Establishing an Effective Referral System for Evidence-Based Prevention Programs

Transcription

1 Establishing an Effective Referral System for Evidence-Based Prevention Programs Sherri Ohly Special Projects Coordinator Michelle Comeau Special Projects Assistant

2 Helping older people live healthier lives through evidence-based prevention programs.

3 High-Level Evidence Based Prevention Programs

4 Research and Findings Research Improved health status, health behavior, and self-efficacy. At one year, the improvements were maintained. Stepping On in Australia: demonstrated a 31% reduction in falls. Wisconsin shown to achieve a 50% reduction

5 Outcomes and Benefits of Self- Management Programs Benefits Designed to enhance regular treatment and diabetes education Complements clinic-based education (such as with Certified Diabetes Educators (CDE s) Strengthens relationship between resource center and medical providers Social benefits for participants

6 Reaching individuals to take evidencebased prevention programs BRONZE SILVER GOLD

7 Promotion of evidence-based prevention programs Have brochure or flyers in the office Hang promotional material around workspace or in hightraffic areas around town. Newspaper/Radio Promotional materials and Outreach Presentation In community To medical staff Partnering with a health care facility Promo material Host Site Encourage patients

8 Referral Process Provider uses letter to followup with patient in goal setting Workshop coordinator and Clinic meet to discuss selfmanagement resource Clinician introduces SME opportunity to patient Patient agrees and signs a referral form Patient letter is sent to provider Referral form is sent to Workshop Coordinator In the workshop patient writes a letter to provider describing what they ve learned Patient attends SME Coordinator communicates with clinic regarding referral status (enrolled, declined, waitlisted) Coordinator contacts referred patient and enrolls in a workshop

9 Workshop coordinator and Clinic meet Connecting with Health Care Providers to discuss self-management resource Where do you start? Cold calls vs using existing relationships Staff members who are not clinicians can be influential Community Educations departments vs Clinical

10 Connecting with Health Care Providers How do you prepare? The Approach Three C s Cost, Convenience, Credibility Highlight proven benefits for patients Distinguish your interventions from competing programs Make it easy to recommend the intervention Power point presentations if appropriate WIHA and GWAAR as a resource

11 Connecting with Health Care Providers Seal the deal Confirm pre-meeting Tailor a referral process that complements their current referral system Create a list of next steps Follow up post-meeting

12 Sample Model: Family Health/La Clinica, Wautoma, WI First Meeting Goal: Awareness about resource and begin discussing a direct referral process 2-3 helpful handouts Have an ask Complementary Process Clear next steps Set date to evaluate process Building and keeping a relationship takes maintenance

13 Family Health/La Clinica, Wautoma, WI Facts/Fax sheet is faxed to ADRC Yes! ADRC calls patient to inform and sign-up for upcoming workshop ADRC tracks outcome of referrals and updates referring provider I feel you could truly benefit from these workshops can I make a referral? Post workshop goals to providers

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19 Sample Model: On-Site Nurse Case Manager Use WiHA s website or County Contact Form Nurse and client call workshop contact or County Coordinator to learn more and register Yes! I feel you could truly benefit from these workshops are you Interested?

20 Understanding the Approach Partnering with Health Providers Develop a Systemic Proactive Approach

21 Sample Model: In-house referrals to diabetes workshops Internal referral sent from clinic to the Karen Yontz Center Attends a workshop! Yes! I feel you could truly benefit from more diabetes info. May I set up a referral? ACTIVATION! 7th Session Post workshop goals to providers

22 Final Focus Go for the GOLD but start wherever you are an build from there Have patience Partnerships take time Pilot, Evaluate, Maintain Each partnership will be different but similar

23 NO MEDICAL RECORDS

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27 Thank You! Sherri Ohly Michelle Comeau Jill Renken