Chronic Care Model Workshop

Transcription

1 Chronic Care Model Workshop Overall Workshop Goal: To understand the Chronic Care Model and its six components. February 7, 2007~Lafayette Holiday Inn February 8, 2007 ~ West Monroe Conference Center Sponsored by DHH Bureau of Primary Care and Rural Health s Diabetes Control Program, & Heart Disease & Stroke Prevention Program with support from the Louisiana Rural Health Association Overcoming deficiencies in the current management of diseases such as diabetes, heart disease, depression, asthma and others will require nothing less than a transformation of health care from a system that is essentially reactive (responding mainly when a person is sick) to one that is proactive and focused on keeping a person as healthy as possible. The Chronic Care Model (CCM) offers a proactive, organized approach that supports the physician and engages the patient, as well as improves outcomes. This educational workshop is designed for all health care professionals, including your quality improvement team. We will offer a nuts-and-bolts description of the implementation of the Chronic Care Model, including its effects on patients and their clinical outcomes, as well as its effects on physicians and staff. Participants will be provided with toolkits to take back to their facilities to assist them with implementing the Chronic Care Model. Don t miss this wonderful FREE educational opportunity! Pick the location that is most convenient for you and plan to attend. Breakfast and lunch will be provided at no cost to all registered participants. Use the form enclosed in this publication to register, or visit the LRHA website, Questions regarding the workshop may be directed to Anne Marsh or Stacy Fontenot by calling LRHA at (985)

2 7:00 a.m. 8:00a.m. Registration and continental breakfast 8:00 a.m. 8:30 a.m. Welcome and Opening Remarks Kristy Nichols, Director, DHH Bureau of Primary Care and Rural Health 8:30 a.m. 9:00 a.m. A System of Care for Chronic Conditions Overview Jessica Sanchez, RN, MS, FNP West Central Cluster Team Support Manager Louisiana State Collaborative Coordinator 9:00 a.m. 12:15 p.m. In-depth Overview of the Chronic Care Model s Six Components 1) Self-Management Jessica Sanchez Understanding the central role of the patient is a vital key to managing illness. This session will help participants develop a framework for supporting patients by defining terms in self-management; educating the patient about self-management support; assisting the patient in setting self-management goals and teaching or improving action planning and problem-solving skills. This important session will provide hands-on training for the application of proven tools. 2) Delivery System of Care Margaret Ford, DON & Hugh Arnold, FCNP -The Medical Center, Sicily Island, LA Proactive delivery of patient care requires not only determining what care is needed, but defining and assigning roles and tasks. The proactive team must ensure that patients get the proper care; providers have centralized, up-to-date information about the patient s status; and that follow-up is a part of the standard procedure. This breakout session provides an overview of some ideas for change. 3) Decision Support: Diabetes Dr. Keith Ramsey, Iberia Comprehensive Community Health Center, New Iberia, LA This session will provide an overview of decision support for planning treatments for diabetes. Special attention will be given to help implement evidence-based guidelines. 10:30 a.m. 10:45 a.m. Break 4) Clinical Information Systems Rebecca Bradley, Project Manager -LA Rural Health Information Technology Partnership An information system that can track individual patients, as well as populations of patients, is a necessity when managing chronic illness. The focus of this session is to illustrate how the information system plays an integral role in successful integration of all of the elements of the CCM.

3 5) Organization of Health Care: The Business Case for the Organizational Transformation Nicole Roberson, PI Coordinator - Iberia Comprehensive Community Health Center, New Iberia, LA To effectively transform the reorganization of health care, senior leadership must recognize these efforts as important and vital, establishing clear goals that are reflected in health care policies, procedures, the business plan and financial planning. How can this be accomplished? This session will offer ideas on how to reach out and engage senior leadership and the Board of Directors; integrate the efforts into the organizational plans and accreditation/certification efforts; as well as involve the entire organization in plans for improvement. Challenges and common obstacles will be discussed. 6) Community Partnerships Speaker Panel Community programs and organizations can support and/or expand a health system s care for chronically ill patients. Unfortunately, these resources are often overlooked. Participants will learn about possible alliances and partnerships. 12:15 p.m. 1:15 p.m. Lunch 1:15 p.m. 2:00 p.m. Chronic Care Model in the LSU Health System Myra Varnado, RN Coordinator Diabetes Education and Diabetes Foot Program This presentation outlines a variety of chronic disease management initiatives undertaken by the LSU Health Care Services Division throughout the state of Louisiana. Specific emphasis of this presentation will be focused on the implementation processes and outcomes of a system wide, evidence-based Lower Extremity Amputation Prevention (LEAP) model program. 2:00 pm. 2:45 p.m. Model for Improvement and Accelerating Change Jessica Sanchez, West Central Cluster Team Support Lead & LA Collaborative Coordinator This session will provide an overview of the CCM and provide preparation for the first meeting of the health care team. Aims, team measures, population-based care and how to test change concepts will be discussed. Teams will have the opportunity to practice running small scale multiple tests to achieve meaningful change. 2:45 p.m. 3:00 p.m. Break.

4 3:00 p.m. 4:00 p.m. Implementation and Team Meeting Jessica Sanchez, RN, MS, FNP West Central Cluster Team Support Manager Louisiana State Collaborative Coordinator An organization seeking to improve their quality of health care for patients with chronic diseases must be motivated and prepared for change throughout their systems. This session will provide attendees with the steps needed to implement the CCM. This will be a good time to raise questions and issues. Time will be provided for team discussion about implementation plans. 4:00 p.m. Workshop Adjourns PRESORT NON PROFIT U.S. POSTAGE PAID NAPOLEONVILLE LA PERMIT # 33 POST OFFICE BOX 387 NAPOLEONVILLE, LA 70390

5 Continuing Education Nurses: The Louisiana Department of Health and Hospitals Office of Public Health Nursing Services Continuing Education Program is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center s Commission on Accreditation. This activity is approved for a maximum of 6.0 contact hours. The Office of Public Health Nursing Services Continuing Education Program assures equal opportunity for all qualified persons without regard to race, color, religion, sex, national origin, age, handicap, marital status or veteran s status in the admission to or participation in any of its programs. The ANCC Commission on Accreditation does not approve or endorse commercial products associated with this activity. Special Accommodations: If special accommodations are required, please notify Anne Marsh at (985) at least seven (7) working days prior to the activity date. Physicians: The Office of Public Health CME Program is accredited by the Louisiana State Medical Society to provide continuing medical education for physicians. The Louisiana Department of Health and Hospitals Office of Public Health, Continuing Medical Education Program designates this educational activity for a maximum of 6.0 AMA PRA Category 1 Credit TM. Physicians should only claim credit commensurate with the extent of their participation in the activity. The DHH Office of Public Health Continuing Medical Education Program Committee will assure the equal opportunity for all qualified persons without regard to race, color, religion, sex, national origin, age, handicap, marital status or veteran s status in the admission to or participation in any of its programs. Special Accommodations: The OPH CME Program fully complies with the legal requirements of the ADA and the rules and regulations thereof. If any participant of this workshop offered by OPH CME Program is in need of accommodations, please do not hesitate to call Anne Marsh at (985) , or submit in writing (985/ fax) at least seven working days prior to this workshop. Disclosures: All speakers except Ms. Jessica Sanchez and Ms. Rebecca Bradley have no significant relation ships with manufacturers of drugs or devices that could be perceived as a conflict of interest in the subject of this presentation. Their presentations will not include discussion(s) of off-label uses of drugs or devices. There is commercial support from the Louisiana Rural Health Association. Ms. Sanchez receives support from the Texas Association of Community Health Centers through the Colorado Community Health Network. Ms. Bradley receives support from a grant project funded by the Agency for Healthcare Research & Quality. She is also a vendor of the Louisiana Rural Health Information Technology Project.