Measuring knowledge, skills and confidence to self manage. Patient Activation Dr Alf Collins...
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Transcript of Measuring knowledge, skills and confidence to self manage. Patient Activation Dr Alf Collins...
Measuring knowledge, skills and confidence to self manage.
Patient Activation
Dr Alf CollinsClinical Associate in Person Centred Care
The Health Foundation
Self management is usual care
Hours with NHS / social care professional = 5-10 in a year
Self management = 8750-55 in a year
So
The system should work in partnership with people with LTCs in order to support them to develop the knowledge, skills and confidence to self manage
People at low levels of activation tend to:
• Feel overwhelmed with the task of managing their health
• Have low confidence in their ability to have a positive impact on their health
• Not understand their role in the care process• Have limited problem solving skills• Have had a great deal of experience with failure in
trying to manage, and have become passive with regard to their health
• Say they would rather not think about their health
As compared to people at low levels of activation, people at higher levels tend to:
• ‘Be engaged’– Come prepared– Ask questions– Make decisions– Have less unmet needs (nb inequalities)
• Have improved clinical outcomes (including mental health)
• Enjoy an improved quality of life • Use less healthcare resource• Feel satisfied at workWhy Does Patient Activation Matter? An Examination of the Relationships Between Patient Activation and Health-Related Outcomes. Jessica Greene and Judith H. Hibbard Journal of General Internal Medicine, published online Nov. 30, 2011
Uses of patient activation measure
Segmentation• Target resources• Use resources
more effectively
Tailored coaching• Start where
people are• Personalise
support
Programme assessment• Quality assure
interventions• Improve quality of
interventions
Predictive modelling• More
sophisticated understanding of drivers of risk
People with Lower Activation Associated with Higher Costs; Delivery Systems Should Know Their Patients’
‘Scores’
Activation as a primary mediator of other indicators.
Activation
Clinical outcomes, including mental
health
Improved QOL, wellbeing
Higher rate of retention at work
Feeling in control
More independent
Lower utilisation of health and social
care resource
Tailored interventions- including health coaching- can support people on their journey of activation
Thus tailored interventions improve all other ‘downstream’ indicators
5 CCGs plus renal registry150,000 patients over 2 years
• Learning plus rigorous evaluation– Pragmatics– Face validity– ‘Coaching for activation’– Collaborative care and support planning– Understanding population health and reducing
inequalities
Questions and challenges
• Concept or measure or both?• PAM as an outcome?• Personal outcomes• Social model of health