The Chronic Care Model (Katherine Gibbs and Melanie Taylor)

Size: px
Start display at page:

Download "The Chronic Care Model (Katherine Gibbs and Melanie Taylor)"

Transcription

1 The Chronic Care Model (Katherine Gibbs and Melanie Taylor) INTRODUCTION A large proportion of time spent by those working currently within the field of primary health care revolves around short consultations initiated by the client to discuss their immediate health issue. The Royal College of General Practitioners notes that the management of chronic disease is often fitted around this acute care ( while I am here can I have my diabetes script ) and it remains largely unsystematic. This episodic care may be of a high standard, but has rarely been planned to meet the longer term needs of patients with chronic illnesses. Chronic illness (also known as long term or life long conditions) is a significant health burden. It is estimated that in New Zealand approximately 70% of clients have one or more chronic illnesses. They are the leading cause of hospitalizations, use 70% of health funds, and account for 80% of all deaths (National Health Committee, 2005). Rapid aging of the population and the greater longevity of people with many chronic conditions (Wagner et al, 2001) mean optimal management of these individuals is becoming critical. Living with a chronic illness can be difficult. It takes a heavy toll on the physical and mental health of the individual and their supporting friends, family and workplaces. Receiving good care and learning how to self manage symptoms can maximise quality of life as well as lessen the impact on the health system. While there is, and presumably always will be, a need for sound, robust acute care, the paradigm shift required for the sustained and effective management of people with life long conditions is challenging. Calls for change have been coming from the highest level (Barr, Robinson, Marin-Link, Underhill, Dotts, Ravensdale, Silivaras,, 2003) and are increasingly heeded around the world. It is now understood that for effective and efficient management of chronic illness a change in systems is required (Wagner, Austin, Davis, Hindmarsh, Schaefer, Bonomi, 2001).

2 This article provides a brief overview of the Wagner chronic care model which MidCentral DHB is now looking to use as its framework of choice for developing systems to better manage care of people living with long term conditions. THE CHRONIC CARE MODEL Ed Wagner MD and his colleagues from America s MacColl Institute for Health Care Innovation developed the Chronic Care Model in the 1990 s after recognising that systems and processes based on an acute care model failed to meet the comprehensive needs of the client with a chronic illness. The Chronic Care Model proposed by Wagner offers a systematic approach to improving health delivery. The central role of the primary care team working in partnership with secondary care colleagues is emphasised. It aims to improve the quality of health outcomes for patients based on the philosophy that care can be delivered more effectively and efficiently if patients with chronic conditions take an active role in their own health and wellness. Concurrently, providers are also supported with the necessary resources and expertise to better assist these people in managing their condition/s. THE CHRONIC CARE MODEL Health System Community Self- Management Support Delivery System Design Decision Support Clinical Information Systems Informed, Activated Client Productive Interactions Prepared, Proactive Practice Team Improved outcomes In this model Wagner places an individual practice setting (such as a General Practice) within the Health System, which in turn is itself situated in the Community.

3 The other four elements within the Health System, namely Self Management Support, Delivery System Design, Decision Support and Clinical Information Systems are grouped together which suggests that quality improvement initiatives, when implemented, would effect care delivery for clients with chronic conditions. For practitioners working in General Practice, these four elements are where the greatest effort and attention should be placed, as influencing the wider health system and community iss problematic and beyond the scope of most individual health providers. Each element is now discussed in turn: * Community In essence this element requires those within the health system to form durable, useful partnerships with other organisations and entities within the wider community. This is important as the health system alone cannot fix or indeed influence the management of chronic conditions in isolation. Community organisations can assist the health system by advocating for polices to improve client care; develop interventions to fill gaps in current services, encourage their members to attend self management programmes and finally provide helpful resource material. * Health System This element emphasises the need to create a culture within the health system that promotes safe, high quality care chronic illness care. All members of the organisation need to be motivated and ready for change for this to occur. Proposed ways of improving care delivery include the promotion of multidisciplinary teamwork, alignment of incentives and improving care coordination across organisations. * Self Management Support This element recognises that merely telling the client what to do or handing them some material to read is not sufficient. True self management involves emphasising the patients central role in managing their health and illness - fostering a sense of responsibility for their own health. The practitioner is encouraged to use effective assessment tools and counselling techniques such as motivational interviewing or health coaching to explore behaviour change. Tools such as goal setting and individual care plans or health and wellness plans are used to assist the client to plan for the change. The practitioner may provide emotional support and further education at this time.

4 * Delivery System Design This element is all about effective teamwork having defined roles and delegated tasks among team members, organising practice around planned care, providing case management for complex patients and ensuring regular follow up of clients as a standard procedure. In essence it is about making sure each client gets they care they need. Health literacy (the patient s ability to understand health related information) and cultural competence are essential components of this element. * Decision Support This element challenges us to embed evidence based guidelines into our daily practice. Treatment decisions need to be based on explicit, proven guidelines supported by research, with the aim of ensuring that all clients receive the best possible care. The use of specialist expertise and effective teaching methods (for practitioners) are also key components of this element. * Clinical Information Systems The ability to share information with clients and providers to coordinate care is vital, as is the technology to track individuals, groups and whole populations. Utilising this type of software means it will be possible to identify relevant sections of the community for proactive care. Timely reminders will be useful to prompt guideline based care. Finally, monitoring and evaluation of care to individuals, groups and population will be possible. In effectively combining all of these elements this Model leads to planned Productive Interactions which over time assures the delivery of critical clinical and behavioural elements of care and which meet the need for patient-centredness. This aspect both assists the development of, and results from the creation of, informed activated clients and prepared proactive practice teams. Informed activated clients have the required knowledge, skill, confidence and motivation to make sound decisions so that they self manage their chronic condition effectively. Prepared, proactive practice teams are those which have the required client information, decision support, people, equipment and time to deliver evidence based clinical management and self management support.

5 The final component is Improved Outcomes. These extend beyond clinical indicators and include factors perceived as important to the client such as improved quality of life and functional outcomes. Cost and reduction of service usage could also be monitored. At MidCentral DHB we have started using the Wagner model as a framework to plan and develop services for clients with long term conditions. In future editions of this Journal we anticipate informing readers through use of this framework as to some of the innovations underway in our region. REFERENCES Barr, V.J., Robinson, S., Marin-Link, B., Underhill, L. Dotts, A., Ravensdale, D., Salivaras, S. (2003). The expanded chronic care model: an integration of concepts and strategies from population health promotion and the chronic care model. Hospital Quarterly, 7, 10, National Health Committee (2005). People with chronic conditions: a discussion paper. Wellington: National Health Committee. Improving Chronic Illness Care (ICIC). Model Elements. retrieved Royal College of General Practitioners retrieved Wagner, E.H., Austin, B.T., Davis, C., Hindmarsh, M., Schaefer, J., & Bonomi, A. (2001). Improving chronic illness care: Translating evidence into action. Health Affairs, 20 (6), This article was recently published in The Practice Nurse Magazine, Volume 7, Number 4 (June 2008).

Operations Manager, Asian Health Services

Operations Manager, Asian Health Services Date: February 2016 (Review Feb 2017) Job Title : Operations Manager, Asian Health Department : Hospital Location : Waitemata District Health Board Sites including North Shore and Waitakere Hospitals Reporting

More information

5. Integrated Care Research and Learning

5. Integrated Care Research and Learning 5. Integrated Care Research and Learning 5.1 Introduction In outlining the overall policy underpinning the reform programme, Future Health emphasises important research and learning from the international

More information

East Gippsland Primary Care Partnership. Assessment of Chronic Illness Care (ACIC) Resource Kit 2014

East Gippsland Primary Care Partnership. Assessment of Chronic Illness Care (ACIC) Resource Kit 2014 East Gippsland Primary Care Partnership Assessment of Chronic Illness Care (ACIC) Resource Kit 2014 1 Contents. 1. Introduction 2. The Assessment of Chronic Illness Care 2.1 What is the ACIC? 2.2 What's

More information

All 28 items with minimal wording changes to reflect prenatal tobacco screening and treatment instead of chronic illness

All 28 items with minimal wording changes to reflect prenatal tobacco screening and treatment instead of chronic illness Assessing Chronic Illness Care Source: Bonomi AE, Wagner EH, Glasgow RE, VonKorff M. Assessment of Chronic Illness Care (ACIC): A practical tool to measure quality improvement. Health Services Research

More information

Clinical Nurse Consultant in Pain Management INFORMATION PACK

Clinical Nurse Consultant in Pain Management INFORMATION PACK Clinical Nurse Consultant in Pain Management INFORMATION PACK CONTENTS: Selection Criteria (please address in a cover letter) & How To Apply Context and Scope HammondCare s Mission, Motivation and Mission

More information

POSITION DESCRIPTION. Clinical Team Coordinator. Adult Community Services Mental Health

POSITION DESCRIPTION. Clinical Team Coordinator. Adult Community Services Mental Health POSITION DESCRIPTION Clinical 0.5 Coordination 0.5 Clinical Adult Community Services Mental Health Date Reviewed: June 2012 Note - as this is a newly created role, the Job Description will be reviewed

More information

SHAPING THE FUTURE OF INTELLECTUAL DISABILITY NURSING IN IRELAND

SHAPING THE FUTURE OF INTELLECTUAL DISABILITY NURSING IN IRELAND Supporting people with an intellectual disability to live ordinary lives in ordinary places SHAPING THE FUTURE OF INTELLECTUAL DISABILITY NURSING IN IRELAND Commenced in 2013 Draft report 2016 Published

More information

Clinical Centre Leader - Physiotherapy (0.50FTE)

Clinical Centre Leader - Physiotherapy (0.50FTE) Date: June 2017 Job Title : Clinical Centre Leader Physiotherapy Department : Corporate Location : Waitemata District Health Board Reporting To : Director Allied Health Scientific and Technical Professions

More information

Learning Lab Objectives. Introduce evidence showing team-based primary care leads to better patient health outcomes.

Learning Lab Objectives. Introduce evidence showing team-based primary care leads to better patient health outcomes. Washington, DC L11: Team-Based Care: Effective Innovations in Practice Dr. Ed Wagner, MD, MPH Director Emeritus & Senior Investigator MacColl Center for Health Care Innovation, Group Health Research Institute

More information

This Position Description is a guide and will vary from time to time and between services and/or units to meet changing service needs

This Position Description is a guide and will vary from time to time and between services and/or units to meet changing service needs POSITION DESCRIPTION This Position Description is a guide and will vary from time to time and between services and/or units to meet changing service needs June 2015 The Canterbury District Health Board

More information

Role Description. Locum General Surgeon - sub speciality Breast. Clinical Leader General Surgery Operations Manager, Surgery

Role Description. Locum General Surgeon - sub speciality Breast. Clinical Leader General Surgery Operations Manager, Surgery Role Description Position: Service / Directorate: Responsible to: Locum General Surgeon - sub speciality Breast General Surgery Surgery, Women s and Children s Health Clinical Leader General Surgery Operations

More information

Does The Chronic Care Model Work?

Does The Chronic Care Model Work? Does The Chronic Care Model Work? A Chartbook created by the staff of: Improving Chronic Illness Care, At Group Health s s MacColl Institute Supported by The Robert Wood Johnson Foundation Grant # 48769

More information

Clinical Nurse Specialist / Nurse Practitioner Intern Women s Health

Clinical Nurse Specialist / Nurse Practitioner Intern Women s Health Date: December 2017 Job Title : Clinical Nurse Specialist / Nurse Practitioner The CNS / NP Intern for Women s Health works in a collaborative environment, to facilitate the development of advanced nursing

More information

Professional Nurse Advisor- Child Protection

Professional Nurse Advisor- Child Protection Date: May 2015 Job Title : Professional Nurse Advisor Child Protection Department : Child Health Services Location : Reporting To : ViP Coordinator for the achievement of service and operational KPIs Head

More information

Position Description

Position Description Position Description Position Title: Reports to: Key Relationships: Direct Reports: Clinical Team Leader Chief Executive Officer/ General Manager Internal: Finance Administrator, Fundraising Manager, Volunteer

More information

POSITION DESCRIPTION

POSITION DESCRIPTION POSITION DESCRIPTION Position details: Title: Reports to: Reports professionally to: Date: Nurse Educator Simulation Starship Child Health Simulation Programme Manager/Nurse Educator Simulation Programme

More information

Speciality Nurse - Fracture Liaison Service

Speciality Nurse - Fracture Liaison Service Date: December 2016 Job Title : Speciality Nurse - Fracture Liaison Nurse Department : Medicine & Health of Older People Location : Waitemata DHB Reporting To : Operations Manager, Medical subspecialties

More information

Kidney Health Australia

Kidney Health Australia Victoria 125 Cecil Street South Melbourne VIC 3205 GPO Box 9993 Melbourne VIC 3001 www.kidney.org.au vic@kidney.org.au Telephone 03 9674 4300 Facsimile 03 9686 7289 Submission to the Primary Health Care

More information

Effectively implementing multidisciplinary. population segments. A rapid review of existing evidence

Effectively implementing multidisciplinary. population segments. A rapid review of existing evidence Effectively implementing multidisciplinary teams focused on population segments A rapid review of existing evidence October 2016 Francesca White, Daniel Heller, Cait Kielty-Adey Overview This review was

More information

Physiotherapist Emergency Department / Admission and Diagnostic Unit

Physiotherapist Emergency Department / Admission and Diagnostic Unit Date: 2015 Job Title : Physiotherapist Emergency Department / Admission and Diagnostic Unit Department : Medicine and Health of Older People Service (Med HOP) Location : Allied Health Inpatients - North

More information

Policy proposals for inclusion in the Food Safety Law Reform Bill

Policy proposals for inclusion in the Food Safety Law Reform Bill Auckland Regional Public Health Service Cornwall Complex Floor 2, Building 15 Greenlane Clinical Centre Private Bag 92 605 Symonds Street Auckland 1150 New Zealand Telephone: 09-623 4600 Facsimile: 09-623

More information

Clinical Nurse Director

Clinical Nurse Director Date: March 2018 Job Title : Clinical Nurse Director Department : Acute and Emergency Medicine Division and Specialty Medicine & Health of Older People Division Location : North Shore Hospital, Waitakere

More information

New Zealand. Standards for. Critical Care. Nursing Practice

New Zealand. Standards for. Critical Care. Nursing Practice New Zealand Standards for Critical Care Nursing Practice New Zealand Standards for Critical Care Nursing Practice Critical Care Nurses Section New Zealand Nurses Organisation Reproduction of material 2014

More information

Expression of Interest. Western NSW Integrated Care Strategy Third Wave Demonstrator Sites

Expression of Interest. Western NSW Integrated Care Strategy Third Wave Demonstrator Sites Expression of Interest Western NSW Integrated Care Strategy Third Wave Demonstrator Sites Closing Date 13 June 2017 Third Wave Demonstrator Sites P a g e 2 Introduction and Overview The Western NSW Integrated

More information

Registered Nurse, Liaison Psychiatry, ECC North Shore Position Description

Registered Nurse, Liaison Psychiatry, ECC North Shore Position Description Date: February 2014 Job Title : Registered Nurse Department : Liaison Psychiatry Location : North Shore Hospital, Waitakere Hospital Reporting To Hours : Team Leader Rostered shifts, 0800-2300, seven days

More information

Operations Manager Waitemata Central Position Description

Operations Manager Waitemata Central Position Description Date: January 2018 Job Title : Operations Manager (NSH or WTH based) Department : Location : Waitemata District Health Board all sites Reporting To : Director Hospital Services Direct Reports Duty Nurse

More information

Job Description. Specialist Nurse with Responsibility for Acute Liaison Band 7

Job Description. Specialist Nurse with Responsibility for Acute Liaison Band 7 Job Description Post Title: Directorate: Service Hours: Managerially Accountable to: Professionally Accountable to: Responsible for: Location: Job Purpose: Dimensions: Key Relationships: Specialist Nurse

More information

Professional and Practice Standards for Multiple Sclerosis Nurses

Professional and Practice Standards for Multiple Sclerosis Nurses Professional and Practice Standards for Multiple Sclerosis Nurses Multiple Sclerosis Nurses Australasia Inc (MSNA) ABN 921 688 53065 Table of Contents: Section Page Project Review Team 1 Acknowledgements

More information

Dementia Clinical Nurse Specialist CMDHB Dementia Care Service

Dementia Clinical Nurse Specialist CMDHB Dementia Care Service POSITION DESCRIPTION Dementia Clinical Nurse Specialist CMDHB Dementia Care Service Date Produced October 2012 Reviewed: Position Holder's Name : Position Holder's Signature :... Manager / Supervisor's

More information

Clinical Nurse Specialist Palliative Care Position Description

Clinical Nurse Specialist Palliative Care Position Description Date: February 2018 Job Title : Department : Hospital Palliative Care Service Location : North Shore Hospital/Waitakere Hospital, Specialty Medicine and Health of Older People Division Reports to [Line]

More information

SMO Gastroenterology and General Medicine Position Description

SMO Gastroenterology and General Medicine Position Description Date: March 2013 Job Title : Senior Medical Officer Gastroenterology and General Department : Gastroenterology Location : Waitemata District Health Board Reporting to : Clinical Director Gastroenterology

More information

Operations Manager - Outpatients

Operations Manager - Outpatients Date: July 2017 Job Title : Operations Manager Outpatients Surgical and Ambulatory Services Department : Surgical & Ambulatory Services Location : All WDHB sites, including North Shore and Waitakere Hospitals

More information

EMPLOYEE HEALTH AND WELLBEING STRATEGY

EMPLOYEE HEALTH AND WELLBEING STRATEGY EMPLOYEE HEALTH AND WELLBEING STRATEGY 2015-2018 Our community, we care, you matter... Document prepared by: Head of HR Services Version Number: Review Date: September 2018 Employee Health and Wellbeing

More information

Job Description. Clinical Nurse Coordinator Perioperative Department Acute Theatres

Job Description. Clinical Nurse Coordinator Perioperative Department Acute Theatres Job Description Clinical Nurse Coordinator Perioperative Department Acute Theatres Report To: Liaise with: Clinical Nurse Manager Perioperative Department Perioperative Associate Clinical Nurse Managers

More information

Operations Manager ORL

Operations Manager ORL Date: October 2016 Job Title : Operations Manager ORL Surgical and Ambulatory Services Department : Surgical & Ambulatory Services Location : All WDHB sites, including North Shore and Waitakere Hospitals

More information

Senior Outpatient Physiotherapist

Senior Outpatient Physiotherapist Date: 2017 Job Title : Senior Outpatient Physiotherapist Department : Allied Health Specialty Medicine and Health of Older People Service Location : Waitemata District Health Board Reporting To : Allied

More information

NHS Somerset CCG OFFICIAL. Overview of site and work

NHS Somerset CCG OFFICIAL. Overview of site and work NHS Somerset CCG Overview of site and work NHS Somerset CCG comprises 400 GPs (310 whole time equivalents) based in 72 practices and has responsibility for commissioning services for a dispersed rural

More information

Specialty Nurse Challenging Behaviours Medicine & Health of Older People

Specialty Nurse Challenging Behaviours Medicine & Health of Older People Specialty Nurse Challenging November 2015 Job Title : Specialty Nurse - Challenging Behaviours This is a pilot role for 6 months: January to June 2016 Department : Medicine and Health of Older Location

More information

Clinical Nurse Specialist Position Description

Clinical Nurse Specialist Position Description Clinical Nurse Specialist Pain Date: Dec 2015 Job Title : Pain Clinical Nurse Specialist Department : Department of Anaesthesia Location : North Shore Reports to [Line] Reports to [Professional] : Director

More information

Occupational Therapist

Occupational Therapist Occupational Therapist Location: Service Type: Responsible to: Accountable to: Appraisal Role Level: Role Level 3 Discharge to Assess Lead Occupational Therapist Clinical Hub Lead Main Purpose The post

More information

Integration. Rosemary Minto Adult Family Nurse Practitioner Chair NZCPHCN, NZNO

Integration. Rosemary Minto Adult Family Nurse Practitioner Chair NZCPHCN, NZNO Integration Rosemary Minto Adult Family Nurse Practitioner Chair NZCPHCN, NZNO Integrated Care a relentless focus on the needs of the patient We may need to throw a rock at a tiger to get changes happening

More information

Comprehensive Primary Care: What Patient Centred Medical Home models mean for Australian primary health care

Comprehensive Primary Care: What Patient Centred Medical Home models mean for Australian primary health care Comprehensive Primary Care: What Patient Centred Medical Home models mean for Australian primary health care WA Primary Health Alliance September 2016 e info@wapha.org.au t 08 6272 4900 2-5, 7 Tanunda

More information

SMO ORTHOPAEDICS - Spine Position Description

SMO ORTHOPAEDICS - Spine Position Description Date: March 2013 Job Title : Senior Medical Officer Orthopaedic Spine Surgeon (Locum) Department : Orthopaedics Location : Waitemata District Health Board Reporting to : Clinical Director Orthopaedics

More information

Clinical Director - Primary Care Position Description

Clinical Director - Primary Care Position Description Date: May 2010 Job Title : Clinical Director Primary Care Department : Planning and Funding Location : Funding and Planning team, Shea Tce. North shore Hospital Reporting To : Director Integration and

More information

Operations Manager Orthopaedic Surgery

Operations Manager Orthopaedic Surgery Date: June 2017 Job Title : Operations Manager Department : Orthopaedic Service Location : All WDHB sites, including North Shore and Waitakere Hospitals Reporting To Clinical/Management Partnership : :

More information

Operations Manager - WDHB ORL and Urology Surgical and Ambulatory Services

Operations Manager - WDHB ORL and Urology Surgical and Ambulatory Services Date: July 2014 Job Title : Operations Manager ORL and Urology Department : Surgical & Ambulatory Services Location : All WDHB sites, including North Shore and Waitakere Hospitals Reports to : GM S&AS

More information

Patient Centred Medical Home Self-assessment (PCMH-A)

Patient Centred Medical Home Self-assessment (PCMH-A) Centred Medical Home Self-assessment (PCMH-A) Practice name: Your name: Date completed: For more information, contact: Colleen Watkins, NQPHN Chronic Care Team m: 0 0 e: info@nqpcmh.com.au w: nqpcmh.com.au

More information

SWLCC Update. Update December 2015

SWLCC Update. Update December 2015 SWLCC Update Update December 2015 Croydon, Kingston, Merton, Richmond, Sutton and Wandsworth NHS Clinical Commissioning Groups and NHS England Working together to improve the quality of care in South West

More information

California Academy of Family Physicians Diabetes Initiative Care Model Change Package

California Academy of Family Physicians Diabetes Initiative Care Model Change Package California Academy of Family Physicians Diabetes Initiative Care Model Change Package Introduction The Care Model (CM) is a unique and proven approach for implementing proactive strategies that are responsive

More information

PATIENT-CENTERED MEDICAL HOME ASSESSMENT (PCMH-A)

PATIENT-CENTERED MEDICAL HOME ASSESSMENT (PCMH-A) SAFETY NET MEDICAL HOME INITIATIVE PATIENT-CENTERED MEDICAL HOME ASSESSMENT (PCMH-A) Organization name Site name Date completed Introduction To The PCMH-A The PCMH-A is intended to help sites understand

More information

NATIONAL TOOLKIT for NURSES IN GENERAL PRACTICE. Australian Nursing and Midwifery Federation

NATIONAL TOOLKIT for NURSES IN GENERAL PRACTICE. Australian Nursing and Midwifery Federation NATIONAL TOOLKIT for NURSES IN GENERAL PRACTICE Australian Nursing and Midwifery Federation Acknowledgements This tool kit was prepared by the Project Team: Julianne Bryce, Elizabeth Foley and Julie Reeves.

More information

Nurse Case Manager (Regional Pacific) Pacific Health Development

Nurse Case Manager (Regional Pacific) Pacific Health Development POSITION DESCRIPTION Nurse Case Manager (Regional Pacific) Pacific Health Development Position Holder's Name:... Position Holder's Signature:... Manager/Supervisor's Name:... Manager/Supervisor's Signature:...

More information

GREY BRUCE CHRONIC DISEASE PREVENTION AND MANAGEMENT FRAMEWORK

GREY BRUCE CHRONIC DISEASE PREVENTION AND MANAGEMENT FRAMEWORK GREY BRUCE CHRONIC DISEASE PREVENTION AND MANAGEMENT FRAMEWORK IMPLEMENTATION TOOL KIT Bumstead, L., Goetz-Perry, C., Miller, L., Solomon, M. (2008) 1 WHERE DID THE CDPM FRAMEWORK COME FROM? Wagner (1999)

More information

POSITION DESCRIPTION

POSITION DESCRIPTION POSITION DESCRIPTION TITLE: Charge Nurse, Oncology Outpatients REPORTS TO: Nurse Unit Manager PROFESSIONAL REPORTING: Nurse Unit Manager LOCATION: Auckland City Hospital (Grafton) AUTHORISED BY: Nurse

More information

HEALTH CARE HOME ASSESSMENT (HCH-A)

HEALTH CARE HOME ASSESSMENT (HCH-A) HEALTH CARE HOME ASSESSMENT (HCH-A) To be used by Health Care Homes involved in stage one implementation To asses practice readiness, monitor progress, and for evaluation purposes. Practice name Your name

More information

PG snapshot Nursing Special Report. The Role of Workplace Safety and Surveillance Capacity in Driving Nurse and Patient Outcomes

PG snapshot Nursing Special Report. The Role of Workplace Safety and Surveillance Capacity in Driving Nurse and Patient Outcomes PG snapshot news, views & ideas from the leader in healthcare experience & satisfaction measurement The Press Ganey snapshot is a monthly electronic bulletin freely available to all those involved or interested

More information

Position title: Nurse Coordinator Nurse Entry to Practice (NETP) & Graduate Programme (Mental Health)

Position title: Nurse Coordinator Nurse Entry to Practice (NETP) & Graduate Programme (Mental Health) POSITION DESCRIPTION Position title: Nurse Coordinator Nurse Entry to Practice (NETP) & Graduate Programme (Mental Health) Date Produced/Reviewed: November 2012 Position Holder's Name: Position Holder's

More information

grampian clinical strategy

grampian clinical strategy healthfit caring listening improving grampian clinical strategy 2016 to 2021 1 summary version For full version of the Grampian Clinical Strategy, please go to www.nhsgrampian.org/clinicalstrategy Document

More information

Managing Chronic Conditions with the Help of Value Net Integrator and Shared Infrastructure ebusiness Models.

Managing Chronic Conditions with the Help of Value Net Integrator and Shared Infrastructure ebusiness Models. Managing Chronic Conditions with the Help of Value Net Integrator and Shared Infrastructure ebusiness Models. Susan Lambert School of Commerce, Flinders University of SA Commerce Research Paper Series

More information

Charge Nurse Manager Adult Mental Health Services Acute Inpatient

Charge Nurse Manager Adult Mental Health Services Acute Inpatient Date: February 2013 DRAFT Job Title : Charge Nurse Manager Department : Waiatarau Acute Unit Location : Waitakere Hospital Reporting To : Operations Manager Adult Mental Health Services for the achievement

More information

POSITION DESCRIPTION

POSITION DESCRIPTION POSITION DESCRIPTION POSITION DETAILS: TITLE: Deputy Chief Nursing Officer REPORTS TO: Chief Nursing Officer LOCATION: Grafton / Greenlane AUTHORISED BY: Chief Executive Officer DATE: August 2018 PRIMARY

More information

4. Hospital and community pharmacies

4. Hospital and community pharmacies 4. Hospital and community pharmacies As FIP is the international professional organisation of pharmacists, this paper emphasises the role of the pharmacist in ensuring and increasing patient safety. The

More information

FIP STATEMENT OF POLICY Pharmacy: Gateway to Care

FIP STATEMENT OF POLICY Pharmacy: Gateway to Care Preamble Knowledge, prevention and management of disease has changed dramatically in recent decades. In addition to the responsibility of governments to provide the fundamental right of health, citizens

More information

NURS6031 Leadership and Collaborative Practice

NURS6031 Leadership and Collaborative Practice NURS6031 Leadership and Collaborative Practice Lecture 1a (Week -1): Becoming a professional RN What is a professional? Mastery of specialist theoretical knowledge Autonomy and control over your work and

More information

Outpatient Dietitian

Outpatient Dietitian POSITION DESCRIPTION Outpatient Dietitian Date Produced/Reviewed: Position Holder's Name:... Position Holder's Signature:... Manager/Supervisor's Name:... Manager/Supervisor's Signature:... Date:... Document

More information

Self Care in Australia

Self Care in Australia Self Care in Australia A roadmap toward greater personal responsibility in managing health March 2009. Prepared by the Australian Self-Medication Industry. What is Self Care? Self Care describes the activities

More information

Generic Registered Nurse

Generic Registered Nurse POSITION DESCRIPTION Generic Registered Nurse Date Produced/Reviewed: July 2007 Position Holder's Name : Position Holder's Signature :... Manager / Supervisor's Name : Manager / Supervisor's Signature

More information

Sir John Oldham National Clinical Lead Quality and Productivity NHS England Jan 2010

Sir John Oldham National Clinical Lead Quality and Productivity NHS England Jan 2010 Sir John Oldham National Clinical Lead Quality and Productivity NHS England Jan 2010 Long term conditions 70% health and social care cost in UK 76% unscheduled admissions 55% GP consultations 93% Medicare

More information

Speech Language Therapist Position Description

Speech Language Therapist Position Description Date: September 2017 Job Title : Department : Child Rehabilitation Service Location : Wilson Centre Reporting To : Therapy Manager, Child Rehabilitation Service Functional Relationships with : Internal

More information

Clinical Director. Position Description

Clinical Director. Position Description Clinical Director Position Description About Pathways and the Wise Group Pathways At Pathways, we provide community-based mental health, addiction and wellbeing services throughout New Zealand. Every year

More information

Directorate/Department: Relevant Trust care group e.g. cancer care Faculty of Health Sciences, University of Southampton Grade: AfC Band 5

Directorate/Department: Relevant Trust care group e.g. cancer care Faculty of Health Sciences, University of Southampton Grade: AfC Band 5 Post Title: Agenda for Change: Job Description Staff Nurse & Clinical Doctoral Fellow Directorate/Department: Relevant Trust care group e.g. cancer care Faculty of Health Sciences, University of Southampton

More information

Position Description: headspace Frankston - Aboriginal Health Liaison Worker

Position Description: headspace Frankston - Aboriginal Health Liaison Worker Vision: Purpose: Values: A community where all young people are valued, included and have every opportunity to thrive To enable young people experiencing serious disadvantage to access the resources and

More information

Strategic Plan

Strategic Plan Strategic Plan 2013-2025 Toi Te Ora Public Health Service (Toi Te Ora) is one of 12 public health units funded by the Ministry of Health and is the public health unit for the Bay of Plenty and Lakes District

More information

WORKING DRAFT. Standards of proficiency for nursing associates. Release 1. Page 1

WORKING DRAFT. Standards of proficiency for nursing associates. Release 1. Page 1 WORKING DRAFT Standards of proficiency for nursing associates Page 1 Release 1 1. Introduction This document outlines the way that we have developed the standards of proficiency for the new role of nursing

More information

Floor Co-ordinator PACU

Floor Co-ordinator PACU Date: June 2013 Job Title : Floor Coordinator PACU Department : Surgical Unit Location : North Shore Hospital Reporting To : Charge Nurse Manager PACU Direct Reports : Registered Nurses Enrolled Nurses

More information

Social Worker, Specialty Medicine and Health of Older People, Acute and Emergency Medicine, and Surgical and Ambulatory Service - Renal

Social Worker, Specialty Medicine and Health of Older People, Acute and Emergency Medicine, and Surgical and Ambulatory Service - Renal Date: February 2018 Job Title : Social Worker, Allied Health, North and West Department : Medicine, and Surgical and Ambulatory Service Location : North Shore and Waitakere Reporting To : 1. Allied Health

More information

POSITION DESCRIPTION

POSITION DESCRIPTION POSITION DESCRIPTION POSITION DETAILS: TITLE: SENIOR RADIATION THERAPIST PROFESSION: RADIATION THERAPY REPORTS TO - OPERATIONALLY: Clinical Team Leaders Treatment/Pre-Treatment PROFESSIONALLY: Professional

More information

The Nursing Council of Hong Kong

The Nursing Council of Hong Kong The Nursing Council of Hong Kong Core-Competencies for Registered Nurses (Psychiatric) (February 2012) CONTENT I. Preamble 1 II. Philosophy of Psychiatric Nursing 2 III. Scope of Core-competencies Required

More information

SCOTTISH BORDERS HEALTH & SOCIAL CARE INTEGRATED JOINT BOARD UPDATE ON THE DRAFT COMMISSIONING & IMPLEMENTATION PLAN

SCOTTISH BORDERS HEALTH & SOCIAL CARE INTEGRATED JOINT BOARD UPDATE ON THE DRAFT COMMISSIONING & IMPLEMENTATION PLAN Appendix-2016-59 Borders NHS Board SCOTTISH BORDERS HEALTH & SOCIAL CARE INTEGRATED JOINT BOARD UPDATE ON THE DRAFT COMMISSIONING & IMPLEMENTATION PLAN Aim To bring to the Board s attention the Scottish

More information

Milton Keynes CCG Strategic Plan

Milton Keynes CCG Strategic Plan Milton Keynes CCG Strategic Plan 2012-2015 Introduction Milton Keynes CCG is responsible for planning the delivery of health care for its population and this document sets out our goals over the next three

More information

Economic Evaluation of the Implementation of an Electronic Palliative Care Coordination System (EPaCCS) in Lincolnshire using My RightCare

Economic Evaluation of the Implementation of an Electronic Palliative Care Coordination System (EPaCCS) in Lincolnshire using My RightCare Economic Evaluation of the Implementation of an Electronic Palliative Care Coordination System (EPaCCS) in Lincolnshire using My RightCare This paper will provide an economic assessment of utilising the

More information

Nursing Developments in Primary Health Care A Summary. NZ Nursing At the heart of health care

Nursing Developments in Primary Health Care A Summary. NZ Nursing At the heart of health care Nursing Developments in Primary Health Care 2001 2007 A Summary 2009 NZ Nursing At the heart of health care Nursing Developments in Primary Health Care 2001 2007 A Summary 1 Acknowledgement The report

More information

Organisational Vision The CDHB s vision is to improve the health and well being of the people living in Canterbury. CLINICAL NURSE SPECIALIST

Organisational Vision The CDHB s vision is to improve the health and well being of the people living in Canterbury. CLINICAL NURSE SPECIALIST POSITION DESCRIPTION This Position Description is a guide and will vary from time to time and between services and/or units to meet changing service needs April 2015 The Canterbury District Health Board

More information

Social Worker, Renal Service Allied Health, WDHB Position Description

Social Worker, Renal Service Allied Health, WDHB Position Description Date: 2013 Job Title : Social Worker - Renal Service and Inpatient teams North and West Department : Medicine & Health of Older People, Surgical & Ambulatory Location : North Shore Hospital & Waitakere

More information

POSITION PROFILE: ABORIGINAL HEALTH WORKER - GENERIC

POSITION PROFILE: ABORIGINAL HEALTH WORKER - GENERIC POSITION PROFILE: ABORIGINAL HEALTH WORKER - GENERIC Position Details Position Title: Employment Status: Permanent Classification: AHW Class 2-6 Salary Range: $41,782 - $85,015 Reports To: Location: Health

More information

Youth AOD Worker - Outreach Box Hill

Youth AOD Worker - Outreach Box Hill Vision: Purpose: Values: A community where all young people are valued included and have every opportunity to thrive To enable young people experiencing serious disadvantage to access the resources and

More information

Child Rehabilitation Service. Physiotherapist

Child Rehabilitation Service. Physiotherapist Date: October 2016 Job Title : Department : Child Rehabilitation Service Location : Wilson Centre Reporting To : Therapy Manager, Child Rehabilitation Service Direct Reports : Nil Functional Relationships

More information

Nurse Educator Child Health- Public Health Nursing Position Description

Nurse Educator Child Health- Public Health Nursing Position Description : September 2015 Job Title : Nurse Educator (0.8) Department : Child Women and Family Service. Location : Across sites where public health nursing teams are located Reporting To : Head of Division Nursing,

More information

Clinic Administrator

Clinic Administrator Date: September 2010 Job Title : Clinic Administrator Pain Management Department : Anaesthetic Department Reporting To : Operations Manager, Theatres, Anaesthesia and SSU. Direct Reports : Nil Functional

More information

CPC+ CHANGE PACKAGE January 2017

CPC+ CHANGE PACKAGE January 2017 CPC+ CHANGE PACKAGE January 2017 Table of Contents CPC+ DRIVER DIAGRAM... 3 CPC+ CHANGE PACKAGE... 4 DRIVER 1: Five Comprehensive Primary Care Functions... 4 FUNCTION 1: Access and Continuity... 4 FUNCTION

More information

Occupational Therapist - Community Specialist Mental Health and Addictions Services Position Description

Occupational Therapist - Community Specialist Mental Health and Addictions Services Position Description Date: January 2017 Job Title : Occupational Therapist - Community Department : Location : Adult Community Mental Health Services (North, West or Rodney) Reporting To : Team Manager Direct Reports : None

More information

POSITION DESCRIPTION

POSITION DESCRIPTION POSITION DESCRIPTION Position details: Title: Reports to: Reports professionally to: Date: Charge Nurse Te Whetu Tawera Nurse Manager Nurse Director Mental Health and Addiction Healthcare Service Group

More information

Registered Nurse Clinical Coach ICU/HDU

Registered Nurse Clinical Coach ICU/HDU Date June 2016 Job Title : Registered Nurse Clinical Coach Department : Intensive Care / High Dependency Unit : Location : North Shore Hospital Reporting To : Charge Nurse Manager for operational support

More information

Clinical Centre Leader - Occupational Therapy (0.5fte)

Clinical Centre Leader - Occupational Therapy (0.5fte) Date: August 2015 Job Title : Clinical Centre Leader - Occupational Therapy (0.5FTE) Department : Allied Health Location : Waitemata District Health Board (Waitemata DHB) Reporting To : Head of Division

More information

Quality Improvement Strategy 2017/ /21

Quality Improvement Strategy 2017/ /21 Quality Improvement Strategy 2017/18-2020/21 Contents Section Title Page Number Foreword from Chair and Chief Executive 2 Section 1 Introduction What does Quality mean to us? What do we want to achieve

More information

Clinical Support Coordinator Clinical Support Services Position Description

Clinical Support Coordinator Clinical Support Services Position Description Date: March 2014 (Review March 2015) Job Title : Clinical Support Coordinator Waitakere Hospital Department : Hospital Operations Location : WDHB, North Shore and Waitakere Hospitals Reporting To Operations

More information

Paediatric Nurse Specialist Continence

Paediatric Nurse Specialist Continence Date: April 2015 Job Title : Paediatric Nurse Specialist Continence Department : Child Women and Family Service Location : Reporting To : Unit manager community for the achievement of service and operational

More information

Clinical Nurse Specialist Breast Cancer & Breast Reconstruction

Clinical Nurse Specialist Breast Cancer & Breast Reconstruction Date : January 2018 Position Title : Clinical Nurse Specialist - Department : Surgical Services. Location : Waitemata District Health Board Reporting To : Head of Division Nursing Surgical and Ambulatory

More information

OUR COMMITMENTS TO CARE A STRATEGY FOR NURSES & ALLIED HEALTH PROFESSIONALS

OUR COMMITMENTS TO CARE A STRATEGY FOR NURSES & ALLIED HEALTH PROFESSIONALS OUR COMMITMENTS TO CARE A STRATEGY FOR NURSES & ALLIED HEALTH PROFESSIONALS Version: 2 Ratified by: Trust Board Date ratified: January 2014 Name of originator/author: Acting Head of Nursing Nursing & AHP

More information

Retrieval Fellow. SA Ambulance Service (SAAS) Adelaide Metro Adelaide Airport MDP3G

Retrieval Fellow. SA Ambulance Service (SAAS) Adelaide Metro Adelaide Airport MDP3G SA Health Job Pack Job Title Retrieval Fellow Job Number 570105 Applications Closing Date 30 July 2016 Region / Division Health Service Location Classification SA Ambulance Service (SAAS) Rescue, Retrieval

More information