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The Heart Manual DepartmentThe Heart Manual Department
www.theheartmanual.comwww.theheartmanual.com
NHS LothianNHS Lothian...
Aim:Aim:
a)a) To provide an overview of the Heart ManualTo provide an overview of the Heart Manual
ServiceService
b) How t...
The Heart Manual Service
HM Facilitator
Training (n = 1500)
HM Website
(700 hits/month)
Audit and
Research
Patient
Involve...
a)a) The Heart Manual ServiceThe Heart Manual Service
 Intellectual Property Rights (IPR) / copyright sit with LHBIntelle...
www.theheartmanual.com
HM users
Canada
HEART MANUAL (HM)HEART MANUAL (HM)
(UK AND ABROAD)(UK AND ABROAD)
heart.manual@nhsl...
The Heart Manual Service contd.,The Heart Manual Service contd.,
 Strong evidence base-3 RCTs (1994, 2007,2009)Strong evi...
Traditional approachesTraditional approaches
 Hospital or communityHospital or community
based classes effectivebased cla...
88
Heart Manual MI and RevascularisationHeart Manual MI and Revascularisation
EditionsEditions
 Part 1:Part 1: Your Heart...
Evidence baseEvidence base
 AnxietyAnxiety
 DepressionDepression
 QoLQoL
 Health perceptionHealth perception
 Exercis...
Think, Do, EmpowerThink, Do, Empower
 Heart Manual programme :Heart Manual programme :
-explores & challenges misconcepti...
1111
Heart Manual TrainingHeart Manual Training
 2 day Heart Manual2 day Heart Manual
Facilitator CourseFacilitator Course
 1...
Facilitation of the Heart ManualFacilitation of the Heart Manual
Heart Manual
MI or
Revascularisation
Editions/
Hard copy ...
HOW
THE CANCER MANUAL
EVOLVED…
 Support patientsSupport patients
living with & beyondliving with & beyond
cancercancer
 Address frequentlyAddress frequ...
In summary…..In summary…..
The Heart Manual embraces self-management as it….The Heart Manual embraces self-management as i...
1717
“The Manual more than
met my expectations, and I
still refer to it now – six
months after my heart
attack”
“The secti...
1818
Thank youThank you
jennifer.elliott@nhslothian.scot.nhs.ukjennifer.elliott@nhslothian.scot.nhs.uk
www.theheartmanual.comww...
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RIWC_PARA_A112 The Heart Manual

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A112 The Heart Manual

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RIWC_PARA_A112 The Heart Manual

  1. 1. The Heart Manual DepartmentThe Heart Manual Department www.theheartmanual.comwww.theheartmanual.com NHS LothianNHS Lothian RI ConferenceRI Conference Edinburgh, October 2016Edinburgh, October 2016
  2. 2. Aim:Aim: a)a) To provide an overview of the Heart ManualTo provide an overview of the Heart Manual ServiceService b) How the Heart Manual works and its evidenceb) How the Heart Manual works and its evidence c) Highlight new developments and collaborationsc) Highlight new developments and collaborations
  3. 3. The Heart Manual Service HM Facilitator Training (n = 1500) HM Website (700 hits/month) Audit and Research Patient Involvement HM Group Department’s Portfolio Collaborations Lothian Health Board  Intellectual Property Rights  Trademarked The Heart Manual (HM) Service Edinburgh Health and Social Care Partnership Cancer Manual (2014-2016) Stroke Workbook HM Programme Revascularisation Edition (n = 4000 p.a.) HM Programme MI Edition (n = 12000 p.a.) Book Digital TIA Manual (2014  ) Book Digital  Exeter University (2012 – 2017)  Heart Cycle (2010 - 2013)  Queens University Belfast (2014 )  Taunton H/C Trust (2014 – 2016) Peking UniversityHospital (2016- Heart Failure Manual 2012-17 *Mapofuse-Appendix In use In development/ trial Shared IPR
  4. 4. a)a) The Heart Manual ServiceThe Heart Manual Service  Intellectual Property Rights (IPR) / copyright sit with LHBIntellectual Property Rights (IPR) / copyright sit with LHB The department’s portfolio includes:The department’s portfolio includes:  MI edition(2016)- digitally formattedMI edition(2016)- digitally formatted  Revascularisation edition (2015)-digitally formattedRevascularisation edition (2015)-digitally formatted  Stroke Workbook (2011)Stroke Workbook (2011)  Cancer manual (2016)Cancer manual (2016)  Training/support of facilitators-from Scotland, rest of UnitedTraining/support of facilitators-from Scotland, rest of United Kingdom and further afield-e.g: Canada, SingaporeKingdom and further afield-e.g: Canada, Singapore
  5. 5. www.theheartmanual.com HM users Canada HEART MANUAL (HM)HEART MANUAL (HM) (UK AND ABROAD)(UK AND ABROAD) heart.manual@nhslothian.scot.nhs.uk The Heart Manual Department Administrative Block, Astley Ainslie Hospital, 133 Grange Loan, Edinburgh, EH9 2HL Canada Republic of Ireland Beijing Singapore Cayman Islands
  6. 6. The Heart Manual Service contd.,The Heart Manual Service contd.,  Strong evidence base-3 RCTs (1994, 2007,2009)Strong evidence base-3 RCTs (1994, 2007,2009)  330 citations of HM in journals (1990-2015)-as an excellent330 citations of HM in journals (1990-2015)-as an excellent example of a facilitated, sustainable & comprehensive resource.example of a facilitated, sustainable & comprehensive resource.  HM facilitators n=1500HM facilitators n=1500  15,000 manuals per annum15,000 manuals per annum Recent collaborations include:Recent collaborations include:  2010-132010-13 Philips Heart Cycle-Heart Failure telehealth -EuropePhilips Heart Cycle-Heart Failure telehealth -Europe  2012-172012-17 NIHR grant/National collaboration-HF manualNIHR grant/National collaboration-HF manual  2013-162013-16 Cancer Manual-in collaboration with Taunton NHSCancer Manual-in collaboration with Taunton NHS  2014 -2014 - TIA /Healthy Brain Manual-in collaboration with QUBTIA /Healthy Brain Manual-in collaboration with QUB
  7. 7. Traditional approachesTraditional approaches  Hospital or communityHospital or community based classes effectivebased classes effective and useful for those whoand useful for those who like groups and canlike groups and can access the classesaccess the classes  However more peopleHowever more people returning to work quicklyreturning to work quickly after an event,after an event, intervention or diagnosisintervention or diagnosis  More flexible deliveryMore flexible delivery approaches neededapproaches needed
  8. 8. 88 Heart Manual MI and RevascularisationHeart Manual MI and Revascularisation EditionsEditions  Part 1:Part 1: Your Heart Condition: the factsYour Heart Condition: the facts Read during hospital stay, CDRead during hospital stay, CD’’ss  Part 2:Part 2: The 6 weekly facilitated home programme,The 6 weekly facilitated home programme, Week 1 Getting home - getting betterWeek 1 Getting home - getting better Week 2 Feeling better, smokingWeek 2 Feeling better, smoking Week 3 Making progress, dietWeek 3 Making progress, diet Week 4 Getting better all the time, weightWeek 4 Getting better all the time, weight Week 5 Feeling more like yourself, exerciseWeek 5 Feeling more like yourself, exercise Week 6 The endWeek 6 The end……and the beginning, blood pressureand the beginning, blood pressure DailyDaily –– Relaxation, Walking, Exercise and Activity recordRelaxation, Walking, Exercise and Activity record  Part 3:Part 3: Facts and advice to aid recoveryFacts and advice to aid recovery
  9. 9. Evidence baseEvidence base  AnxietyAnxiety  DepressionDepression  QoLQoL  Health perceptionHealth perception  Exercise knowledgeExercise knowledge  SmokingSmoking  Exercise levelsExercise levels  Cost effectivenessCost effectiveness  BPBP  CholesterolCholesterol  Cardiac symptomsCardiac symptoms  Programme AdherenceProgramme Adherence  Self-reported behaviourSelf-reported behaviour  GP visitsGP visits  Hospital re-admissionsHospital re-admissions Lewin et al (1992) Dalal et al (2007)Lewin et al (1992) Dalal et al (2007) Taylor (2007) Jolly (2007, 2009)Taylor (2007) Jolly (2007, 2009) Henwood & Barnes (2008)Henwood & Barnes (2008) Dalal et al (2010,2015)Dalal et al (2010,2015) 99
  10. 10. Think, Do, EmpowerThink, Do, Empower  Heart Manual programme :Heart Manual programme : -explores & challenges misconceptions,-explores & challenges misconceptions, normalising experiences,normalising experiences, -develops strategies for dealing with stress-develops strategies for dealing with stress -Helps people-Helps people dodo something about theirsomething about their condition –condition – - planning, goal setting, self-monitoring- planning, goal setting, self-monitoring
  11. 11. 1111
  12. 12. Heart Manual TrainingHeart Manual Training  2 day Heart Manual2 day Heart Manual Facilitator CourseFacilitator Course  1 day Health Care1 day Health Care Support WorkersSupport Workers coursecourse  1 day Update day1 day Update day  2 day Trainers course2 day Trainers course
  13. 13. Facilitation of the Heart ManualFacilitation of the Heart Manual Heart Manual MI or Revascularisation Editions/ Hard copy or Digital Hospital facilitation Spec nurse or trained facilitator Phone follow up Home visit Clinic review/ Specialist ax Phone follow up Home visit Spec nurse or trained facilitator Clinic setting Spec nurse or trained facilitator Discharge to GP/Practice nurse Referral to specialist Service for 1:1 Community Cardiac Rehab class Stand alone Exercise class e.g. BACPR Instructor or local gym Community facilitation
  14. 14. HOW THE CANCER MANUAL EVOLVED…
  15. 15.  Support patientsSupport patients living with & beyondliving with & beyond cancercancer  Address frequentlyAddress frequently asked questionsasked questions  Help support &Help support & encourage positiveencourage positive behavioural changesbehavioural changes  Be facilitated byBe facilitated by specially trainedspecially trained cliniciansclinicians A RESOURCE TOA RESOURCE TO
  16. 16. In summary…..In summary….. The Heart Manual embraces self-management as it….The Heart Manual embraces self-management as it….  Enhances health consultationsEnhances health consultations  Reduces GP consultationsReduces GP consultations  Improves hospital readmission ratesImproves hospital readmission rates  Reduces in patient staysReduces in patient stays  Reduces outpatient visitsReduces outpatient visits  Provides understanding for the familyProvides understanding for the family  Improves medication compliance andImproves medication compliance and managementmanagement  Reduces A & E attendanceReduces A & E attendance Jones (2007), DoH (2006), (2007), (2008) Dalal (2010,2015)Jones (2007), DoH (2006), (2007), (2008) Dalal (2010,2015)1616
  17. 17. 1717 “The Manual more than met my expectations, and I still refer to it now – six months after my heart attack” “The sections on risk factors helped me make informed decisions with regard to my lifestyle” “My facilitator has always been understanding, informative and supportive” “All the feelings and fears I had, I found they were common and it explained why we feel like this”
  18. 18. 1818
  19. 19. Thank youThank you jennifer.elliott@nhslothian.scot.nhs.ukjennifer.elliott@nhslothian.scot.nhs.uk www.theheartmanual.comwww.theheartmanual.com

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