Objectives. About Allina Health

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1 Innovative Delivery Models: Lay Healthcare Workers Transforming Patient Melissa Hutchison, MPH and Amanda Hunt, MPH October 2015 Objectives Articulate the increasing importance of lay healthcare workers in care delivery Summarize two successful care models currently in practice that are primarily focused on relationships with patients Identify resources available for implementation and evaluation within your practice 2 About Allina Health 3 1

2 Copilot Institute Partnering to transform care delivery through the use of lay healthcare workers The Institute partners with experts to gather knowledge and study the use of lay healthcare workers in care delivery. The Institute and its partners co-create practical tools and resources to translate research into practice. The Institute works with organizations to support the adoption and ongoing evaluation of lay healthcare workers in care delivery. 4 Why Lay Healthcare Workers? 5 Why Lay Healthcare Workers (LHWs)? Background Healthcare has become very expensive Triple Aim & ACA pressures More consumer influence to improve quality Current structure is not sustainable Need to understand & respond to multiple cultures Most factors affecting health occurs outside of the clinic Benefits of LHWs: Develop long-term relationships Fill gaps in care Bridge between community resources and healthcare Support traditional healthcare positions Diversify workforce, provide cultural competent support Are a lower cost solution 6 2

3 PHASE ONE PHASE TWO CURRENT STATE Lay Healthcare Workers at Allina Health Access Behavioral Analyst Management Community Coordinator Equity Independent Living Specialist Integrative Health & Wellness Coach LifeCourse Stroke Program What we learned as we looked within our own organization: 1. There are many different types of roles being used within our system, yet they are disconnected 2. There is no collective support for this workforce 3. Although there are obvious distinctions between the roles, there are shared functions and competencies across roles 7 Research Based Model: Model Recruiting s Empathetic, friendly, outgoing Understand limits of role Bilingual when needed At least 2 years college No experience required Training: 2 weeks; disease basics How to shop for medications Finding resources Documentation in EHR HIPAA, ethics Scope of practice Behavior change theory 8 Research Based Model: Model Reviewed team based care models and literature Three s One primary care clinic in Minneapolis, MN About 300 patients Randomized controlled trial 12 s 6 diverse primary care clinics in urban, suburban and rural areas in MN >2,100 patients Analyzed the impact the Model has on the Triple Aim Support the implementation and evaluation of the Model and its adaptations 9 3

4 Research Based Model: Model Improved patient health Improved patient experience Minimized cost of care 31% more likely to meet care goals than those with usual care 21% more likely to quit tobacco Enhanced social support Understood how to manage their illness Created a more positive perception of their care Patients had fewer hospitalizations & ED visits Enhanced care delivery teams at a low cost 94% of clinical staff thought they were an effective use of resources 10 The Model Research in Practice Access Management Equity LifeCourse Stroke Program 11 Research in Practice: LifeCourse The problem: Chronically ill patients utilize the majority of healthcare resources Patients and caregivers struggle to coordinate increasingly complex care across multiple care settings with multiple providers Non-medical factors play a large part in determining medical outcomes. is often based on what is the matter with you? and not what matters most to you? 12 4

5 Research in Practice: LifeCourse LifeCourse LifeCourse is a late life supportive care model that helps individuals and families navigate serious illness. It is part of a system strategy for addressing complex, serious illness, and for increasing access to palliative care. Focus: whole person care for people with serious illness Intervention: care guides work closely with patients and families, supported by an interdisciplinary team of clinicians 13 Research in Practice: LifeCourse Participant Outcomes Key Friends & Family Quality of Life* System Outcomes Experience*** Quality of Life** Goals honored Experience*** Team wellbeing Hospice Days Hospital Days Emergency Visits Total Cost of 14 * FACIT-PAL (Functional Assessment of Chronic Illness Therapy - Palliative ) ** PROMIS 29 (Patient Reported Outcome Measurement Information System) *** LifeCourse Experience tool Lay Healthcare Workers in Practice Behavior change within a traditional healthcare system is slow Leadership engagement has an impact on the direction of the work and ease of implementation Difficult to add innovative resources to an already tight economic situation New patient-focused roles in healthcare can be perceived as threatening to some clinical staff Building new programs require system/process changes across multiple functions (HR, IT, L&D, COMM.) 15 5

6 Next Steps Determine problem you re trying to solve. Identify your patient population. Identify existing LHW roles and models in practice. Engage stakeholders. Determine organizational capacity. Develop plan, including measurement. 16 Online Tools and Resources Visit: carecopilotinstitute.org Information about lay healthcare workers elearning modules Planning and evaluation templates Model research and resources 17 Questions? Amanda Hunt, MPH Melissa Hutchison, MPH

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