and strategies to overcome Barrier Time Clinician skill set Clinician confidence Staff changes Patient consent High winter demand Patient cognition Patient understanding Strategy Phased approach Additional training Support and subject experts Wider team adoption Improved patient information Predictive planning In progress In progress

17 Case Study

18 What s next for PAM in SESLHD? Continuation of PAM study Improve support processes through SESLHD health coaching redesign project Spread PAM use to additional clinical services Continue work with ACI on consumer enablement and patient reported measures