Showing posts with label health priorities. Show all posts
Showing posts with label health priorities. Show all posts

Tuesday, November 18, 2014

HCCA ANNUAL GENERAL MEETING



HCCA’s Annual General Meeting was held on Thursday 25 September at 3:00pm in the Griffith Community Hall. It was a magnificent event with a very strong turnout and I would like to thank to all attendees for their time and participation.

We are very pleased to introduce our new Executive Committee as elected at our AGM.
 Our Executive Committee members are as follows:
- Dr Sue Andrews – President
- Dr Michelle Banfield - Vice-President
- Hugh Crawford – Treasurer
- Bill Heins - Member (for two year term)
- Fran Parker - Member (for two year term)
- John Didlick -Member (for two year term)
- Marcus Bogie - Member (for two year term)
- Adele Stevens - Member (for one year term)
- Bev McConnell - Member (for one year term)

HCCA would like to thank the outgoing Executive Committee members David Lovegrove for his support for HCCA over many years and contribution to the governance of this organisation.

The AGM was followed by a panel discussion on the politics of health and the role of consumer organisations in ensuring that our health system meets the needs of the community. We were very pleased to hear from two HCCA members, Fiona Tito Wheatland, Russell McGowan and also Adam Stankevicius, the Chief Executive Officer of the Consumers Health Forum.

Fiona Tito Wheatland kicked off the panel discussion looking at how consumers and people alike have differing power and knowledge. Fiona noted that everyone has their own feelings regarding health and health services. An example of this was Fiona’s mother, she did not want to make a fuss so Fiona waited until her mother passed away to make complaints surrounding her health services. It can sometimes be more complicated if you are advocating for someone else, rather than yourself.

Consumers need to be at the core of the health service, but it is always around the needs of the provider. An example Fiona gave was the processes in which nurse administer morphine. Rather than administering morphine when it was best for the patient, nurse were more focused on when it was the best and easies time for them.

They were taking blood test every morning because that’s what they do. The efficient running of their word is more important. This shows how political the health service is. There are some serious issues with aged care.

Fiona stated that doctors and nurses need to response to consumer’s feelings. It is quite difficult to change the way doctors and nurses deal with patients as they are trained in the structure of an apprenticeship, this means the same issues are only passed onto each generation of doctors and nurse, such as keeping a distance. Change will be hard as doctors and nurses will have to give up power and move to a new model.

Fiona finished with saying that patient centred care is still not the main model supported within health services. There is still a lot of work to be done and a need for more consumer input.

Russell McGowan followed Fiona, Russell’s presentation to members was looking at the aspect of ensuring our health system meets community needs. Russell started off with the question “Are we patients or are we consumers?” The answer was we are who we say we are, sometimes we identify our self’s as consumers and sometimes as patients. Consumers are people, we bring that to the table. We are also carers and citizens.

Consumers come in all shapes and sizes, with mixed experiences of life. There are three dimensions to consumers, these are:
  • Active/passive
  • Informed/uninformed
  • Positive/negative

Consumers as participants, Healthcare works best when consumers are active partners in decision making. Consumers are more likely to adopt and maintain healthy behaviours and follow care plans when they feel in control. This means better clinical hand over, better clinical decisions when consulted, improved medication management, minimised wastage, minimisation of duplicated tests and learn from mistakes.

Consumer groups / organisations represent millions of healthcare consumers, when everyone works together its more power full. Consumer groups / organisations cover such a broad spectrum, this includes population groups: older people, women, culturally diverse and Illness and self-help groups which includes diabetes, arthritis, cardiovascular and prostate cancer.

Consumer groups deliver opportunities to build opportunities to work with health care organisations. They also provide support and training to consumers so they can participate in service planning, tap into community views and compile/research into consumer experiences and expectationsRussell finished with the statement that we should see consumers as the solution. We can make a difference, the glass is still only half full.

Adam Stankevicius, the Chief Executive Officer of the Consumers Health Forum, was the final speaker from the panel. Adam started by saying it’s a really interesting time to be in health policy, it could be seen as a blessing or a curse. The current political environment is not focused on health policy, where two of the main political parties very light on health issues.

One of the main issues today is that the things currently shaping health policies are not brought up by the health minister, rather by other ministers. The current Government feels there is no need for a therapeutic goods administration. The current Australian government believes regulation can be through the American system. However this is an issues, as removing red tape and deregulation can have detrimental effects. The regulation should be provided through states and territories, this is a clear sign that Australian is moving towards more of a U.S health system. The importance of having Health Care Consumers’ and Consumers’ Health Forum is to ask and debate these ideas is such a vital part of shaping a better health system for all.

Fiona Tito Wheatland, Russell McGowan and Adam Stankevicius all gave fantastic talks, providing everyone with a different perspectives at different levels of the health system. We would like to thank all three panel member for giving up their time and sharing their valuable views and experience of the health system. 


Nick Wales
Project Officer - HIP 

Saturday, August 9, 2014

International Patient and Family Centred Care Conference #6

Providence Health Care – Shared Care Partners for Patients

Like every other health service Providence are looking at an ageing demographic that is threatening to overload their health care system and this has prompted health care funders to understand that there is a need to have activated, engaged patients. Supporting people to self-manage is certainly one way to deal with the challenge but you can’t have activated and engaged patients who are skilled at self-management unless you have a system that supports consumers and our families in self management.

The Canadian health care system is one of the prized assets of their country, they value this and want to maintain it. This has come up in many of the sessions and as I talk to people about our universal health care and the way in which it is being eroded they understand my anger about this.

The Shared Care Committee initially conceived to improve working relationships between primary and specialty care. Very quickly the made the patients voice an important part of the dialogue. It is a joint project between BC Medical Association and Ministry of Health. At the table is also health authorities, and a patient representative. It has spawned a number of projects wich they listed on their slide, an impressive list that makes me want to find out more. Today they are talking about the project of the lower mainland, around Vancouver.

The challenge to involve patients and look at rational service delivery is most difficult in big cities along the 49th parallel as they have a model that is costly, disconnected and specialty –centric. Now, the 49th parallel to me makes my think of a kd lang album and a brewery I found in Vancouver but there is obviously another meaning. 

There are 600 more specialists in Vancouver than family physicians and specialists are not always deployed in the right way, and communication between the two are not always meaningful and patients get lost in the shuffle. So the geography is ripe for improvement in shared care. Sounds a lot like Australian health system.

They want to be able to communicate better, address the access issues that are preventing people from receiving the care they need, to improve patient flow, patient journey. And they want to minimise duplication and inefficiency in the system as it is an issue that is preventing specialists from responding to patient needs. The panel spoke about the benefits of having the Ministry of Health involved and committed to bringing about change. The Ministry also recognises that chronic disease management belongs in the community with the family care provider, not the acute care hospitals. Some hospitals want to get into the business of chronic disease management but this is better placed in the community. So they are very concerned with trying to rebalance the work that is going on between specialities, acute and community based primary care.

The Patient Voices Network in BC is a resource for patient representatives and members of advisory councils. So patients are connected to a broader base. Doctors and those working in the health services are somewhat relieved that the patient representatives do not have an axe to grind.

Patient and provider experience, important to not only engage patients but also health care providers in service redesign. They have three prongs to their work. SLIDE includes cost and one other element I didn't catch but will check out.

They find that it is all too easy to make assumptions about what patients need and what is important to them but to have a patient representative at the table these assumpltions can be unpacked and challenged. For example, the ability to receive a copy of the consultation notes. They want access to this information as they often have the chronic disease for the rest of their life and they want to learn as much as they can about this. But some patients will require more support than others to understand this. And timing of appointments is a big issue as those people who love out of town have difficulty in getting to their early in the morning.

They have guidelines and there is a good slide on this. The first thing they say is: include patients form the beginning and have them as full team members.

They also set out some practical advice about the logistics including providing instruction on how to get to the meeting room, provide refreshments and food and need to check for allergies and sensitivities; provide reimbursement ; think about the time of meetings as many people with chronic conditions have a full time job managing their condition just to get there and some may also need to make arrangements to have time off work.

It was fascinating to hear Robert Levy MD, a respiratory physician, reflect on specialist behaviour. He said that lung, heart, diabetes and kidney team all got together as they realised that they were slow to understand that works for one set of organs may not be helpful to other organs. Their training is very organ specific but their patients have more than one set of organs. I always love hearing this. I know that my body has more than one set of organs. We really need to do something about medical education so that they have a more holistic perspective.

The panel reflected on Successful Initiatives
RACE- RapidAccess to Consultative Expertise. Real time telephone access. It is phone line for family physic and. It is a phone line with a selection of specialty services. In 2010 it started with five services and has grown to 22 services. They take more than 15,000 calls to the line. 78% of calls are answered within 10 minutes and 60% of calls avoid unnecessary consults and 32% of calls avoid unnecessary ED presentations. They have estimated that there is a saving to the system of $200 per call.
They have developed RACE in a box, with 5 page booklet on how to set this up.
RACE calls take about 5 minutes and medication advice, testing advice, affirming the view of the Family Physician. They receive 35% of the usual fee of seeing a patient face to face consult but this will take an hour once they see the patient and then write up the consult. So it does free up resources. 
Acknowledgment of referral – fax back form. This is a great idea as often this is when patients fall into a crevice. I am surprised that the Fax is King. And there was no mention of an electronic solution, shared records.
Notification of admission: So now family physicians are notified that their patients are in hospital. The notification includes an invitation to the FP to participate in the discharge planning process.

Three levels of patient participation: individual, organisations and system
Hang Tough Arthritis Support Group. Arthritis increases your risk of heart disease. And anyone with inflammatory arthritis is at risk, regardless of age and gender. IT is not a benign diseases and we do not need to be protected for the tough messages as we need to know this so we can make decisions around our own care.

Patient Voices Network Framework. Patients as Partners Partnerships Framework looks really interesting. We are currently reviewing the ACT Health Consumer and Carer Participation Framework http://health.act.gov.au/c/health?a=dlpubpoldoc&document=2771so I will definitely be looking at this one more closely.

The slide gives examples of how they contribute. They get a greater understanding of the organisation and the services. They have the positive opportunity to improve the system for others. Many people come to the Network because they experience care that was not a good as it could be and this provides an opportunity t make a difference to others.

A couple of gems from the consumer members of the panel:

We have discovered many of the gaps in the system as we have often fallen through them

What every patient wants is good, safe care in a timely manner

Communication is a theme that emerges across the patient journey: referrals to specials, clarity for patients, consults, support for complex chronic diseases, system acknowledgement of patient realises, hospital communications.

The Patient Voices Network has a series of videos of consumer representatives that you need to watch. Really inspiring!

Another fabulous session that I look forward to sharing with my networks.

Darlene Cox
@darlenecox


Friday, September 18, 2009

Consumer experiences of self managing chronic conditions

In August HCCA facilitated a workshop of around 50 consumers on behalf of the ACT Division of General Practice (ACTDGP). This workshop is part of Interprofessional Learning Project currently underway involving ANU and the ACTDGP.

Consumers were asked specifically about what helps them to self management their chronic conditions and what barriers they encounter in their self management. Participants worked in table groups to share their experiences and document their ideas.










A number of speakers also gave presentations to participants.

Russell McGowan (Pictured) talked about the national level reform in chronic conditions and also talked about his involvement with the Consumers Health Forum project on developing resources to support people to self manage their chronic conditions

Judy Stone, told the participants about the Interprofessional Learning programs currently underway in ACT Health

Other speakers included Susan Abbott (ANU), Amanda Plowright (SHOUT), Ann Thomson (RSI and Overuse Injury Association) and Jo Stewart, a peer leader for the Living a Healthy Life with Chronic Conditions workshops.

Enablers

Knowledge of the system and their condition were identified as important enablers for consumers. Working with a doctor who is knowledgeable about the condition, treatment options and available supports was also important. Research, particularly using the internet, was mentioned as were self help courses as a way of gaining knowledge.

Some existing services were identified as significant enablers for managing chronic conditions: Job Access, psychology services, hydro pools and other services sere identified as desirable. Good medical services particularly GP services were also identified as enablers.

Participants identified the need for appropriate design for people with chronic conditions.

Participants repeatedly identified support from others, groups, families, friends, as important enablers for management of chronic conditions.

When communication channels are respectful, informed, inclusive and personable they were seen as enabling the management of chronic conditions. Effective communication between health providers facilitated by good record keeping was also identified.

Participants identified good treatment and plans to treat as important in enabling them to manage a chronic condition. This plan could include lifestyle factors. A multi pronged or holistic approach was mentioned.

Having plenty of money was identified as an enabler to self managing a chronic condition.

Participants identified that a positive attitude and determination are useful enablers.

Barriers

Participants were very vocal about the need for health professionals to interact with them as people first. They want respectful, honest, considered and comprehensive communication about their situation.

Lack of Medical Profession Knowledge about chronic conditions was seen as a barrier to the management of those conditions and the variation between doctors knowledge was raised by participants.

Participants recognized that they needed to be well informed about their chronic conditions, however they were struggling to gather reliable information which would help them to successfully manage their chronic conditions. They were also concerned about the level of general knowledge in the community about chronic conditions.

The shortage of doctors in Canberra both GP’s and specialists was seen as a barrier to managing chronic conditions. This was reflected in many comments about waiting times to see doctors.

Participants identified specific areas of service deficit as a barrier to managing chronic conditions. These included, interpreter services, hydro therapy, rehab gyms, well resourced support groups, advice advocacy services, and service closures.

Carers were recognized by participants as central to their ability to self manage their chronic conditions and when carers were not available self management was threatened.

Participants were acutely aware of the need to provide well designed, accessible public spaces and transport and that when this did not exist it was a barrier to managing chronic conditions.

Poor dental services were identified as a barrier to self management of chronic conditions.

Isolation from community was a concern for participants.

Participants repeatedly highlighted the added costs associated with managing a chronic condition: home help, medication, therapy, tests and medical visits. Loss on income was also mentioned. Several participant also mentioned their concerns around transparency in decision making around the cost of ordering tests and intervention.

Participants were frank about their concerns about their experiences where they perceived a power imbalance in their interactions with the medical profession in managing their chronic conditions.

A report is currently being finalised for ACTDGP and will be available on the HCCA website soon.

Monday, November 10, 2008

HCCA 2009-10 health budget priorities

HCCA input to ACTCOSS submission for 2009 - 2010 ACT Health Budget
HCCA views and priorities for 2009-2010 reflect a continuation of those proposed last year. While supporting the outlays proposed through the Capital Assets Development Program, HCCA argues that these additional capital assets and infrastructure must be seen as a means to providing the necessary services.
It is also important to ensure that the immediate service needs are met at the same time as the investment in the medium to long term infrastructure is taking place – there must be balance.

Identified Priority Areas - which warrant increased resources and policy emphasis

Primary health care

  • Ensure supply of GPs and nurses to ACT through recruitment and training programs
  • Restructuring of health workforce eg nurse practitioners and allied health assistants
  • Chronic condition management, including support for self-management
  • Community health centres/clinics (Walk-in/Super GP clinics)• Community based services – including allied health services and support
  • Health promotion and illness reduction

Aged and palliative care

  • Develop appropriate housing/residential needs
  • Develop transition facilities/services including convalescence beds
  • Expanded respite care
  • South side hospice
  • Palliative care services and community based services
  • ACT based spinal injury rehabilitation centre and services
  • Improve access to HACC programs and services for residents of aged care facilities

Community infrastructure and supportive care programs

  • Enhancement of aged care services inc equipment loan scheme
  • Dental health
  • IPTAS
  • NGO support networks

Mental health

Consumer participation in ACT Health

  • Need additional training resources and support to meet increased demand for consumer representatives from government
  • E-health (electronic information, digitised images, individual health) will require more informed consumer representatives and improved consumer health literacy
  • Develop consumer advocates and system “navigators”

Cancer services


Maternity care