Patient Engagement, Shared Decision Making and PCNA Educational Materials

Transcription

1 Patient Engagement, Shared Decision Making and PCNA Educational Materials Kim Newlin, RN, ANP-C, FPCNA Board Member, PCNA April 7 th, 2016

2 Objectives Identify ways to improve patient engagement at a provider and organizational level Understand the key components and the importance of shared decision making Identify educational materials available through PCNA

3 Patients and Health Outcomes Patients who are more actively involved in their health care experience have better health outcomes and lower costs Modern health care is complex, and patients struggle to obtain, process, communicate, and understand even basic health information and services Many patients lack health literacy: true understanding of their medical conditions US health care system often has seemed indifferent to patients' desires and needs "Health Policy Brief: Patient Engagement," Health Affairs, February 14, 2013.

4 2001 IOM Report Crossing the Quality Chasm: A New Health System for the 21st Century Reforms are needed to achieve a "patientcentered" health care system that provides care that is "respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions." "Health Policy Brief: Patient Engagement," Health Affairs, February 14, 2013.

5 Who s in Charge? Patients are in control. No matter what we as health professionals do or say, patients are in control of these important self-management decisions. When patients leave the clinic or office, they can and do veto recommendations their doctor makes. Glasgow RE, Anderson RM Diabetes Care Dec;22(12):2090-2

6 Patient Activation vs. Patient Engagement "Patient activation" refers to a patient's knowledge, skills, ability, and willingness to manage own health and care "Patient engagement" combines patient activation with interventions designed to increase activation and promote positive patient behavior (e.g. preventive care or exercising regularly) Patient engagement is one strategy to achieve the "triple aim" of improved health outcomes, better patient care, and lower costs "Health Policy Brief: Patient Engagement," Health Affairs, February 14, 2013.

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9 Where Does Shared Decision Making Fit? Shared decision making (SDM) is a collaborative process that allows patients and their providers to make health care decisions together, taking into account the best scientific evidence available, as well as the patient s values and preferences.

10 Shared Decision Making (SDM) Shared decision-making is the process by which a health care provider communicates to the patient personalized information about the options, outcomes, probabilities, and scientific uncertainties of available treatment options and the patient communicates his or her values and the relative importance he or she places on benefits and harms. Foundation for Informed Medical Decision Making 10

11 The Perspectives of 2 Experts Diagnosis CLINICIAN Pathophysiology Prognosis Treatment Options Treatment Outcome Risk/Benefit associate with each option PATIENT/ FAMILY Personal experience of illness Social and family context Values Preferences Attitudes/feelings regarding risk

12 SDM: Steps in the Process Invite patient to participate Both parties share Information Clinician introduces concept of patient participation in decision making Clinician offers options and describes the associated risks/benefits Patient and family expresses his/her preference/values: What matters most or what are the priorities for the patient and family

13 Patient Decision Aids When more than one option exists, decision aids may aid in achieving consensus or agreement Tools that help people become involved in decision making by making explicit the decision that needs to be made, providing information about the options and outcomes, and by clarifying personal values. They are designed to complement, rather than replace, counseling from a health practitioner.

14 Decision Aids & Training Ottawa Hospital Research Institute:

15 Patient Decision Aids Ottawa Hospital Research Institute:

16 Personal Decision Guide

17 Patient Decision Aids Mayo Clinic Shared Decision Making National Resource Center

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19 Creative Ways to Engage Patients 1. Offer Telemedicine 2. Text messages to patients a. Memotext for medications (memotext.com) 3. Telehealth support (case managers) 4. Offer Bedside Tablets 5. Offer Online Communities 6. Cater to Bilingual Patients

20 Online Training Ottawa Hospital Research Institute:

21 Vendors Salesforce: view/ ABG Communications: Caradigm: Emmi Solutions:

22 An Under-utilized Resource In our country, patients are the most under-utilized resource, and they have the most at stake. They want to be involved and they can be involved. Their participation will lead to better medical outcomes at lower costs with dramatically higher patient & customer satisfaction. Charles Safran, M.D. President, American Medical Informatics Association Testimony Before the Subcommittee on Health of the House Committee on Ways and Means

23 PCNA ( Prevention Starts With Us Since our inception in 1992, PCNA has become the premier nursing organization dedicated to treatment and prevention of cardiovascular diseases. We support leadership, advocacy, lifelong learning and empowerment of the nursing community. With a national and international reach of more than 38,000 professionals, over 3,000 active members and 20 chapters across the United States, PCNA is diligently furthering its mission and impact.

24 PCNA Education Tools Clinical Tools & Patient Education Materials Atrial Fibrillation brochure Heart Failure education sheets Heart-Healthy Toolbox Cholesterol Fact Sheet

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30 Questions 1. What are you doing as an organization to improve patient engagement? 2. Are your patient education tools written in a way that your patients can understand and do they engage them?

31 Thank You.. What Questions Do You Have For Me?