Rural Pulmonary Rehab Program-

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1 Rural Pulmonary Rehab Program- Saskatchewan s s First Presented by: Sandra Pieterse, Nurse Practitioner and Lia Boxall, Nurse Practitioner Kelsey Trail Health Region

2 Kelsey Trail RHA 41,500 population 53% over 40 yrs of age 9.5% are First Nations 3 District Hospitals and 3 Community Hospitals 116 acute care beds 7 PHC sites 8 Telehealth locations

3 Respiratory Data Acute Admissions KTHR # of admissions COPD Asthma

4 Why Pulmonary Rehab? COPD is the fourth most common cause of hospitalization ti among men and the sixth most common cause of hospitalization among women By 2020, it is estimated that COPD will be the third leading cause of death world wide It is the only chronic disease with increasing mortality

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7 Physician Engagement g Current COPD Best Practice guidelines summary taken to MAC meeting Formal request from MAC for Pulmonary Rehab in KTHR Breathworks Resource Kits were distributed ib t d to all MD s prior to the MAC

8 Supportive Initiatives Live Well with Chronic Conditions Program is available in 9 communities KTHR Tobacco Free Policy Apr 2011-in effect KTHR Tobacco Brief Interventions by providers Jan 2010

9 Overview Health Quality Council of SK focused on management of COPD Collaboration between Primary Health Care and Therapies Made use of Saskatchewan Lung Association s s COPD Toolkit Exercised in individual sites and used telehealth for education

10 Telehealth At a Glance Telehealth Saskatchewan is a Sask Health program with an effective approach to improve access to health services. Telehealth Saskatchewan uses communication and information technology to support the delivery of clinical care and professional education services.

11 Using live, two-way videoconferencing, health care providers can enable a remote patient to visit' an out-of-town health care provider from their home community rather than having to travel

12 KTHR Telehealth Program 9 sites in KTHR Good distribution throughout the region 3 main hospitals Access to full array of services that are needed to management Chronic Diseases and other Healthcare issues

13 Why Use Telehealth? Increase access to HCP in the region Reduce Travel (both providers and clients) Better use of regional resources time management

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15 Who Can Participate

16 Focus on small group education and exercise sessions Goals Help patients breathe easily Increase activity Decrease hospital stay time and admissions Fewer respiratory infections Encourage patients to expect more and enjoy life!

17 The Process Booking time, space, people Obtaining referrals Physicians, NP s s, HCW Inclusion and exclusion criteria Booking clients for preliminary assessment Subjective and objective assessments St. Georges Questionnaire 6 minute walk test Introduced the Action Plan

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19 The Program Started with education first in the initial session followed by one hour of exercise In the following sessions we exercised first then took part in education Exercise sessions Monitored RPE, SOB, SpO2, HR, BP, time, reps

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21 Discharge Living Well with Chronic Conditions Discharge assessment 6 minute walk test St. George s Questionnaire Summary to referring physicians/np s Community walking programs

22 Improved Access

23 Results Minute Walk Test Feet Pre Post

24 Results 80 St George's Symptom Activity Impacts Total Pre Post

25 Participants Responses Most reported useful information was the breathing techniques for relaxation and for exertion All would recommend to family and friends All feel that they benefited from the program and feel more confident about their health What changes were recommended: More class time Not to run during seeding, not to run in winter Some lecturers spoke too quietly Information on what the final days are like before you die.

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27 Questions?

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