Bridging the gap in HI through COP - Dr Uzma Haque.pptx

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Bridging the gap in HI through communities of practice

Healthcare

Stark differences
 Unfair and avoidable differences in health
 Arise due to different conditions
 Born, live, work and age in
 These determine how easy it is for us to access
 People at risk of HI find it the hardest to access
 This can change with your help

Facts
 Post code is more important than the genetic code in predicting death
 Instead of focusing on preventing death we need to focus on Living Well
 Mental distress is over medicalised in the most deprived areas

Effects on us – Allostatic load
 Reduction in Joy at work
 Burnout
 Reduced productivity
 Adverse health outcomes
 Absenteism/presenteism
 Toxic work environments
 Low morale

 What is my role as a Health Care Practitioner in tackling
HI
 Between us we have over 4 million contacts a week
 Public really values our advice
 Helping them connect with services that can help meet
their needs
 Join forces with other allied healthcare practitioners
 Speak up at meetings to give your views
 Every little helps

Communities of practice – Deprivation
medicine
 People who share a common goal/passion
 How to help people Living well
 Who will benefit with regular interactions
 Has a level of expertise or experience around a topic
 Source of support
 Discussion topics guided by membership
 Our NEL data
 Mental distress
 Building resilience
 Deep End medicine
 Neurodiversity and Us
 Homelessness

Our Community of Practice
 Every third Wednesday of the month
 Virtually at 12:30 for an hour
 Join us through event bright
 Various topics guided by our attendees
 Multi - professional team across NEL
 Email uzma.Haque@nhs.net to join
 Whats app group 07980878361
 Next is on the 18th of October 2023

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During your journey through this slide deck Geriatric Population. Geriatric Palliative and End-of-Life Care you will experience what it means to die badly. After practicing as a Geriatric Clinician for over a decade what I know for sure is: Life is a tremendous gift. 100% of us are going to die. If you don't communicate your end-of-life plan, then you should plan on dying badly. In The Cost of Dying: End-of-Life Care on CBS 60 minutes Steve Kroft interviews Doctor Ira R. Byock. “Families cannot imagine that there could be anything worse than their loved one dying, but in fact there are things worse, generally it’s having someone you love die badly.” ~Doctor Ira Byock “Dr. Byock what do you mean dying badly?” ~Mr. Kroft “Dying suffering, dying connected to machines, denial of death at some point becomes a delusion and we start acting in ways that make no sense whatsoever.” ~Doctor Ira Byock A majority of Americans say they want to die at home. Why is this not happening? Place of death should be regarded as an essential goal in end-of-life care. Let’s explore how the end-of-life decision occurs? For Doctors Bernacki & Block (2014) found in their review and synthesis of best practices that physician attitudes, training, and perceptions of feeling inadequate in managing the emotional and behavioral reactions of patients all play a role. A majority of trainees were not taught how to communicate and they express strong desires to learn more. Physician barriers also include not addressing psychosocial concerns, placing focus on diagnoses, treatments, and procedures during discussions about the medical care at the end-of-life. For Patients Bernacki & Block (2014) found that patients who do bring up dying concerns with their physicians often meet barriers and often are not aware that they are at the end-of-life. Patients that have not set goals based on meaningful conversations about their desires may overuse life-prolonging treatment and underuse services that support quality of life. Conclusion Bernacki & Block (2014) found that there is a large body of evidence demonstrating that early discussions of serious illness care goals are associated with: ♛ beneficial outcomes for patients, ♛ no harmful adverse effects, and ♛ potential cost savings. Apply & Do To prevent dying badly start early conversations, enhance your knowledge and establish goals. Dreams are only dreams until you write them down. When you write dreams down then they become goals. Do ♛ The Conversation Project a collaboration with the Institute for Healthcare Improvement. http://theconversationproject.org/starter-kit/intro/ Do your conversation kit now and make your loved ones aware of your wishes. Wishing you the very best, Michelle Bernacki RE, Block SD, for the American College of Physicians High Value Care Task Force. Communication About Serious Illness Care Goals: A Review and Synthesis of Best Practices. JAMA Intern Med. 2014;174(12):1994-2003.

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