National Disparities LAN Event Managing the Opioid Crisis: Perspectives from Rural Communities Wednesday, March 14, 2018 3:00 4:30 PM ET
Welcome and Reminders Please be prepared for sharing and open discussion Slides and a recording from today s session can be found on: http://qioprogram.org/nationaldisparities-lan-event-march-2018 Melanie Wasserman Event Lead Nora Serres Chat Manager
Agenda Continuing Education (CE) Details Quick Recap January 10 Medication Safety LAN Event Sarah Schoonman, Patient Jennifer Goulet, Community Health Worker Discussion Wrap-Up
Purpose of the Series Audience: Patients, community and healthcare providers, local partners, federal partners, and Quality Improvement Organization (QIO) Program partners (*registration required) Purpose: Offer virtual training and networking events to help you meet your goals for health equity, addressing disparities, and optimal health for all Expectations: Participants will gain knowledge that is directly applicable to their work in healthcare quality improvement and acquire information that can be easily shared among their own community, organization, or team Topics: Topics will be aligned with the CMS Quality Strategy goals
Learning Outcomes Identify at least one process improvement you can make to manage patients pain in a way that is even safer, more effective, and patient- centered Describe at least one example of how communities have helped individuals to safely manage pain Explain how community health workers can support safe and patient-centered pain management
Things to Think About Will you commit to being Attentive Active Actionable Show your commitment by clicking the green checkmark!
Continuing Education Credit Continuing education credit is available for: Physicians and Physician Assistants Registered Nurses and Nurse Practitioners Dietitians Pharmacists and Pharmacy Technicians Certificate of Attendance
Instructions for Obtaining CE Attend the entire event Complete the evaluation that will pop up at the conclusion of the event There is a separate evaluation required for CE that will load in your browser following completion of the general evaluation Once you submit your CE evaluation, you will be provided with a certificate to retain for your records For technical assistance, please email Patty Nelson (patty.nelson@qinncc.hcqis.org)
CE Information Physicians: This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of AKH Inc., Advancing Knowledge in Healthcare, CRW & Associates and Telligen. AKH Inc., Advancing Knowledge in Healthcare is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for Physicians. AKH Inc., Advancing Knowledge in Healthcare designates this live activity for a maximum of 1.5 AMA PRA Category 1 Credit(s). Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physician Assistants: NCCPA accepts AMA PRA Category 1 Credit from organizations accredited by ACCME. Pharmacy: AKH Inc., Advancing Knowledge in Healthcare is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. AKH Inc., Advancing Knowledge in Healthcare approves this knowledge-based activity for 1.5 contact hours (0.15 CEUs). UAN 0077-9999-18-014-L04-P; UAN 0077-9999-18-014- L04-T. Initial Release Date 3/14/2018 1
CE Information, Continued Registered Nurses: AKH Inc., Advancing Knowledge in Healthcare is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. This activity is awarded 1.5 contact hours. Nurse Practitioners: This activity has been planned and implemented in accordance with the accreditation Standards of the American Association of Nurse Practitioners (AANP) through the joint providership of AKH Inc., Advancing Knowledge in Healthcare, CRW & Associates and Telligen. AKH Inc., Advancing Knowledge in Healthcare is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 030803 This activity is approved for 1.5 contact hour(s) which includes 0 hour(s) of pharmacology. Activity ID #218105 Dietitians: AKH Inc., Advancing Knowledge in Healthcare is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR). Registered dietitians (RDs) and dietetic technicians, registered (DTRs) will receive 1.5 continuing professional education units (CPEUs) for completion of this program/material. CDR Accredited Provider #AN008. The focus of this activity is rated Level 2. Learners may submit evaluations of program/materials quality to the CDR at www.cdrnet.org. 2
Disclosure of Financial Relationships & Commercial Support The planners and faculty do not have any relevant financial relationships to disclose. AKH Inc., CRW & Associates, The Lewin Group, and Telligen do not have any relevant financial relationships to disclose. No commercial support was received for this activity.
Disclosure of Financial Relationships & Commercial Support Disclosures: It is the policy of AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of its continuing education activities. The author must disclose to the participants any significant relationships with commercial interests whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflicts of interest are resolved by AKH prior to accreditation of the activity and may include any of or combination of the following: attestation to non-commercial content; notification of independent and certified CME/CE expectations; referral to National Author Initiative training; restriction of topic area or content; restriction to discussion of science only; amendment of content to eliminate discussion of device or technique; use of other author for discussion of recommendations; independent review against criteria ensuring evidence support recommendation; moderator review; and peer review. Disclosure of Unlabeled Use and Investigational Product: This educational activity may include discussion of uses of agents that are investigational and/or unapproved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Disclaimer: This course is designed solely to provide the healthcare professional with information to assist in his/her practice and professional development and is not to be considered a diagnostic tool to replace professional advice or treatment. The course serves as a general guide to the healthcare professional, and therefore, cannot be considered as giving legal, nursing, medical, or other professional advice in specific cases. AKH Inc. specifically disclaim responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through participant's misunderstanding of the content.
Method of Participation You must participate in the entire activity to receive credit. A statement of credit will be available upon completion of an online evaluation/claimed credit form. The link to the online evaluation will be provided after completion of the activity. If you have questions about this CME/CE activity, please contact AKH Inc. at service@akhcme.com.
Who s in the room? What entity or type of organization do you represent? CMS Home Health Agency Hospital Nursing Home/Skilled Nursing Facility Patient, Family, or Caregiver Representative Pharmacy/Pharmacist Provider/Practice QIN-QIO Other (please specify in chat)
Meet Your Speakers Sarah Schooman Patient and Health Information Management Professional Jennifer Goulet Community Health Worker Melanie Wasserman, PhD Managing Consultant The Lewin Group
Recap from January 10 Medication Safety LAN Pain has a psychological component; can be managed to reduce opioid use Expert how to advice from Dr. Amy Wachholtz, University of Colorado, Denver Example of a community-based educational intervention from Mitzi Daffron, QSource Slides and recording available at: http://qioprogram.org/medication-safety-lan-eventjanuary-2018
What s Different about Today s Call Pain has a practical component too; can be managed to reduce opioid use Patient and Community Health Worker perspective Slides and recording available at: http://qioprogram.org/national-disparities-lan-eventmarch-2018
Campaign for Meds Management: Mission Identify and promote resources and interventions that support the following: Improve medication use and management, especially in high-risk medication populations High-risk medications include opioids, anticoagulants, and diabetic drugs Advance patient-centered shared decision-making Emphasize the patient voice in healthcare Disseminate favorable resources and tools utilized, promoted, and/or created by QIN-QIOs http://qioprogram.org/campaign-meds-management
Call to Action: Join the CMM http://qioprogram.org/campaign-medsmanagement Who should join the CMM EVERYONE
Sarah s Story Sarah Schoonman Patient and Health Information Management Professional
Questions to run on Patients: How does Sarah s experience resonate with your own? Clinicians: What s a process improvement you can make to better support patients like Sarah? I ll ask you these questions again after Sarah s presentation
A Community Health Worker s Perspective Jennifer Goulet Community Health Worker
Questions to run on How have communities helped individuals to safely manage pain? How can community health workers (CHWs) support safe and patient-centered pain management?
Community Health Workers A Resource for the Community Jennifer Goulet, CHW March, 14, 2018
Overview What is a Community Health Worker (CHW) North Country (New Hampshire) Culture North Country Demographics Rural Challenges Social Determinants of Health North Country Health Consortium s (NCHC) CHW Program CHWs and Pain Management
What is a Community Health Worker (CHW)?
American Public Health Association Definition A community health worker is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. Liaison Link Intermediary
Various Titles of the Community Health Worker! Wellness Coach Outreach Worker Home Visitors Case Manager
Thriving and Surviving in the North Country
North Country Culture Culture is defined as a congruent set of practices, attitudes and beliefs that shape people s way of surviving. A culture of poverty exists in northern NH. There is diversity among the socioeconomic classes.
North Country Demographics
Rural Challenges Live Free or Die is the NH state motto which is taken very seriously by NH citizens especially in the most northern and rural areas, also referred to as the North Country. The rural nature of the area coupled with the region s culture of fierce independence creates unique challenges. North Country residents face many of the same barriers to health as the rest of the state and country, however, these barriers are further complicated by culture, independence and access. We are challenged with the same social determinants of health, however, in a very different setting.
Social Determinants of Health The social determinants of health are the economic and social conditions and their distribution among the population that influence individual and group differences in health status. Access to Healthcare Transportation Housing Social Support Financial Instability Health Literacy AND SO MUCH MORE To improve the health of our populations, we must address the socioeconomic and behavioral factors that influence the majority of health.
CHW Program The current model is grant funded, supported by state and federal funds Partnered with health centers and human service organizations Specific Focus Women s Health and preventative Screenings Chronic Disease Self-Management Chronic Disease Self-Management for adults 65+
CHWs and Chronic Pain Clients Credit: Christina McCann, Joint Base Elmendorf-Richardson Public Affairs
Patient Engagement A concept that combines a patient's knowledge, skills, ability and willingness to manage their own health and healthcare with an intervention to promote and increase that participation.
The CHW and Patient Engagement Teach Self-Management Skills Make Resource Connections Provide Tools for Ongoing Self-Management Build Decision Making Skills Improve Health Literacy Provide Education Teach Advocacy Skills The CHW meets the Patient where they are at.
Peeling the Onion This Photo by Unknown Author is licensed under CC BY-NC-SA
Road Blocks in Pain Management Culture Mental Health Literacy Lack of Services Accessibility Communication Social Isolation
The Community Health Worker is often the only member of the healthcare team who can address the whole person and not just the immediate problem!!!
Thank You!
Facilitated Discussion Chat in your questions and comments. Press *1 on your telephone key pad to enter the teleconference queue.
Individual Reflection What are your key takeaways?
Call to Action: Join the CMM http://qioprogram.org/campaign-medsmanagement Who should join the CMM EVERYONE
More Calls to Action Involve patients and CHWs in treatment plans Close the loop on referrals Inform patients on pain management, treatment options, and safe use of opioid and non-opioid medications when prescribed Complete the post-event assessment upon exiting WebEx: https://www.surveymonkey.com/r/8scpgxz
Call For Future Topics We want to hear from you! Do you have a need or desire to hear about a certain topic? Submit your ideas in chat or email us at: QINNCC@area-d.hcqis.org
2018 Million Hearts Hypertension Control Challenge Identify clinicians, clinical practices, and health systems that meet the Million Hearts 2022 target* for hypertension control Application cycle: February 20 th, 2018 - April 6 th, 2018 https://millionhearts.hhs.gov or https://www.challenge.gov *At or above 80% hypertension control rate (<140 mmhg systolic and <90 mmhg diastolic) of adult population 18-85
Save the Date! Join us for the next: Medication Safety LAN Event, Wed. April 11, 2018 National LAN Event, Wed. May 9, 2018 National Disparities LAN Event, Wed. June 13, 2018 Registration is required! Register at: qualitynet.webex.com
Follow the QIO Program on Social Media! https://twitter.com/qioprogram https://www.youtube.com/channel/ucp- 3KliHRoKeozEs-7ohQnw
Thank you! This material was prepared by Telligen, the Quality Innovation Network National Coordinating Center, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 11SOW-QINNCC-01928-02/21/18