Donegal County Councils ‘Experience of Developing a Poverty Profile’
Developing a One Page Profile for Covid-19 Health Care ...
Transcript of Developing a One Page Profile for Covid-19 Health Care ...
Developing One Page Profilesfor
COVID-19 Health Care SettingsMichael Smull
The Learning Community for Person Centered Practices
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What is a One Page Profile?
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Passport
COVID – 19 Passport: Elaine Smith(See reverse for health care person-centered profile)
Note: Information on this form may not be complete
PERSONAL INFORMATIONFirst Name (Nickname) Last Name DOB or AgeElaine None Smith 66Street Address City, State, Zip123 Rose Lane Austin, Texas 78745Emergency Contact Emergency Contact Phone/EmailJ.J. Smith (Husband) XXX-XXX-XXXX [email protected]/Legal Representative Parent/Legal Representative Phone/EmailNone NoneInsurance Information Pharmacy Information (Most Commonly Used)Medicaid CVS at 1935 IH-35, Austin, TexasPrimary Care Provider/Contact Information Specialty Care/Contact InformationDr. Flower at XXX-XXX-XXXX Dr. Tu;ip at XXX-XXX-XXXX
Passport
COVID – 19 Passport: Elaine Smith(See reverse for health care person-centered profile)
Note: Information on this form may not be complete
CURRENT SYMPTOMS/RISK FACTORSCurrent COVID 19
Symptoms (Check all that apply)
Date Started Risk Factors (Check all that apply) Risk Factors (Check all that apply)
Temp. over 100.4 ° F 12/6/20 � Long-term care resident � Cancer� Dry Cough � Transplant Age 65 or overMalaise/Fatigue 12/6/20 � COPD/Emphysema/Asthma � Pregnant Shortness of breath 12/6/20 � Current/Former Smoker � Severe obesity� Nasal congestion � Liver Disease � HIV/AIDS� Diarrhea � Intellectual disability � Kidney disease Loss of smell/taste 12/6/20 � Neurological disorder � Homeless� Sore throat � Heart disease � Chronic bronchitis Low blood oxygen 12/6/20 � Corticosteroid use � Other Headache 12/6/20 Mental illness/substance use � Other
Passport
COVID – 19 Passport: Elaine Smith(See reverse for health care person-centered profile)
Note: Information on this form may not be complete
HEALTH CONDITION LIST MEDICATION LIST ALLERGIESHigh Blood PressureVertigoAnxiety
Med#1Med#2Med#3
Penicillin
PERSON HAS DO NOT RESUSOTATE (DNR) ORDER – Location of document and/or contact information if known: Husband keeps it in safety deposit box at bank
PERSON HAS ADVANCE DIRECTIVE – Location of document and/or contact information if known: Husband keeps it in safety deposit box at bank
� PERSON HAS PSYCHIATRIC ADVANCE DIRECTIVE or other Advance Crisis Planning Tool and/or has designated a Health Care Proxy decision maker – Location of document and/or contact information if known:
Passport
One Page ProfileFront Back
Person Centered Description
My mom is a quiet woman. She tries to keep people from noticing
her. She is polite and is very intelligent, resourceful, frugal, and creative. She writes poems and has
had several published.
Mom loves her sons and they are very important to her. She lost two other sons in tragic accidents. Mom
does not express love with a hug but through a phone call and
immediate hang-up when answered. It is expressed with her tolerance when her sons try to take
care of her – she wants to be independent and left alone.
Mom is a simple person that carries her “Nuclear Football” (important papers) where ever she goes. She
drinks coffee from an old percolator and politely declines a good Keurig
brewed cup.
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Mom often gets scared at the voices she hears, the people that try to get in her business, the cameras planted in the holes around the house, and the
memories of abuse.
Mom is good at managing her funds and making ends meet. She often
gives the little she has to help someone else. This often frustrated me because she was often worse off than the person she helped. But this taught me the importance of other people and that self-sacrifice is a
noble characteristic.
Mom wanted to die on her own. She did not want me to sit with her. She wanted me to help her get dressed
and leave the hospital room. I think she had lost so much that in this
moment of silence…all alone…she could leave assured that my pain
would not be as great as hers.
I would like to introduce you to my mom
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Passport
COVID – 19 Passport: Betty Consford(See reverse for health care person-centered profile)
Note: Information on this form may not be complete
PERSONAL INFORMATIONFirst Name (Nickname) Last Name DOB or AgeBetty Mom Consford 89Street Address City, State, Zip321 John ST., Apt 107 Austin, Texas 78745Emergency Contact Emergency Contact Phone/EmailRandy Consford (Son) XXX-XXX-XXXX Parent/Legal Representative Parent/Legal Representative Phone/EmailNone NoneInsurance Information Pharmacy Information (Most Commonly Used)Medicaid CVS at 1935 IH-35, Austin, TexasPrimary Care Provider/Contact Information Specialty Care/Contact InformationDr. Roberts at XXX-XXX-XXXX N/A
Passport
COVID – 19 Passport: Betty Consford(See reverse for health care person-centered profile)
Note: Information on this form may not be complete
CURRENT SYMPTOMS/RISK FACTORSCurrent COVID 19
Symptoms (Check all that apply)
Date Started Risk Factors (Check all that apply) Risk Factors (Check all that apply)
Temp. over 100.4 ° F 12/6/20 � Long-term care resident � Cancer� Dry Cough � Transplant Age 65 or overMalaise/Fatigue 12/6/20 COPD/Emphysema/Asthma � Pregnant Shortness of breath 12/6/20 Current/Former Smoker � Severe obesity� Nasal congestion � Liver Disease � HIV/AIDS� Diarrhea � Intellectual disability � Kidney disease� Loss of smell/taste � Neurological disorder � Homeless� Sore throat � Heart disease Chronic bronchitis Low blood oxygen 12/6/20 � Corticosteroid use � Other� Headache Mental illness/substance use � Other
Passport
COVID – 19 Passport: Betty Consford(See reverse for health care person-centered profile)
Note: Information on this form may not be complete
HEALTH CONDITION LIST MEDICATION LIST ALLERGIESHigh Blood PressureSchizophrenia (“Called Back Problems”)
Med#1Med#2Med#3
No Known Allergies
PERSON HAS DO NOT RESUSOTATE (DNR) ORDER – Location of document and/or contact information if known: Betty has it in Nuclear Football (Son has copy)
PERSON HAS ADVANCE DIRECTIVE – Location of document and/or contact information if known: Betty has it in Nuclear Football (Son has copy)
� PERSON HAS PSYCHIATRIC ADVANCE DIRECTIVE or other Advance Crisis Planning Tool and/or has designated a Health Care Proxy decision maker – Location of document and/or contact information if known:
Passport
COVID – 19 Passport: Randy Consford(See reverse for health care person-centered profile)
Note: Information on this form may not be complete
PERSONAL INFORMATIONFirst Name (Nickname) Last Name DOB or AgeRandall Randy Consford 61Street Address City, State, Zip123 Iwo Jima Ave. New Braunfels, TXEmergency Contact Emergency Contact Phone/EmailCathy (Wife) XXX-XXX-XXXXParent/Legal Representative Parent/Legal Representative Phone/EmailNone NoneInsurance Information Pharmacy Information (Most Commonly Used)Medicaid CVS at 1935 IH-35, New BraunfelsPrimary Care Provider/Contact Information Specialty Care/Contact InformationDr. Grey at XXX-XXX-XXXX Dr. Izzie at XXX-XXX-XXXX (Endocrinologist)
Passport
COVID – 19 Passport: Randy Consford(See reverse for health care person-centered profile)
Note: Information on this form may not be complete
CURRENT SYMPTOMS/RISK FACTORSCurrent COVID 19 Symptoms
(Check all that apply)Date Started Risk Factors (Check all that apply) Risk Factors (Check all that
apply) Temp. over 100.4 ° F 12/6/20 � Long-term care resident � Cancer� Dry Cough � Transplant � Age 65 or overMalaise/Fatigue 12/6/20 � COPD/Emphysema/Asthma � Pregnant� Shortness of breath � Current/Former Smoker � Severe obesity� Nasal congestion � Liver Disease � HIV/AIDS� Diarrhea � Intellectual disability � Kidney disease Loss of smell/taste 12/6/20 � Neurological disorder � Homeless� Sore throat � Heart disease � Chronic bronchitis� Low blood oxygen � Corticosteroid use Diabetes Type II Headache 12/6/20 � Mental illness/substance use � Other
Passport
COVID – 19 Passport: Randy Consford(See reverse for health care person-centered profile)
Note: Information on this form may not be complete
HEALTH CONDITION LIST MEDICATION LIST ALLERGIESDiabetes Type II Med#1
Med#2Med#3
Swine Flu
� PERSON HAS DO NOT RESUSOTATE (DNR) ORDER – Location of document and/or contact information if known:� PERSON HAS ADVANCE DIRECTIVE – Location of document and/or contact information if known:� PERSON HAS PSYCHIATRIC ADVANCE DIRECTIVE or other Advance Crisis Planning Tool and/or has designated a Health Care Proxy decision maker – Location of document and/or contact information if known:
How Can I Make a One Page Profile?
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One
-Pag
e Bl
ank
Shee
t
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What is Important to
What People Like and Admire about
How to best support
For a good match: characteristics needed to be present or absent
InsertPhoto Here
Before DevelopingAsk These Questions…
• Where is the One Page Profile going to be used? What is the context?• What do you want people to learn from reading the One Page Profile?• What do you want people to do with the learning?
Remember
• If no one reads it . . .If no one uses it. . .
It was a wasted effort
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The Context is a COVID-19 Health Care Setting
What do we know about the setting(s)?• Staff are very busy, may be
overwhelmed• They want to provide the best care
in the time they have• They are very interested helping
patients feel less anxious, more comfortable
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What Will Work in the COVID-19 Health Care Setting?
• Basic Health Information• A focused One Page Profile
• Some examples…
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Getting Started
• Review the questions• Who knows the answers to all of the questions? Whose input do you
need?• Can the person whose profile it is answer all the questions? Do you need
others to assist?
• If others, who? Family members? Close friends? Care givers?• Who can tell you what others like and admire?
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What Do Others Like, Admire, orAppreciate about Me?
• What are you good at, proud of?• What do people praise you for?• What do people say your good qualities are?
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What is important to you?
• Who do you need to stay in contact with and what is the best way to do that - their phone numbers or email
• What helps you feel better when you are sick or upset• What helps you wind down, relax, or sleep• List any spiritual practices that help you feel grounded• What helps you feel valued and respected
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What Does Good Support Look Like?
• Describe how staff can help you feel less anxious or uncomfortable, or calm or safe
• Describe the best way for staff to communicate with you• Outline how staff can help prepare you for procedures, tests, and
changes in care• Explain how you might express pain• Include how you prefer to take medications• Include any physical or environmental accommodations you might
need• Describe any tips that might help staff help you
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Review your notesWrite a first draft
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Look for the 4, 5, or 6 most important things for staff to know for each section
1Use simple, plain language
2Keep the statements brief –complete thoughts, not necessarily complete sentences
3When it is done, read it out loud -it should take no more than a minute
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Share, edit, add a photo
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Share
Share the 1st draft with the person and those they choose
Get
Get feedback and edit based on the feedback
Add
Add missing information but don’t make it too long
Add Photo
Add a photo (if possible)
Include
Include the health passport
Print it so that it is 1 page with the one page profile on the front and the heath passport on the back
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TIPS• Print it so that it is 1 page with the one-page profile on the front and the heath
passport on the back.• Print multiple copies and put them where they will be taken to the hospital –
part of a “go bag”• Consider laminating or putting in plastic sleeves• In the hospital –
• Post it where it will be seen• Make sure it moves with the person (people may be moved multiple times)• Improve the one-page description
• Ask the person who helps the best and why• Ask those providing care to note any new learning
• If there are phone updates on status – ask• Leave space to write on the template
Passport
One Page ProfileFront Back
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For more information contact:Jeff [email protected]
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