This document provides an overview and agenda for a one-day workshop on collaboration in primary health care teams. The workshop aims to provide 25 health care professionals with the knowledge, skills, and confidence to collaborate effectively. Through lectures, activities, and exercises, participants will conceptualize collaboration and practice collaborative processes applicable to their work. Upon completing the training, participants will be able to describe collaborative practice concepts and principles; identify target populations, required team members, and information sources for collaboration; compare skills and functions of team members; and apply a collaborative practice process to a case study.
The Practical Playbook
National Meeting 2016
www.practicalplaybook.org
Bringing Public Health and Primary Care Together: The Practical Playbook National Meeting was at the Hyatt Regency in Bethesda, MD, May 22 - 24, 2016. The meeting was a milestone event towards advancing robust collaborations that improve population health. Key stakeholders from across sectors – representing professional associations, community organizations, government agencies and academic institutions – and across the country came together at the National Meeting to help catalyze a national movement, accelerate collaborations by fostering skill development, and connect with like-minded individuals and organizations to facilitate the exchange of ideas to drive population health improvement.
The National Meeting was also a significant source of tools and resources to advance collaboration. These tools and resources are available below and include:
Session presentations and materials
Poster session content
Photos from the National Meeting
The conversation started at the National Meeting is continuing in a LinkedIn Group "Working Together for Population Health" and Twitter. Use #PPBMeeting to provide feedback on the National Meeting.
The Practical Playbook was developed by the de Beaumont Foundation, the Duke University School of Medicine Department of Community and Family Medicine, the Centers for Disease Control and Prevention (CDC), and the Health Resources & Services Administration (HRSA).
Infusing Health Equity into Multi-Sector CollaborationsPractical Playbook
The Practical Playbook
National Meeting 2016
www.practicalplaybook.org
Bringing Public Health and Primary Care Together: The Practical Playbook National Meeting was at the Hyatt Regency in Bethesda, MD, May 22 - 24, 2016. The meeting was a milestone event towards advancing robust collaborations that improve population health. Key stakeholders from across sectors – representing professional associations, community organizations, government agencies and academic institutions – and across the country came together at the National Meeting to help catalyze a national movement, accelerate collaborations by fostering skill development, and connect with like-minded individuals and organizations to facilitate the exchange of ideas to drive population health improvement.
The National Meeting was also a significant source of tools and resources to advance collaboration. These tools and resources are available below and include:
Session presentations and materials
Poster session content
Photos from the National Meeting
The conversation started at the National Meeting is continuing in a LinkedIn Group "Working Together for Population Health" and Twitter. Use #PPBMeeting to provide feedback on the National Meeting.
The Practical Playbook was developed by the de Beaumont Foundation, the Duke University School of Medicine Department of Community and Family Medicine, the Centers for Disease Control and Prevention (CDC), and the Health Resources & Services Administration (HRSA).
The document discusses collective impact and the role of backbone organizations in Wayne County. It provides an overview of collective impact principles and conditions, describing how Forward Wayne County acts as a backbone organization to guide vision, support aligned activities, establish shared measurements, build public will, and advance policy. It then outlines Forward Wayne County's work over the past year to address issues like early childhood success, neighborhood development, and employability. Moving forward, it plans to focus on continuous communication, data analysis, resource mobilization, and dashboard development to improve outcomes county-wide through collective impact.
Implementation of Results-Based Accountability in Children and Family SectorClear Impact
Ensuring child and family well-being and protection faces a complexity of challenges. Results-Based Accountability (RBA) provides a simple, disciplined framework to take action and measure the impact of prevention, early intervention and protective services. This webinar will provide three examples of using RBA to set a vision of success; measure the current situation and improve the future for children and families.
At the conclusion of this webinar, participants will:
Learn practical ways to implement RBA for Child Protection and Well-Being
Have examples of performance measures for specific child and family support and intervention services
Understand a comprehensive approach to tracking performance measures statewide using the Clear Impact Scorecard.
Learn of successful curves that continue to be improved in child, youth and family well-being.
Check out more videos and webinars on our website: https://clearimpact.com/resources/videos/
The Power of ABCD and Results-Based Accountability for Greater Impact and Res...Clear Impact
Asset Based Community Development (ABCD) is a place-based framework pioneered by John McKnight and Jody Kretzmann, founders of the ABCD Institute at Northwestern University. ABCD builds on the gifts (skills, experiences, knowledge, and passions) of local residents, the power of local associations, and the supportive functions of local institutions to build more sustainable communities for the future.
This webinar is for participants interested in discovering how the frameworks of Asset-Based Community Development and Results-Based Accountability can be used together to help build stronger, safer, healthier communities and neighborhoods. You will learn how to build the relationships and accountability necessary to unlock the gifts of the residents, associations and organizations in a community. During this webinar you will hear stories of effective impact through the power of Asset-Based Community Development and Results-Based Accountability.
Webinar topics include:
Introduction to ABCD and RBA – Definitions & Principles
Examples of ABCD and RBA in action
Why place-based strategies and community engagement are critical
The roles of residents in building a stronger community
The new role of institutions – How institutions can use all their assets to build a stronger community
Tools for agencies – Leading by stepping back
Asset Mapping – Discover-Ask-Connect – From Mapping to Mobilizing
Check out more videos and webinars on our website: https://clearimpact.com/resources/videos/
Achieving Measurable Collective Impact with Results-Based Accountability - Mu...Clear Impact
Partners from local, state and national initiatives are working together to understand how to meet the conditions of collective impact. Organizations often seek like-minded partners in order to reach common goals. Partnerships are formed. Meetings are held. But to what end? Stakeholders are convened from numerous programs aimed at support community well-being. These partnerships often find themselves continuing to focus on the outcomes for individuals, rather than on the collective impact of aligned partners throughout the community. Over time, meeting attendance falls and partners end up falling short of measurable results. What causes these well-intentioned efforts to flounder?
This workshop series will detail how partners and stakeholders can understand and implement the five conditions of collective impact by implementing the RBA framework. Each webinar will focus on a specific condition, allowing participants to have a deeper understanding of what it takes to practically apply RBA to meet that condition. The series will also include case studies that illustrate how partner organizations can align their efforts to achieve measurable community results with sustainable change. Participants are encouraged register for the full series, as each webinar will build upon the content from previous sessions.
Check out more videos and webinars on our website: https://clearimpact.com/resources/videos/
Health education focuses on providing information to help individuals make better health choices, while health promotion takes a broader socio-ecological approach to address underlying social, economic, and environmental factors that influence health. Community organizing brings community members together to identify shared health problems, mobilize resources, and implement collective solutions through consensus building. The social ecological model recognizes that individual health behaviors are shaped by multiple levels of influence, so both individual and environmental/policy interventions are often needed for effective and sustainable behavior change.
Results-Based Accountability Professional Certification Information SessionClear Impact
With a Results-Based Accountability (RBA) Professional Certification from Clear Impact, you and your organization can
- Master the principles of RBA in a hassle-free online format,
- Expand your knowledge and skillset in performance
management,
- Become better equipped to lead data-driven initiatives
- Become more efficient at creating measurable results for your
customers and communities.
In this recorded information session and Q&A, we show you how an RBA Professional Certification can benefit you. We’ll describe the program in more detail, teach you how to get started, and answer any questions.
The Practical Playbook
National Meeting 2016
www.practicalplaybook.org
Bringing Public Health and Primary Care Together: The Practical Playbook National Meeting was at the Hyatt Regency in Bethesda, MD, May 22 - 24, 2016. The meeting was a milestone event towards advancing robust collaborations that improve population health. Key stakeholders from across sectors – representing professional associations, community organizations, government agencies and academic institutions – and across the country came together at the National Meeting to help catalyze a national movement, accelerate collaborations by fostering skill development, and connect with like-minded individuals and organizations to facilitate the exchange of ideas to drive population health improvement.
The National Meeting was also a significant source of tools and resources to advance collaboration. These tools and resources are available below and include:
Session presentations and materials
Poster session content
Photos from the National Meeting
The conversation started at the National Meeting is continuing in a LinkedIn Group "Working Together for Population Health" and Twitter. Use #PPBMeeting to provide feedback on the National Meeting.
The Practical Playbook was developed by the de Beaumont Foundation, the Duke University School of Medicine Department of Community and Family Medicine, the Centers for Disease Control and Prevention (CDC), and the Health Resources & Services Administration (HRSA).
Infusing Health Equity into Multi-Sector CollaborationsPractical Playbook
The Practical Playbook
National Meeting 2016
www.practicalplaybook.org
Bringing Public Health and Primary Care Together: The Practical Playbook National Meeting was at the Hyatt Regency in Bethesda, MD, May 22 - 24, 2016. The meeting was a milestone event towards advancing robust collaborations that improve population health. Key stakeholders from across sectors – representing professional associations, community organizations, government agencies and academic institutions – and across the country came together at the National Meeting to help catalyze a national movement, accelerate collaborations by fostering skill development, and connect with like-minded individuals and organizations to facilitate the exchange of ideas to drive population health improvement.
The National Meeting was also a significant source of tools and resources to advance collaboration. These tools and resources are available below and include:
Session presentations and materials
Poster session content
Photos from the National Meeting
The conversation started at the National Meeting is continuing in a LinkedIn Group "Working Together for Population Health" and Twitter. Use #PPBMeeting to provide feedback on the National Meeting.
The Practical Playbook was developed by the de Beaumont Foundation, the Duke University School of Medicine Department of Community and Family Medicine, the Centers for Disease Control and Prevention (CDC), and the Health Resources & Services Administration (HRSA).
The document discusses collective impact and the role of backbone organizations in Wayne County. It provides an overview of collective impact principles and conditions, describing how Forward Wayne County acts as a backbone organization to guide vision, support aligned activities, establish shared measurements, build public will, and advance policy. It then outlines Forward Wayne County's work over the past year to address issues like early childhood success, neighborhood development, and employability. Moving forward, it plans to focus on continuous communication, data analysis, resource mobilization, and dashboard development to improve outcomes county-wide through collective impact.
Implementation of Results-Based Accountability in Children and Family SectorClear Impact
Ensuring child and family well-being and protection faces a complexity of challenges. Results-Based Accountability (RBA) provides a simple, disciplined framework to take action and measure the impact of prevention, early intervention and protective services. This webinar will provide three examples of using RBA to set a vision of success; measure the current situation and improve the future for children and families.
At the conclusion of this webinar, participants will:
Learn practical ways to implement RBA for Child Protection and Well-Being
Have examples of performance measures for specific child and family support and intervention services
Understand a comprehensive approach to tracking performance measures statewide using the Clear Impact Scorecard.
Learn of successful curves that continue to be improved in child, youth and family well-being.
Check out more videos and webinars on our website: https://clearimpact.com/resources/videos/
The Power of ABCD and Results-Based Accountability for Greater Impact and Res...Clear Impact
Asset Based Community Development (ABCD) is a place-based framework pioneered by John McKnight and Jody Kretzmann, founders of the ABCD Institute at Northwestern University. ABCD builds on the gifts (skills, experiences, knowledge, and passions) of local residents, the power of local associations, and the supportive functions of local institutions to build more sustainable communities for the future.
This webinar is for participants interested in discovering how the frameworks of Asset-Based Community Development and Results-Based Accountability can be used together to help build stronger, safer, healthier communities and neighborhoods. You will learn how to build the relationships and accountability necessary to unlock the gifts of the residents, associations and organizations in a community. During this webinar you will hear stories of effective impact through the power of Asset-Based Community Development and Results-Based Accountability.
Webinar topics include:
Introduction to ABCD and RBA – Definitions & Principles
Examples of ABCD and RBA in action
Why place-based strategies and community engagement are critical
The roles of residents in building a stronger community
The new role of institutions – How institutions can use all their assets to build a stronger community
Tools for agencies – Leading by stepping back
Asset Mapping – Discover-Ask-Connect – From Mapping to Mobilizing
Check out more videos and webinars on our website: https://clearimpact.com/resources/videos/
Achieving Measurable Collective Impact with Results-Based Accountability - Mu...Clear Impact
Partners from local, state and national initiatives are working together to understand how to meet the conditions of collective impact. Organizations often seek like-minded partners in order to reach common goals. Partnerships are formed. Meetings are held. But to what end? Stakeholders are convened from numerous programs aimed at support community well-being. These partnerships often find themselves continuing to focus on the outcomes for individuals, rather than on the collective impact of aligned partners throughout the community. Over time, meeting attendance falls and partners end up falling short of measurable results. What causes these well-intentioned efforts to flounder?
This workshop series will detail how partners and stakeholders can understand and implement the five conditions of collective impact by implementing the RBA framework. Each webinar will focus on a specific condition, allowing participants to have a deeper understanding of what it takes to practically apply RBA to meet that condition. The series will also include case studies that illustrate how partner organizations can align their efforts to achieve measurable community results with sustainable change. Participants are encouraged register for the full series, as each webinar will build upon the content from previous sessions.
Check out more videos and webinars on our website: https://clearimpact.com/resources/videos/
Health education focuses on providing information to help individuals make better health choices, while health promotion takes a broader socio-ecological approach to address underlying social, economic, and environmental factors that influence health. Community organizing brings community members together to identify shared health problems, mobilize resources, and implement collective solutions through consensus building. The social ecological model recognizes that individual health behaviors are shaped by multiple levels of influence, so both individual and environmental/policy interventions are often needed for effective and sustainable behavior change.
Results-Based Accountability Professional Certification Information SessionClear Impact
With a Results-Based Accountability (RBA) Professional Certification from Clear Impact, you and your organization can
- Master the principles of RBA in a hassle-free online format,
- Expand your knowledge and skillset in performance
management,
- Become better equipped to lead data-driven initiatives
- Become more efficient at creating measurable results for your
customers and communities.
In this recorded information session and Q&A, we show you how an RBA Professional Certification can benefit you. We’ll describe the program in more detail, teach you how to get started, and answer any questions.
This document discusses using a performance management system to help health departments maintain accreditation through the Public Health Accreditation Board (PHAB). It outlines three keys to an effective performance management system for reaccreditation: 1) Driving and capturing continuous improvement at every level, 2) Aggregating, engaging, and sharing data and learning across stakeholders, and 3) Linking various plans and assessments like the community health assessment, improvement plan, and department strategic plan. The document provides examples and explanations of how a performance management system can help health departments demonstrate accountability, continuous quality improvement, and advancing population health as required for PHAB reaccreditation.
Achieving Measurable Collective Impact with Results-Based Accountability - Co...Clear Impact
Achieving Measurable Collective Impact with Results-Based Accountability - Common Agenda
Partners from local, state and national initiatives are working together to understand how to meet the conditions of collective impact. Organizations often seek like-minded partners in order to reach common goals. Partnerships are formed. Meetings are held. But to what end? Stakeholders are convened from numerous programs aimed at support community well-being. These partnerships often find themselves continuing to focus on the outcomes for individuals, rather than on the collective impact of aligned partners throughout the community. Over time, meeting attendance falls and partners end up falling short of measurable results. What causes these well-intentioned efforts to flounder?
This workshop series will detail how partners and stakeholders can understand and implement the five conditions of collective impact by implementing the RBA framework. Each webinar will focus on a specific condition, allowing participants to have a deeper understanding of what it takes to practically apply RBA to meet that condition. The series will also include case studies that illustrate how partner organizations can align their efforts to achieve measurable community results with sustainable change. Participants are encouraged register for the full series, as each webinar will build upon the content from previous sessions.
Check out more videos and webinars on our website: https://clearimpact.com/resources/videos/
The document discusses best practices for community investment programs. It recommends starting early to understand local needs, developing innovative solutions for social problems, and regularly measuring impact. Effective programs identify business objectives, minimize ad hoc activities, and align investments with project timelines. Programs are most successful when they involve local stakeholders, build local capacity, and empower communities through partnership and self-mobilization. Good processes are important, including choosing partners, setting objectives, monitoring progress, evaluating outcomes, and managing finances. Front-loading efforts and using a multi-strand strategy can help address both short and long-term needs in a community.
Karen Finn, Vice President of Professional Services at Clear Impact, provides tips for conducting effective virtual meetings. She discusses the importance of preparation, having clear objectives, an agenda, and guidelines. Some keys to effective virtual meetings are asking participants to sign in early and provide backup contact information in case of disconnections. Videoconferencing allows sharing screens to take notes. Common issues like people talking over each other can be avoided using features like mute, hand raising, and breakout rooms.
Final webinar-slides-the-very-best-rba-examplesClear Impact
This document provides examples of organizations that have successfully implemented Results-Based Accountability (RBA). It summarizes implementations in Tompkins County, New York, Alameda County Public Health Department in California, the Colorado Department of Education, and United Way of Brazoria County. It also describes an RBA professional certification program.
Clear Impact is introducing a new case management software called Compyle that integrates with their existing Scorecard platform. Compyle allows organizations to collect and track participant data, create and send custom surveys, analyze results, and push data into Scorecard. Pricing for Compyle starts at $200 per month for small organizations and scales up based on the number of included participants.
Businesses & Public Health: Partnering for PreventionCoalitions Work
Explores why businesses should focus on strategies that change policies, systems & environments within workplace, as well as advocate for community-wide changes that make their employees healthier when not at work!
This document discusses types of groups, stages of group development, roles in groups, community organizing, and social service work. It covers:
1) Different types of groups including recreational, educational, problem-solving, self-help, socialization, and therapeutic groups.
2) The typical stages of group development which include orientation, authority, negotiation, functional, and disintegration stages.
3) Key roles that individuals may take on in groups such as the scapegoat, deviant, leader, and gatekeeper.
4) Models of community work including locality development, social planning, social action, and pragmatic approaches.
5) The core skills and roles involved in community organizing,
Community Development - Building a Healthy Community - by Abid JanAbid Jan
This document provides an overview of community development. It defines community development as a grassroots process where communities organize, plan, develop healthy options, empower themselves, and achieve social, economic, cultural and environmental goals. It discusses principles of community development including taking a long-term approach, focusing on community assets, and empowering community members. The document also outlines the role of community developers in supporting communities and the relationship between community development and social determinants of health. Finally, it presents a community development framework for bringing stakeholders together to coordinate plans to address community needs.
Designing a Crime Prevention Community Based Program - Abid Jan OttawaAbid Jan
This document outlines a proposed community safety initiative called the No Community Left Behind (NCLB) program for the Banff Avenue Community. The key components of the NCLB program include community mobilization, law enforcement, community policing, neighborhood restoration, prevention and empowerment. It proposes establishing a steering committee comprised of community partners to provide leadership and oversight. Other elements include conducting a community needs assessment, developing a strategic action plan, implementing programs and activities, and evaluating outcomes. The goal is to collaboratively address crime, social issues, and improve quality of life through coordinated community engagement and leveraging of resources.
HTN Collective impact in Austin Final SlidesNikki Trevino
The document summarizes the work of the Healthy Youth Partnership (HYP) in Austin, Texas to improve youth services through collaboration. HYP was formed to address the needs identified in a needs assessment involving numerous organizations. It focuses on collective impact principles like having a common agenda, shared measurement systems, mutually reinforcing activities, continuous communication, and backbone support. HYP has experienced both support like from partner organizations and challenges like lack of funding in sustaining its work. It outlines strategies used to strengthen collaborations like leadership development and funding partnerships.
Realising the Value Stakeholder Event - Main slide deckNesta
This document provides an agenda and background information for a stakeholder event called "Realising the Value". The event aims to empower people and communities to take a more active role in managing their health and care. It will include workshops on understanding value, desired behavioral changes, prioritizing approaches, and how the system can better support individuals and communities. The program seeks to demonstrate the impact of person-centered approaches, develop tools to support implementation, and provide recommendations to enable the healthcare system to work more collaboratively with patients and communities.
This document discusses community engagement and coalitions, noting that community engagement involves collaborating with community groups to address issues affecting well-being. It emphasizes focusing on community assets and needs, valuing community members as partners, and combining community wisdom with expertise. Coalitions are most effective when they build trust, recruit new resources and allies, and create better communication. This allows for strengthened communities and accountability as well as improved health outcomes. The document provides guidance on engaging communities in coalitions, including knowing the community, identifying relevant organizations, overcoming barriers, and providing opportunities for members to contribute.
Racial justice and the climate movementEPIPNational
A challenge as complex as climate change demands approaches that link its social and ecological dimensions. Importantly, the destructive effects of our fossilfuelbased way of life are uneven, harming some people more than others. The impacts of climate change are also uneven. For example, coastal storms, sea level rise, and drought disproportionately affect certain populations. Real solutions to the climate crisis will require a significant level of socioeconomic change, as we decarbonize many sectors of society including energy, agriculture, and transportation, to name a few. Socioeconomic restructuring on this scale raises the critical issue of equity: solutions must work for everyone.
To best create climate solutions that meet the needs of everyone, we must create space for historically less privileged populations to lead. A more inclusive and intersectional movement will allow all groups to learn how patterns of oppression and privilege operate in our society, as well as, understand how they intersect with environmental justice and the ability to influence public policy. It will also build trusting relationships that leverage the power of diverse alliances and intersections, broadening our work beyond the confines of singleissue environmental organizing.
To that end, this webinar will answer the following: “How can we honor the intersectionality of climate change in a way that invites historically excluded populations to lead us toward an unstoppable climate movement?” Participants will walk away with guidance and lessons learned from philanthropists and practitioners who are applying an inclusive and intersectional approach to strengthen their work.
Co-Sponsored by Environmental Grantmakers Association (EGA)
Speakers:
Farhad Ebrahimi, Chorus Foundation
Samantha Harvey, Environmental Program Officer, Overbrook Foundation; Program Manager, BEA for Impact
Vernard Williams, Director, Race and Justice Initiative, Alliance for Climate Education
Elizabeth Yeampierre, Executive Director, UPROSE
Ending homelessness through employment and housing requires a focused effort aimed at building linkages with the mainstream workforce system, using innovative, proven strategies and advocating for the necessary resources and supports. Homeless jobseekers with barriers to employment are disadvantaged in the best of times. In the current economy, agencies need better tools and skilled practice. In this pre-conference session, we will help participants make use of new the Community Employment Pathway guidebook provided by the Department of Housing and Urban Development (HUD) to create training and job opportunities, explore how hopeFound has combined a Housing First, work first program using motivational interviewing as a cornerstone practice. Speakers also addressed the need for local and national advocacy for financial resources, employment encouraging policies, and access to mainstream services.
Fix it or flee it: Proven approaches for dealing with failing, flagging and f...Greg Melia, CAE
This document provides guidance on assessing association programs that are failing, flagging, or floundering. It outlines a 5-step process: 1) Define goals of the assessment; 2) Conduct research on the program's history, impact, and data; 3) Measure the program's impact and outcomes; 4) Analyze the program's efficiency and costs; 5) Implement the assessment with key stakeholders and communicate the results. Throughout, it emphasizes identifying the program's original goals, understanding costs, measuring impact both quantitatively and qualitatively, and involving stakeholders in the process to facilitate changes based on the findings.
Realising the Value Stakeholder Event -Workshop: How does the system support Nesta
Workshop D - How does the system support communities/individuals and how could it do it better?
The levers and drivers that national bodies put in place and how these are used locally have a significant impact on working in partnership with communities and patients. These levers and drivers include regulation, targets, outcomes measures, financial flows, annual contracting cycles, clinical standards, workforce training and revalidation etc.
This workshop will draw upon your experience and evidence to address two questions:
How these levers and drivers get in the way of working in partnership with patients and communities?
What is the best blend of approaches to support commissioners and providers locally to harness the energy of patients and communities
Realising the Value Stakeholder Event - Workshop:Let's think in terms of beha...Nesta
Workshop B - Let's think in terms of behaviour: What changes do we want to see?
Participants will be shown how the Behavioural Insights Team approach projects in terms of targeting specific behaviours to change. Participants will then work together to do just this for the Realising the Value programme, thinking about what changes they would like to see amongst people, patients and practitioners. This will help form outcome measures for the RtV programme and will give participants a new way of thinking about making tangible change happen in their own organisations.
H. daniels duncan consulting abcd and community partnerships 08 06 2013hddabcd
This document outlines an asset-based community development workshop. It discusses using community members' skills and passions, rather than focusing only on needs, to create change. The workshop covers collective impact initiatives, asset mapping residents' gifts to identify existing community strengths, and engaging residents in building a stronger community through collaboration. Effective partnerships are built on shared purpose, relationships and trust between organizations and community members.
Assessing Capacity for Community Change Efforts: Learnings From an Adaptive I...Innovation Network
Should community change efforts be focused on funding coalitions or funding a flexible group of community leaders? The Kansas Health Foundation has embraced a four-pronged community change model that targets community leaders as key agents of change within each of their funded communities. Innovation Network, the evaluation partner for the Kansas Health Foundation's Healthy Communities Initiative, developed and deployed an assessment tool designed to contribute to the assessment of leadership capacity in effecting community change.
In this presentation at the American Evaluation Association's annual conference in Washington, D.C., Kat Athanasaides and Veena Pankaj (Innovation Network) and Deanna Van Hersh (The Kansas Health Foundation) shared lessons learned about developing and deploying a capacity assessment tool. They also discussed what these tools can -- and cannot -- tell you about a coalition's capacity in conducting community change work.
The document discusses the South Eastern Sydney Recovery College (SESRC), an educational initiative in Australia focused on mental health recovery. It operates using a co-production framework where people with lived experience of mental health issues and professionals jointly plan and deliver courses. Staff interviews found co-production within the Recovery College setting was transformational. Since opening in July 2014, the Recovery College has held courses for over 100 students, including consumers, carers, clinicians, and staff. Feedback has been positive about the inclusion of lived experience perspectives.
This document provides a blueprint for implementing interprofessional care in Ontario. It outlines the context, including demands on the healthcare system that necessitate new collaborative models of care. The blueprint was developed through extensive consultation with healthcare and education leaders. It presents 4 key recommendations to advance interprofessional care through actions like preparing current and future caregivers via interprofessional education, and supporting organizational structures, regulations, and policies that enable collaborative team-based care. The goal is to provide guidance to transform the healthcare system through system-wide adoption of interprofessional care.
This document discusses using a performance management system to help health departments maintain accreditation through the Public Health Accreditation Board (PHAB). It outlines three keys to an effective performance management system for reaccreditation: 1) Driving and capturing continuous improvement at every level, 2) Aggregating, engaging, and sharing data and learning across stakeholders, and 3) Linking various plans and assessments like the community health assessment, improvement plan, and department strategic plan. The document provides examples and explanations of how a performance management system can help health departments demonstrate accountability, continuous quality improvement, and advancing population health as required for PHAB reaccreditation.
Achieving Measurable Collective Impact with Results-Based Accountability - Co...Clear Impact
Achieving Measurable Collective Impact with Results-Based Accountability - Common Agenda
Partners from local, state and national initiatives are working together to understand how to meet the conditions of collective impact. Organizations often seek like-minded partners in order to reach common goals. Partnerships are formed. Meetings are held. But to what end? Stakeholders are convened from numerous programs aimed at support community well-being. These partnerships often find themselves continuing to focus on the outcomes for individuals, rather than on the collective impact of aligned partners throughout the community. Over time, meeting attendance falls and partners end up falling short of measurable results. What causes these well-intentioned efforts to flounder?
This workshop series will detail how partners and stakeholders can understand and implement the five conditions of collective impact by implementing the RBA framework. Each webinar will focus on a specific condition, allowing participants to have a deeper understanding of what it takes to practically apply RBA to meet that condition. The series will also include case studies that illustrate how partner organizations can align their efforts to achieve measurable community results with sustainable change. Participants are encouraged register for the full series, as each webinar will build upon the content from previous sessions.
Check out more videos and webinars on our website: https://clearimpact.com/resources/videos/
The document discusses best practices for community investment programs. It recommends starting early to understand local needs, developing innovative solutions for social problems, and regularly measuring impact. Effective programs identify business objectives, minimize ad hoc activities, and align investments with project timelines. Programs are most successful when they involve local stakeholders, build local capacity, and empower communities through partnership and self-mobilization. Good processes are important, including choosing partners, setting objectives, monitoring progress, evaluating outcomes, and managing finances. Front-loading efforts and using a multi-strand strategy can help address both short and long-term needs in a community.
Karen Finn, Vice President of Professional Services at Clear Impact, provides tips for conducting effective virtual meetings. She discusses the importance of preparation, having clear objectives, an agenda, and guidelines. Some keys to effective virtual meetings are asking participants to sign in early and provide backup contact information in case of disconnections. Videoconferencing allows sharing screens to take notes. Common issues like people talking over each other can be avoided using features like mute, hand raising, and breakout rooms.
Final webinar-slides-the-very-best-rba-examplesClear Impact
This document provides examples of organizations that have successfully implemented Results-Based Accountability (RBA). It summarizes implementations in Tompkins County, New York, Alameda County Public Health Department in California, the Colorado Department of Education, and United Way of Brazoria County. It also describes an RBA professional certification program.
Clear Impact is introducing a new case management software called Compyle that integrates with their existing Scorecard platform. Compyle allows organizations to collect and track participant data, create and send custom surveys, analyze results, and push data into Scorecard. Pricing for Compyle starts at $200 per month for small organizations and scales up based on the number of included participants.
Businesses & Public Health: Partnering for PreventionCoalitions Work
Explores why businesses should focus on strategies that change policies, systems & environments within workplace, as well as advocate for community-wide changes that make their employees healthier when not at work!
This document discusses types of groups, stages of group development, roles in groups, community organizing, and social service work. It covers:
1) Different types of groups including recreational, educational, problem-solving, self-help, socialization, and therapeutic groups.
2) The typical stages of group development which include orientation, authority, negotiation, functional, and disintegration stages.
3) Key roles that individuals may take on in groups such as the scapegoat, deviant, leader, and gatekeeper.
4) Models of community work including locality development, social planning, social action, and pragmatic approaches.
5) The core skills and roles involved in community organizing,
Community Development - Building a Healthy Community - by Abid JanAbid Jan
This document provides an overview of community development. It defines community development as a grassroots process where communities organize, plan, develop healthy options, empower themselves, and achieve social, economic, cultural and environmental goals. It discusses principles of community development including taking a long-term approach, focusing on community assets, and empowering community members. The document also outlines the role of community developers in supporting communities and the relationship between community development and social determinants of health. Finally, it presents a community development framework for bringing stakeholders together to coordinate plans to address community needs.
Designing a Crime Prevention Community Based Program - Abid Jan OttawaAbid Jan
This document outlines a proposed community safety initiative called the No Community Left Behind (NCLB) program for the Banff Avenue Community. The key components of the NCLB program include community mobilization, law enforcement, community policing, neighborhood restoration, prevention and empowerment. It proposes establishing a steering committee comprised of community partners to provide leadership and oversight. Other elements include conducting a community needs assessment, developing a strategic action plan, implementing programs and activities, and evaluating outcomes. The goal is to collaboratively address crime, social issues, and improve quality of life through coordinated community engagement and leveraging of resources.
HTN Collective impact in Austin Final SlidesNikki Trevino
The document summarizes the work of the Healthy Youth Partnership (HYP) in Austin, Texas to improve youth services through collaboration. HYP was formed to address the needs identified in a needs assessment involving numerous organizations. It focuses on collective impact principles like having a common agenda, shared measurement systems, mutually reinforcing activities, continuous communication, and backbone support. HYP has experienced both support like from partner organizations and challenges like lack of funding in sustaining its work. It outlines strategies used to strengthen collaborations like leadership development and funding partnerships.
Realising the Value Stakeholder Event - Main slide deckNesta
This document provides an agenda and background information for a stakeholder event called "Realising the Value". The event aims to empower people and communities to take a more active role in managing their health and care. It will include workshops on understanding value, desired behavioral changes, prioritizing approaches, and how the system can better support individuals and communities. The program seeks to demonstrate the impact of person-centered approaches, develop tools to support implementation, and provide recommendations to enable the healthcare system to work more collaboratively with patients and communities.
This document discusses community engagement and coalitions, noting that community engagement involves collaborating with community groups to address issues affecting well-being. It emphasizes focusing on community assets and needs, valuing community members as partners, and combining community wisdom with expertise. Coalitions are most effective when they build trust, recruit new resources and allies, and create better communication. This allows for strengthened communities and accountability as well as improved health outcomes. The document provides guidance on engaging communities in coalitions, including knowing the community, identifying relevant organizations, overcoming barriers, and providing opportunities for members to contribute.
Racial justice and the climate movementEPIPNational
A challenge as complex as climate change demands approaches that link its social and ecological dimensions. Importantly, the destructive effects of our fossilfuelbased way of life are uneven, harming some people more than others. The impacts of climate change are also uneven. For example, coastal storms, sea level rise, and drought disproportionately affect certain populations. Real solutions to the climate crisis will require a significant level of socioeconomic change, as we decarbonize many sectors of society including energy, agriculture, and transportation, to name a few. Socioeconomic restructuring on this scale raises the critical issue of equity: solutions must work for everyone.
To best create climate solutions that meet the needs of everyone, we must create space for historically less privileged populations to lead. A more inclusive and intersectional movement will allow all groups to learn how patterns of oppression and privilege operate in our society, as well as, understand how they intersect with environmental justice and the ability to influence public policy. It will also build trusting relationships that leverage the power of diverse alliances and intersections, broadening our work beyond the confines of singleissue environmental organizing.
To that end, this webinar will answer the following: “How can we honor the intersectionality of climate change in a way that invites historically excluded populations to lead us toward an unstoppable climate movement?” Participants will walk away with guidance and lessons learned from philanthropists and practitioners who are applying an inclusive and intersectional approach to strengthen their work.
Co-Sponsored by Environmental Grantmakers Association (EGA)
Speakers:
Farhad Ebrahimi, Chorus Foundation
Samantha Harvey, Environmental Program Officer, Overbrook Foundation; Program Manager, BEA for Impact
Vernard Williams, Director, Race and Justice Initiative, Alliance for Climate Education
Elizabeth Yeampierre, Executive Director, UPROSE
Ending homelessness through employment and housing requires a focused effort aimed at building linkages with the mainstream workforce system, using innovative, proven strategies and advocating for the necessary resources and supports. Homeless jobseekers with barriers to employment are disadvantaged in the best of times. In the current economy, agencies need better tools and skilled practice. In this pre-conference session, we will help participants make use of new the Community Employment Pathway guidebook provided by the Department of Housing and Urban Development (HUD) to create training and job opportunities, explore how hopeFound has combined a Housing First, work first program using motivational interviewing as a cornerstone practice. Speakers also addressed the need for local and national advocacy for financial resources, employment encouraging policies, and access to mainstream services.
Fix it or flee it: Proven approaches for dealing with failing, flagging and f...Greg Melia, CAE
This document provides guidance on assessing association programs that are failing, flagging, or floundering. It outlines a 5-step process: 1) Define goals of the assessment; 2) Conduct research on the program's history, impact, and data; 3) Measure the program's impact and outcomes; 4) Analyze the program's efficiency and costs; 5) Implement the assessment with key stakeholders and communicate the results. Throughout, it emphasizes identifying the program's original goals, understanding costs, measuring impact both quantitatively and qualitatively, and involving stakeholders in the process to facilitate changes based on the findings.
Realising the Value Stakeholder Event -Workshop: How does the system support Nesta
Workshop D - How does the system support communities/individuals and how could it do it better?
The levers and drivers that national bodies put in place and how these are used locally have a significant impact on working in partnership with communities and patients. These levers and drivers include regulation, targets, outcomes measures, financial flows, annual contracting cycles, clinical standards, workforce training and revalidation etc.
This workshop will draw upon your experience and evidence to address two questions:
How these levers and drivers get in the way of working in partnership with patients and communities?
What is the best blend of approaches to support commissioners and providers locally to harness the energy of patients and communities
Realising the Value Stakeholder Event - Workshop:Let's think in terms of beha...Nesta
Workshop B - Let's think in terms of behaviour: What changes do we want to see?
Participants will be shown how the Behavioural Insights Team approach projects in terms of targeting specific behaviours to change. Participants will then work together to do just this for the Realising the Value programme, thinking about what changes they would like to see amongst people, patients and practitioners. This will help form outcome measures for the RtV programme and will give participants a new way of thinking about making tangible change happen in their own organisations.
H. daniels duncan consulting abcd and community partnerships 08 06 2013hddabcd
This document outlines an asset-based community development workshop. It discusses using community members' skills and passions, rather than focusing only on needs, to create change. The workshop covers collective impact initiatives, asset mapping residents' gifts to identify existing community strengths, and engaging residents in building a stronger community through collaboration. Effective partnerships are built on shared purpose, relationships and trust between organizations and community members.
Assessing Capacity for Community Change Efforts: Learnings From an Adaptive I...Innovation Network
Should community change efforts be focused on funding coalitions or funding a flexible group of community leaders? The Kansas Health Foundation has embraced a four-pronged community change model that targets community leaders as key agents of change within each of their funded communities. Innovation Network, the evaluation partner for the Kansas Health Foundation's Healthy Communities Initiative, developed and deployed an assessment tool designed to contribute to the assessment of leadership capacity in effecting community change.
In this presentation at the American Evaluation Association's annual conference in Washington, D.C., Kat Athanasaides and Veena Pankaj (Innovation Network) and Deanna Van Hersh (The Kansas Health Foundation) shared lessons learned about developing and deploying a capacity assessment tool. They also discussed what these tools can -- and cannot -- tell you about a coalition's capacity in conducting community change work.
The document discusses the South Eastern Sydney Recovery College (SESRC), an educational initiative in Australia focused on mental health recovery. It operates using a co-production framework where people with lived experience of mental health issues and professionals jointly plan and deliver courses. Staff interviews found co-production within the Recovery College setting was transformational. Since opening in July 2014, the Recovery College has held courses for over 100 students, including consumers, carers, clinicians, and staff. Feedback has been positive about the inclusion of lived experience perspectives.
This document provides a blueprint for implementing interprofessional care in Ontario. It outlines the context, including demands on the healthcare system that necessitate new collaborative models of care. The blueprint was developed through extensive consultation with healthcare and education leaders. It presents 4 key recommendations to advance interprofessional care through actions like preparing current and future caregivers via interprofessional education, and supporting organizational structures, regulations, and policies that enable collaborative team-based care. The goal is to provide guidance to transform the healthcare system through system-wide adoption of interprofessional care.
Spring 2014 Global Health Practitioner Conference BookletCORE Group
This document provides information about the 2014 CORE Group Global Health Practitioner Conference held from May 5-9, 2014 in Silver Spring, MD. The conference theme is "Health for All Starts in the Community" and aims to explore community health strategies, share resources and technical information, and strengthen CORE Group's working groups. It lists sponsors, contributors and objectives of the conference. It also provides an overview of CORE Group including its vision, mission and expertise. It describes the eight CORE Group working groups that participants can join.
Kate Bukowski Health Promoting Practices Presentationkate_bukowski
The document discusses a health promoting practices quality framework and ProCare Health's strategy. It outlines how health promoting practices can improve patient health, increase patient enrollments and practice income, and reduce avoidable hospitalizations. The benefits for practices include less busy clinicians, professional development opportunities, and quality improvement. It then discusses how health promoting practices are based on overseas models and government directives in New Zealand. It focuses on integration across disciplines and improving relationships between practices, clinicians, patients, and communities. The last part outlines a five step process for practices to work on a health issue through self-assessment, using a toolkit, and quality improvement plans with support from health promoters.
The student completed a practicum at the Orlando VA Medical Center developing and implementing an educational program for nursing staff on caring for veterans with PTSD. The goals were to assess nursing staff needs, develop a teaching program using evidence-based research, and evaluate its effectiveness in improving veteran quality of life. The program was well-received and led to positive outcomes on nursing knowledge. The experience enhanced the student's skills as a nurse educator and provided opportunities for professional advancement.
Faculty development in interprofessional education and practiceJose Frantz
The document discusses interprofessional education and collaborative practice. It identifies interprofessional collaboration as key to improving healthcare outcomes. It also discusses developing common language and understanding differences in teaching approaches to provide educators with skills to train health professions students. A priority is interprofessional collaboration in clinical practice in sub-Saharan Africa. The need for flexible assessment policies in online interprofessional education is also mentioned.
Primary Health Care Strategy:
Key Directions for the Information Environment. Case study report and composite success model.
Steve Creed & Philip Gander
This document provides information and resources to support self-management of long-term conditions in Scotland. It discusses 10 approaches to improving self-management, including empowering people to have more control over their care, promoting better mental health and wellbeing, enabling better access to information and support, developing care plans, supporting medication management, using telehealth, supporting carers, commissioning self-management resources, using patient records, and training staff. For each approach, examples of relevant projects and contacts for additional information are provided. The overall aim is to enhance patient outcomes and experiences by promoting self-management.
The document discusses community health nursing standards of practice, with a focus on home health nursing. It provides an overview of the Canadian Community Health Nursing standards, which include standards on health promotion, prevention and protection, maintenance and restoration, professional relationships, capacity building, health equity, evidence-informed practice, and professional responsibility. Examples are given of how home health nurses apply each standard in practice, such as providing health education to diabetes patients, encouraging preventative behaviors like handwashing during COVID, and advocating for policies that promote health equity. The standards aim to define excellence in community health nursing and guide nurses in their important work.
SMART GOAL
Leadership SMART Goal Leadership goal Setting a goal is important since it really gives clarity to a person’s vision. A goal specifies the outcome of what one wants to accomplish (Jay, 2011). Developing a SMART leadership goal ensures that one’s goal is actually focused and offers a clear idea of what one wants to accomplish. In essence, a goal that is SMART makes it simpler for one to come up with pertinent activities, to measure his or her progress towards accomplishing the goal, and know when he or she has met his/her goal (Jay, 2011). For me, setting a SMART goal will make what I want tangible since I am declaring to myself that this is really what I want. Basically, the SMART goal will help me to focus my everyday energy towards making my dreams and wishes come true. My set goal is SMART in the following way: Specific: Haughey (2014) pointed out that a specific goal has to be focused, detailed, and stated clearly. My goal is specific enough; it is to work in interdisciplinary/interprofessional teams by Week 10 (as selected from the Institute of Medicine (IOM)). In these teams, I should be able to work with other professionals to offering the best care available to transplant patients and help the patients before the transplant, during the transplant, and after. To accomplish this goal, I will greet and introduce myself to various health professionals in the Transplant Services Department so familiarize my self with the department and the transplant of patients and cooperate, collaborate, communicate, and integrate care in teams to ensure that care is continuous and reliable. In the future health care system, health professionals will have to understand the advantage of high levels of cooperation, coordination, and standardization to guarantee excellence, continuity, safety, and reliability. In short, they will have to think of themselves as a team working in and contributing to a larger system. As Don Berwick, Institute for Healthcare Improvement, said at the summit, The team members integrate their observations, bodies of expertise, and spheres of decision making. Thus this competency refers to the various disciplines working together to address the needs of patients. Interdisciplinary teams are critical in dealing with the increasing complexity of care, coordinating and responding to multiple patient needs, keeping pace with the demands of new technology, responding to the demands of payors, and delivering care across settings Teams tend to reduce the utilization of redundant or duplicate services, and they also tend to develop more creative solutions to complex problems because of their members’ diverse academic backgrounds and experience. Patients needing chronic care, critical acute care, geriatric care, and care at the end of life require smooth team functioning because of the complexity of their needs. Different means and settings for delivering care, such as managed care, community-based care, rehabilitation centers,.
Clinical Workforce Development NCA Informational WebinarCHC Connecticut
Learn more about training and technical assistance offered through Community Health Center Inc.'s National Cooperative Agreement (NCA) on Clinical Workforce Development. Hear more about FREE Learning Collaboratives opportunities to enhance or implement a model of Team-Based Care at your Health Center, and how to implement a Post-Graduate Residency program for Nurse Practitioners and Post-Doc Clinical Psychologists.
Nursing and Midwifery - WHO report and recommendations (2008-2014)GHWA
This technical report summarizes information from a WHO conference on strengthening nursing and midwifery. It discusses the Strategic Directions for Nursing and Midwifery 2011-2015 framework, the WHO progress report on nursing and midwifery from 2008-2012, publications on the role of nurses and midwives in addressing noncommunicable diseases, and draft competencies for midwifery educators. The report also provides information on the Global Forum of Government Chief Nursing and Midwifery Officers in 2012 and 2014.
2021-2022 NTTAP Webinar: Building the Case for Implementing Postgraduate NP R...CHC Connecticut
Join us as we discuss the drivers and processes of implementing a postgraduate nurse practitioner residency program at your health center, the benefits of implementing a postgraduate residency program, and the residency tracks for Family, Psychiatric/Mental Health, Pediatric, and Adult-Gerontology Nurse Practitioners.
We will be joined by Charise Corsino, Program Director of the Nurse Practitioner Residency Program, and Nicole Seagriff, Clinical Program Director of the Primary Care Nurse Practitioner Residency Program, from the Community Health Center Inc.
The Central Adelaide and Hills Medicare Local identified overweight and obesity as a key concern through population health profiling in 2012. They developed a healthy weight strategy using stakeholder engagement and community consultation methods. This included workshops, programs, and communication strategies. The strategy aimed to clarify care pathways for general practices and inform future management of overweight and obesity. It resulted in two documents: a monograph summarizing obesity trends, recommendations, and general practice support, and a pathway document to guide practices in managing overweight and obesity patients.
Team Health Overview Danielle Byers & Rob Wilkinsbyersd
This document summarizes a consultation forum aimed at improving team-based care through clinical education programs. The forum's goals are to consult on ways to better prepare graduates for collaborative practice and identify opportunities to foster teamwork. Improving collaboration is intended to benefit staff experience and retention as well as patient safety, satisfaction and outcomes. The document discusses concepts of interprofessional education and practice and cites evidence that team-based care improves quality. It outlines Team Health's model and partnerships to coordinate training across sectors to develop collaborative competencies through multi-faceted strategies including online learning and clinical placements.
The aim of this study was to investigate if a HWC program conducted by coaching trainees in a university/worksite setting would have a positive impact on participants’ health and well-being. Moreover, we wanted to evaluate the effects of HWC in wellness scores when face-to-face meetings and additional social-embedded support activities are offered to participants. HWC trainees in CtbW used several coaching strategies including coaching role definition, patient centeredness, visioning, participant self-determined goals through self-discovery, promotion of self-mastery and growth mindset, strengths support, accountability and ownership setting, intrinsic motivation, and supporting environmental and social activities.
Fall 2014 Global Health Practitioner Conference BookletCORE Group
1) CORE Group is a global network that aims to improve community health practices for underserved populations through collaborative action and learning.
2) At their 2014 conference, they discussed how NGOs can strengthen health systems with a focus on community health workers and mobile health tools.
3) CORE Group is currently partnering with USAID's Maternal and Child Survival Program and the Food Security and Nutrition Network to apply their expertise in knowledge management, community health strengthening, and expanding partnerships.
The document provides an overview of the newly formed Team Health program at the Clinical Education and Training Institute (CETI), which aims to improve teamwork, communication and collaboration for safer patient-centered care. It summarizes outcomes from two statewide consultation forums, which identified priorities for preparing new clinical graduates and enhancing team-based care. The consultations generated consensus that the Team Health program is evidence-based and can be implemented in coordination with Local Health Districts and other related programs.
Practical Guidance for Incorporating Health Equity Learning_Jennifer Winestoc...CORE Group
This document outlines guidance from the Maternal and Child Health Integrated Program (MCHIP) for incorporating health equity considerations into program design. It defines health equity and describes a 6-step process and checklist to help programs 1) understand equity issues in their area, 2) identify disadvantaged groups, 3) decide on strategies, 4) set goals, 5) implement activities, and 6) monitor equity-focused indicators. Examples are provided from MCHIP country programs. The guidance was created to ensure equity is systematically addressed and improvements can be demonstrated. Attendees then participated in an exercise to apply the guidance to their own country programs.
This document provides a map showing the locations of Family Health Teams across Northern Ontario implemented in three waves:
1) The map shows the locations of Family Health Teams in various communities across Northern Ontario, grouped into large, community, small, and rural sites.
2) The Family Health Teams were implemented in three waves, with teams in different regions of Northern Ontario launching in each wave.
3) The map identifies the regions covered by each wave and provides the number of family physicians in each type of site to characterize their size.
Family Health Teams have been established across Northern Ontario in 3 waves:
- Wave 1 included large teams of 21-30 family physicians, community teams of 11-20 physicians, and small/rural teams of 5 or fewer physicians. Teams were located in communities across central, eastern, western and Champlain regions.
- Wave 2 expanded coverage with additional large, community and small/rural teams in northeast, northwest, southeast, southwest and Toronto regions.
- Wave 3 further increased access with more large teams in central, eastern and western regions and additional community and small/rural teams across the north.
This document provides guidance on managing waiting times in the NHS in Scotland. It outlines 10 golden rules for waiting time management that put the patient's interests first. It emphasizes the importance of appropriate referrals, adequate services, clinical prioritization of patients, and keeping patients informed of wait times. The document stresses partnership between primary and secondary care and accurate information on waiting lists. It discusses initiatives to treat backlogs versus long-term strategies to close gaps between demand and capacity. NHS Boards are asked to develop local plans that meet and exceed national targets through leadership, risk assessment, resource planning, and patient consultation.
This guidebook shares stories from nine Ontario communities that have undertaken healthy community initiatives. The stories describe their experiences and processes to raise awareness, build connections, and take action around health issues. Community members then reflected on these stories and identified "words of wisdom" from their experiences. Finally, the guidebook provides a framework and questions to help other communities document and share their own stories to guide their healthy community efforts.
The document provides tips and tools for registered dietitians working in interdisciplinary primary care settings. It outlines a proposed model for nutrition services with the RD responsible for overall management and the most in-depth nutrition counselling. It describes assessing community needs, nutrition screening, referral processes, nutrition advice and counselling. A typical nutrition counselling process is outlined including pre-screening referrals, initial visits, nutrition planning visits, follow-up visits and coordinating with the interdisciplinary team. Various tools developed in a demonstration project are also included to support RDs.
This document outlines a screening project conducted with primary care providers to identify at-risk women and incorporate screening tools for alcohol, smoking, and abuse into practice. It provided a screening and resource package, conducted academic detailing, and administered pre- and post-test questionnaires. The results showed increased screening rates for tobacco, alcohol, and abuse from pre- to post-test. While the response rate for the post-test was lower, providers reported increased use of screening tools and community referrals. The academic detailing approach was found useful by most providers.
This document outlines Saskatchewan's Action Plan for Primary Health Care, which aims to strengthen primary health care services in the province. It describes the vision for an integrated primary health care system delivered through networks of health care providers. The plan establishes defined roles for Regional Health Authorities and the government in managing, operating and funding primary health care. It also outlines characteristics of the new system and a phased implementation approach over 10 years to establish primary health care teams accessible to all residents.
The Role And Value Of Primary Care Practiceprimary
This document summarizes discussions from a 2002 conference on building consensus for healthcare reform in Canada. It includes summaries of two presentations:
1. Marie-Dominique Beaulieu's presentation on the role and value of primary care. She defines primary care and argues for strengthening it in Canada. She calls for changes like developing primary care teams with nurses and better information systems.
2. Howard Bergman's presentation in which he argues for strengthening and transforming primary care as the foundation of the healthcare system. He calls for an evidence-based approach and investing in primary care to improve health outcomes. Both agree comprehensive reform is needed, not just changes to primary care itself.
The document describes The Model for Improvement, which provides a framework for developing, testing, and implementing changes that lead to improvement. The model consists of two parts: 1) three fundamental questions to guide improvement work, and 2) Plan-Do-Study-Act cycles to test changes rapidly through small-scale trials. Using this approach can help achieve successful, low-risk change through a simple and effective process of continuous learning and adaptation.
This document summarizes the final report from the Forum on Teamworking in Primary Healthcare. The forum was convened by several national healthcare organizations to examine teamworking in primary care. The report found evidence that effective teamwork occurs when roles are clearly defined and rewarding, communication is good, and there are shared goals. It identified barriers like competing demands, status differences, and lack of resources. The report provides recommendations to improve teamworking at both the organizational and team member levels. It also highlights several examples of successful teamworking initiatives in UK primary care settings.
The document discusses strategies for improving patient flow and reducing cycle times in medical practices. It describes how mapping patient flows, measuring cycle times, and identifying interruptions can help practices pinpoint bottlenecks. Practices have found that small tests of change focused on areas like visit planning, co-locating staff, efficient office design, exam room standardization, documentation shortcuts, and streamlined check-in/out processes can uncover hidden capacity and increase revenue. The key is developing a deep understanding of the current process from the patient's perspective before envisioning an ideal flow and implementing changes while monitoring for unintended consequences. Physician leadership and a team effort are essential to successfully redirecting patient flow.
Snap%2 B Framework%2 Bfor%2 B General%2 B Practiceprimary
This document presents the Smoking, Nutrition, Alcohol and Physical Activity (SNAP) Risk Factor Framework for General Practice. The framework was developed to provide integrated approaches for general practitioners to support behavioral risk factor management for smoking, nutrition, alcohol and physical activity.
It identifies these four risk factors as major contributors to disease burden and outlines seven outcomes areas for action: organizational structures, financing, workforce development, information systems, communication, partnerships and referral networks, and research. The framework is intended to streamline support for general practices and encourage collaboration across different organizations and levels of care.
The document is the first annual report from the Health Results Team, which was created by the Minister of Health and Long-Term Care to improve patient access to healthcare in Ontario. The report details progress made in the first year to transform the healthcare system through initiatives like establishing Local Health Integration Networks, reducing wait times, implementing Family Health Teams, and improving information management. The Health Results Team worked across the healthcare community and achieved many milestones to deliver on the vision of creating a more integrated, sustainable, and patient-centered healthcare system.
This document provides updates on chronic disease management initiatives including the Chronic Disease Management Collaborative (CDMC). Key information includes:
1. An explanation of delivery system design which involves defining roles, using planned interactions, providing case management, and ensuring regular follow-up to effectively manage chronic illnesses.
2. Details on upcoming training for the Clinical Practice Redesign program and information sessions on a new diabetes education program using group visits.
3. Announcements of learning workshops and conferences on chronic disease management and diabetes.
The document discusses the role of registered dietitians in primary health care. It begins by explaining that primary health care focuses on wellness promotion rather than just illness treatment. It also notes that nutrition is important for health but access to nutrition services is limited. The document then describes key elements of primary health care, including using a population health approach, comprehensive services, coordination of care, interdisciplinary teams, and cost-effectiveness. It outlines the practice of registered dietitians in primary health care, including their skills in health promotion, education, and working with communities. Examples are provided of how dietitians contribute to quality of life, health outcomes, and cost containment through various strategies and actions.
Rg0035 A Guideto Service Improvement Nhs Scotlandprimary
This document provides a guide to using various tools and techniques for improving health care services. It focuses on using process mapping to analyze patient journeys through the health care system. Process mapping involves capturing each step of a patient's experience in a visual map to identify issues like bottlenecks, unnecessary steps, or handoffs between staff. Preparing for process mapping by defining the scope and goals and involving relevant staff and patients is important. Once complete, process maps can reveal problems and opportunities for improving efficiency and patient experience.
This document discusses the role of dietitians in collaborative primary health care mental health programs. It was developed as part of the Canadian Collaborative Mental Health Initiative to help integrate specialized services like nutrition and mental health expertise into primary care settings. Individuals with mental health issues are often nutritionally at risk due to factors like eating disorders, mood disorders, medication side effects, poverty and more. Dietitians are uniquely qualified to assess nutritional needs in this population and develop interventions as part of mental health care teams. However, more resources and strategies are still needed to fully realize dietitians' potential contributions to mental health care.
When relationships break down in organizations, it is often due to a lack of clear communication and shared understanding. The document outlines five common types of relationship breakdowns - role confusion, conflicting priorities, hidden expectations, communication issues, and resistance to change - and recommends strategies to address each one. These strategies include sharing key information, setting interaction agreements, building communication skills, and individual coaching. Addressing the root causes through open discussion and setting clear expectations is generally more effective than superficial fixes like team-building classes.
The article discusses rethinking the challenge of change management in organizations. It argues that traditional change management focuses too much on changing individual attitudes and behaviors and not enough on changing organizational systems and structures. The article proposes an alternative framework that views organizational change as an ongoing process of adaptation and focuses on aligning organizational components like strategy, culture and structure with each other and the external environment.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
2. Acknowledgements
Building A Better Tomorrow
An Atlantic Provincial Primary Health Care Initiative
Many people and organizations contributed to the Collaboration in Practice Module for the
Building A Better Tomorrow Initiative. The Nova Scotia Department of Health, the New Brunswick
Department of Health and Wellness, the Newfoundland Department of Health and Community
Services and the Prince Edward Island Department of Health and Social Services gratefully
acknowledges the contributions of Future Learning Inc. who designed the module, the Members
of the Provincial Education Advisory Committees, the Accreditation Teams, Dalhousie University
(Continuing Medical Education, Faculty of Medicine) and Memorial University’s Centre for
Collaborative Health Professional Education, Faculty of Medicine who reviewed the module and
specifically the facilitators and health care providers of the Atlantic provinces who participated in
the piloting of the module.
Production of this module has been made possible through a financial
Contribution from the Multijurisdictional Envelope of the Primary Health Care Transition Fund,
Health Canada.
The views expressed herein do not necessarily represent the official
policies of Health Canada, the Nova Scotia Department of Health, the New Brunswick
Department of Health and Wellness, the Newfoundland Department of Health and
Community Services and the Prince Edward Island Department of Health and Social
Services.
Building A Better Tomorrow, Primary Health Care
Nova Scotia Department of Health
PH: 902-424-3522
Fax: 902-424-0402
E-mail: primaryhealthcare@gov.ns.ca
www.gov.ns.ca/health/pchrenew
3. Collaboration in Practice Participant’s Manual
Building a Better Tomorrow
Atlantic Provinces Primary Health Care Initiative
Through Building a Better Tomorrow (BBT), a Health Canada funded initiative, all four Atlantic Provinces are working
together to develop and deliver education and training opportunities that will support health care providers to become
part of a primary health care team.
The need for health care providers to successfully embrace change has been of great concern and one met with
varying degrees of success. BBT is creating and delivering effective educational and orientation content that will
support and sustain change, not create new models of care.
A needs analysis was conducted to identify the learning needs of health care providers and to ensure sufficient input
from key stakeholders across the four provinces. Providers, professional bodies and educational institutions have all
played a part in the development of effective content.
Based on the focus groups conducted during the development of the proposal and the completed needs assessment,
with frontline health care providers the following content areas were identified; understanding of primary health care,
conflict management, team building, working with the community, working with the electronic patient record,
facilitation, collaborative practice and clinical program planning and evaluation. The needs analysis has been used to
further refine these areas, identify other content and develop the curriculum outline and delivery methods.
Education working groups and accreditation teams have been created that include; interprofessional practitioners
from all four Atlantic Provinces, university extension departments, academia representatives, regulatory bodies,
professional health associations and representatives of provincial community and health programs. The groups serve
in a consultative and advisory role with respect to the development of the educational content and delivery methods.
An Atlantic education-working group was established and includes consultants from Dalhousie University (Continuing
Medical Education, Faculty of Medicine) and Memorial University’s Centre for Collaborative Professional Education,
Faculty of Medicine, who provide expert consultation and technical advice. The working group brings together
information from all four provincial education advisory groups across the Atlantic Provinces on a regular basis to
ensure there is a sharing of knowledge and a coordinated effort toward content and delivery development and
evaluation.
Partnerships developed with key stakeholders through this initiative, as well as learning from experience, will sustain
this change management strategy. Exploring opportunities to embed curricula into existing continuing educational
programs, along with the development of curricula in post-secondary training and education programs for new
providers, will facilitate sustainability.
For additional information, contact your provincial project manager as listed below:
New Brunswick Yves Ducharme yves.ducharme@gnb.ca
Newfoundland and Labrador Brenda Hancock BrendaHancock@gov.nl.ca
Nova Scotia Gerard Murphy murphygt@gov.ns,ca
Prince Edward Island Diane Boswall hdboswall@ihis.org
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4. Collaboration in Practice Participant’s Manual
UNIT 1
Building a Better Tomorrow Initiative
One focus of primary health care is on teams of health care professionals working together to
improve the health of all citizens. That’s a big change from a system that has depended upon
family doctors working solo, or in small groups, to look after us.
Building a Better Tomorrow is a federally funded initiative, which has all four Atlantic Provinces
working together to assess, develop and deliver the training and skills health care providers need
to support transition to Primary Health Care practice.
The first step was to determine precisely what health care professionals need to learn to fulfill their
roles in a primary health care environment. The providers, professional bodies and educational
institutions have all helped to develop content. The courses themselves are being delivered
through post-secondary training and education programs, as well as existing continuing education
programs. This way, health care providers make a greater contribution to primary health care
renewal.
Other Building a Better Tomorrow Initiatives
Prince Edward Island
– Understanding Primary Health Care
– Collaboration in Practice
Newfoundland and Labrador
– Team Building I & II
– Electronic Patient Record
New Brunswick
– Facilitating Adult Learning I & II
– Electronic Patient Record
Nova Scotia
– Building Community Relationships
– Electronic Patient Record
Newfoundland and Labrador and New Brunswick
– Conflict Resolution
Nova Scotia and Prince Edward Island
– Getting Started in Program Planning and Evaluation
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5. Collaboration in Practice Participant’s Manual
COLLABORATION IN PRACTICE
AGENDA
Introductions
Definitions for Collaborative Practice
Principles of Collaborative Practice
BREAK
Target Populations
Roles and Scope of Practice in the Primary Health Care Team
Collaborative Practice Workshop (Part One)
LUNCH
Collaborative Practice Workshop (Part Two)
BREAK
Strategies for Collaboration
Closing
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6. Collaboration in Practice Participant’s Manual
Workshop Description
This practical one-day workshop is for health care professionals who would like to
acquire the knowledge, skills and confidence so that they can collaborate effectively
within a primary health care environment. This workshop is intended for no more than
25 people in total, to adequately manage activities. Success will be best achieved if
your entire team can participate – for the purpose of the workshop, individuals working
in three different disciplines should be represented. Through lectures, activities, and
practical exercises, participants conceptualize collaboration and will practice
collaborative processes applicable to their working lives.
Upon completion of the training, participants will be able to:
• Describe the concepts, principles and practical application of the
collaborative practice process as they relate to their specific role as a
primary health care team member.
• Describe the process to identify the target population, who needs to be
involved, and the information sources that are required in the collaborative
practice process.
• Compare and contrast the skills and functions of all members of the
primary health care team.
• Apply a collaborative practice process to their work in providing primary
health care services.
• Summarize the strategies of collaboration and apply this understanding to
their work as primary health care providers.
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7. Collaboration in Practice Participant’s Manual
UNIT 2
Definitions
Primary Health Care
Primary health care refers to the basic, everyday health care services assessed by
Canadians.
Primary health care is about:
Preventing people from becoming ill or injured
Managing chronic conditions
Making the most effective use of health provider expertise
Treating acute and episodic illness
Efficiency and co-ordination
Access
Individuals playing an active role in their own health care
Primary health care defies a single, easily understood definition. However, there is a
general acceptance of, and support for, the following four key pillars or elements that
underpin all models:
Healthy Living
Healthy living encompasses prevention, the management of chronic illness,
encouraging support for self-care and the idea that factors outside of the health
system can influence individual and community health.
Team Approach
The team approach is about health care providers working together to improve the
continuity of care, reduce duplication and ensure individuals have access to
appropriate health professionals. Patients/clients are a part of the team, as well, and
are involved in, and empowered to make, decisions about their own health.
Access 24/7
Primary health care is about ensuring that Canadians have greater access to the
right services when and where they are needed. It recognizes that Canadians need
advice, information, and care outside of regular office hours.
Information
Primary health care is about improved sharing of information between health
providers and expanded access to information for Canadians using the health
system or seeking health advice. It’s about using tools like electronic health records
and diagnostic instruments to improve the quality, access and co-ordination of health
information.
From National Primary Health Care Awareness Strategy Web site: www.phc-ssp.ca.
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8. Collaboration in Practice Participant’s Manual
Definitions (cont’d.)
Population Health
“Population health refers to the health of a population as measured by health status
indicators and as influenced by social, economic and physical environments, personal
health practices, individual capacity and coping skills, human biology, early childhood
development, and health services. The population health approach focuses on the
interrelated conditions and factors that influence the health of populations over the life
course, identifies systematic variations in their patterns of occurrence, and applies the
resulting knowledge to develop and implement policies and actions to improve the
health and well-being of those populations. “(Health Canada, 2002)
A population health approach is one that is targeted to the entire population rather than
individuals. It refers to the health of a population (e.g., a province) or sub-population
(e.g., Aboriginal people) and assesses health status and health status inequities over
the life span at the population level. This approach considers why people smoke, eat
unhealthily, and are physically inactive. The approach tackles the environment and
conditions that influence healthy choices and health outcomes.
Population health strives to make healthy choices the easy choices. Reducing the risk
factors for chronic disease is the greatest opportunity to improve the health of
Canadians and to sustain the country’s health care system.
There are two main approaches to promotion and prevention which address the
common risk factors for chronic disease:
1) Those that aim to improve the knowledge and skills of individuals.
2) Those that aim to promote healthy public policy and supportive environments that
make healthy lifestyle choices easy choices.
In the past, most efforts have been directed at individual knowledge and skills, but this
approach has proven to have limited success in changing these risk factors. Rather
than focusing on educating individuals alone, the aim of a population health approach is
to create environments and conditions that are conducive to creating and maintaining
healthy habits.
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9. Collaboration in Practice Participant’s Manual
A population health approach requires that policy and program decisions are based on
sound evidence. Information on health status, the determinants of health and the
effectiveness of interventions are used to assess health, identify priorities and develop
strategies to improve health. Best practices make effective use of available resources.
Achieving population-wide changes requires a long-term commitment that includes
multiple interventions carried out in a co-ordinated way at different levels over a period
of time. As well, certain settings such as schools, workplaces, municipalities and local
communities offer practical opportunities for effective health promotion.
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10. Collaboration in Practice Participant’s Manual
Definitions (cont’d.)
Collaboration
“A process through which parties who see different aspects of a problem can
constructively explore their differences and search for solutions that go beyond their
own visions of what is possible. Collaboration involves joint problem solving and
decision-making among key stakeholders in a problem or issue.” (Chronic Disease
Prevention Alliance of Canada, 2001)
Collaborative Practice
“Collaborative practice is an interprofessional process for communication and decision
making that enables the separate and shared knowledge and skills of care providers to
synergistically influence the client/patient care provided.”
(Way and Jones)
The benefits of a collaborative practice approach include:
• patients/clients have improved access to other physicians and providers located in
the practice;
• continuity of care is enhanced;
• physicians have the potential to take on new patients who do not currently have a
family physician. The practice population is expected to increase as a result of
alternate providers providing services and as a result of efficiencies gained by
appropriate utilization of providers; and
• physicians and other providers have an opportunity to work in a more supportive and
collegial environment.
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11. Collaboration in Practice Participant’s Manual
The Four Levels of Partnership
While many people use the word quot;collaborationquot; to refer to any type of partnership,
there are really several different types of partnerships, of which collaboration is only
one. These different types of partnerships form a continuum, which runs from least to
most intensive commitment.
Collaboration
Cooperation
Coordination
Communication
Communication
The least committed level of partnership, communication includes activity that has as its
purpose sharing of information and non-material resources.
Coordination
includes activity between two or more agencies or organizations that has as its purpose
prevention of duplication of efforts and assurance of provision of service.
Cooperation
Slightly more intensive, cooperation is activity between two agencies or sectors that
aims at some integration of operations, while not sacrificing the autonomy of either
party.
Collaboration
The most intensive level of partnership, collaboration is a mutually beneficial and well-
defined relationship which involves people from different agencies or sectors of the
community joining together to achieve a common goal. Usually, that goal could not be
achieved as efficiently (or at all) by any individual organization. The result is a highly
shared endeavor in which members eventually commit themselves as much to the
common goal as to the interests of their own organizations.
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12. Collaboration in Practice Participant’s Manual
Communication Coordination Cooperation Collaboration
Color
commitment
low formality high
personal contact
Color
high autonomy low
Examples of high and low levels of commitment, formality, personal contact and
autonomy:
LOW HIGH
Verbal agreement to work
Memorandum of Understanding
Commitment together if the opportunity
exists between partners.
arises.
No set procedures for any Established procedure for
Formality
aspect of shared work. managing disputes.
Little or no interaction between Regularly scheduled partner
Personal Contact
partners. meetings.
Partners consult with each Each partner operates its own
Autonomy other on a regular basis to plan program with little thought of what
each organizations schedule. the other partner is doing.
Source: http://www.sustainabilityonline.com/HTML/Collaboration/index.html
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13. Collaboration in Practice Participant’s Manual
Definitions (cont’d.)
Team
“A team is a small number of people with complementary skills who are committed to a
common purpose, performance goals, and approach for which they hold themselves
mutually accountable.” (from The Wisdom of Team, p. 45)
Characteristics of Effective Interprofessional Health Care Teams
• members provide care to a common group of patients;
• members develop common goals for patient outcomes and work toward those goals;
• appropriate roles and functions are assigned to each member, and each member
understands the roles of the other members;
• the team possesses a mechanism for sharing information;
• the team possesses a mechanism to oversee the carrying out of plans, to assess
outcomes, and to make adjustments based on the results of those outcomes.
What are the main issues for Teams?
• What is the team’s direction/purpose?
• Who performs which tasks and with whom?
o roles and responsibilities
• What mechanisms are needed to facilitate and maintain high team performance?
o conflict resolution, information sharing, leadership
Leadership and decision making
• What types of team member behaviors foster high work accomplishments?
o teamwork knowledge, skills, attitudes
o knowledge and practice skills
Limitations of interprofessional team care
• process of team formation is time consuming & requires matching of schedules of
different team members
• collaboration requires communication between team members, which takes time
away from patient appointments in busy practices
• a comprehensive approach to health care may lead to increased use of limited
services and resources
• a successful team requires on-going conflict resolution and goal re-assessment;
failure of these tasks may impair health care delivery
Grant RW, Finnocchio LJ, and the California Primary Care Consortium Subcommittee on Interdisciplinary
Collaboration. Interdisciplinary Collaborative Teams in Primary Care: A Model Curriculum and Resource Guide. San
Francisco, CA: Pew Health Professions Commission, 1995.
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14. Collaboration in Practice Participant’s Manual
Effective Team Decision Making - The Steps
• Recognize the problem
• Define the problem
• Gather relevant information
• Develop alternative strategies
• Select best alternative
• Implement best alternative
• Evaluate the outcome
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15. Collaboration in Practice Participant’s Manual
UNIT 3
Principles of Collaboration
Working collaboratively requires a shift from the current primary care system where
providers often work quite independently of each other, to one where a variety of
providers work together to combine resources and strategies, and share responsibility
for their patients.
Collaboration enhances communication, increases the efficient use of health care
resources, and can improve health outcomes and quality of care including patient and
provider satisfaction (CNA, CMA, 1996; Schraeder, Shelton and Sager, 2001; Goldberg,
Jackson, Gater, Campbell and Jennett, 1996; Schmitt, 2001; Koerner, Cohen, and
Armstrong, 1985; and Lorenz, Mauksch, and Gawinski, 1999).
Eight key principles, based on those proposed by the Canadian Medical Association
(1996) and the Canadian Nurses Association (1996), form the basis for collaboration in
family health centres in Prince Edward Island:
• Client-centred care with a minimum of two caregivers from different disciplines
working together with the client to meet assessed health needs;
• Shared or common vision, values and philosophy focused on meeting care needs;
• A clear definition and understanding of team member roles and responsibilities by all
stakeholders;
• A climate of respect, trust, mutual support and shared decision-making;
• Effective communication among all team members;
• Empowerment of all team members;
• Respect for autonomous professional judgement; and
• Respect for autonomous choices and decisions of the care recipient
NOTE: There are other collaborative practice teams, not clinically-based, that work
very successfully using these same principles.
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16. Collaboration in Practice Participant’s Manual
Take some time to conduct a private assessment of how your team is currently doing in
manifesting the principles of collaborative practice. Provide a rating from 0 (not
currently happening) to 5 (a well-established practice) in response to each of these
questions:
# Question Rating (0 – 5)
1. Do team members trust each other?
2. Do team members respect each other?
3. Are team members committed to collaboration?
4. Do team members co-operate with each other?
5. Do team members communicate with each other?
6. Do team members demonstrate flexibility?
7. Do team members have a good understanding of the distinction
between roles?
8. Do team members believe that they could not do their jobs as well
without each other’s assistance?
9. Does your team have a formal means to facilitate dialogue among all
team members?
10. Do your team members talk together about similarities and differences
including role, competencies and stereotypes?
Identify your team’s top strength and your top challenge.
What are some successful collaboration strategies that you know of or have practiced in
your work setting?
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17. Collaboration in Practice Participant’s Manual
UNIT 4
Target Populations
What characterizes a “prepared” practice team? At the time of the visit, they have the
patient information, decision support, people, equipment, and time required to deliver
evidence-based clinical management and self-management support.
Their evidence-gathering is an on-going process. The team continually updates its
knowledge of the health status of their client population and the trends of target groups.
For example, they access and utilize local and regional surveillance data along with
demography and epidemiology. They use community resources such as the Heart and
Stroke Foundation or the Diabetes Education Centre. They match the information and
resources with their clients’ needs.
Team members need to find answers to this series of questions:
• Who is the target group?
• What data sources provide information on the target group?
• What does the data say about the target group?
• What community resources are available and appropriate for the target group?
Understanding target populations helps team members to meet the needs of the
community. Along with clients/patients, they work to understand how they can
effectively combine resources to address the needs of the target population.
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18. Collaboration in Practice Participant’s Manual
UNIT 5
Roles and Scope of Practice
“Without trust and respect, cooperation cannot exist. Assertiveness becomes
threatening, responsibility is avoided, communication is hampered, autonomy is
suppressed and co-operation haphazard.” (Norsen, 1995)
The key elements of interdisciplinary teams include the following:
• Physicians, registered nurses, and other providers work together as a cohesive team
with shared responsibility for patient/client outcomes, and practice to the full extent
of their skills and competencies. The different skills offered by various providers are
complementary and when combined, will be synergistic providing patients/clients
with improved primary health care services. For example, dietitians can play a key
role as part of an interdisciplinary team in the prevention and management of
chronic disease. Education is key to preventing the progression of diabetes.
Similarly, 85% of seniors have one or more chronic conditions such as osteoporosis,
hypertension, diabetes, and heart disease, all of which can benefit from nutrition
intervention (Dietitians of Canada, 2001).
In PEI family health centres:
• Physicians and registered nurses will form the interdisciplinary team initially,
followed by other providers such as mental health therapists and dieticians
depending on the needs of the patient/client population. A triage system will be in
place for access in person or by phone, and for guidance to the most appropriate
provider.
• Once registered, patients/clients will have a comprehensive assessment completed
to identify health concerns and risk factors. While diagnosis and treatment of acute
and episodic illnesses will be integral to this service, health providers will place more
emphasis on health promotion and education to help patients/clients in the self-care
and management of chronic disease. Improved coordination and
comprehensiveness of service will potentially lead to fewer complications and
hospitalizations for chronic conditions such as mental illness, diabetes and heart
disease.
• Integration with community-based services will be enhanced, as team members
collaborate with healthy living coordinators and provide referral to community
organizations and other parts of the health and social services system who have
essential roles in the continuum of care for prevention, support and management of
disease conditions. Partnerships with the community and other sectors will be
formed to implement innovative strategies for reducing risk factors for chronic
disease.
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19. Collaboration in Practice Participant’s Manual
Successful collaboration is based on provider equality not on hierarchy or supervision.
This involves a mutually agreed upon division of roles and responsibilities which may
vary according to the nature of the practice, personalities, and skill sets of the
individuals.
Some of the elements for successful collaboration include:
• Mutual trust and respect
• Recognition of unique expertise
• Understanding of team members’ scope of practice
• Good team structure
• Understanding of legal responsibility
• Dealing with hierarchy
• Team members’ practical experience
• Shared values
Successful collaboration should result in case management that has these features:
• Regularly assesses disease control, adherence, and self-management status.
• Either adjusts treatment or communicates a need to primary care immediately.
• Provides self-management support.
• Provides more intense follow-up.
• Provides navigation through the health care process.
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20. Collaboration in Practice Participant’s Manual
UNIT 6
Collaboration Workshop
Protocols
Care management protocols and/or guidelines have been developed to assist in
negotiating roles, functions and responsibilities of providers in the care process for
health / disease entities. The protocols/guidelines reflect the principle of collaboration
and are flexible enough to enable providers to practice to the full extent of their
education and experience while maintaining patient choice and patient safety. Advice of
professional organizations is sought regarding professional practice issues.
Collaborative efforts in family health centres in Prince Edward Island are based on the
work of the Institute for Health Improvement in Boston. Recognizing the burden of
chronic disease on individuals and health care systems, the Institute identified the need
for a model of care that would result in better outcomes for clients. The Institute
recognized that to effectively meet the needs of clients with chronic diseases,
collaboration with the client and various care givers and professionals is essential.
The Institute developed a process to build a quot;Collaborativequot; for a specific chronic
disease that involved a review of the latest literature and clinical practice guidelines,
collaboration with other professionals and educators involved and a review of
recommendations. Recognizing that the process of implementing such a model had to
be cognizant of time used away from clinical practice, the Institute developed a
workshop process that includes education about collaboration and team building, use of
recommended clinical practice guidelines that include client centered care, regular
follow-up by a team of professionals and educators, and teaches and encourages client
self-monitoring skills.
The United Kingdom National Health Service (NHS) have adopted the concept of
quot;Collaborativesquot; to address the needs of clients with chronic diseases and other
common problems in their community. There are over 2500 practice settings in
England and Wales using the collaborative process to provide service to specific health
problems, and the NHS have included a new program within the Department specifically
to encourage and support quot;Collaborativequot; practice settings.
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21. Collaboration in Practice Participant’s Manual
For Facilitators and Scribers
Goal: Team members will experience the process of negotiating ‘Who does
what?” for the Collaborative Practice patients/clients with the disease /
health entity chosen by the team.
By the end of this session, the team will have reviewed the first page of the Practice
Guidelines and come to some decision on these matters:
A) Which staff members need to be added to the Practice Guidelines for your
Collaborative Practice?
B) What activities on the list have shifted and to whom?
C) What was the process like?
• Did the process move the team any closer to deciding ‘Who does
what?’
• What did the process (negotiating / give and take) feel like?
• What needs to happen for this process to work back at your
Collaborative Practice?
Your Role as Facilitator includes these responsibilities:
• Keep people on track. (Experiencing the process is extremely important!)
• Ensure everyone has input and challenge non-movers / non-participants if
necessary.
• Ensure that group decisions made on the matters listed above (A, B, & C) are
recorded accurately. (This is not a word-smithing exercise, but you may need to
check that the wording reflects the decisions that were made by the group).
• Enlist a team member to report back to the larger group.
Your Role as Scriber includes these responsibilities:
• You are not expected to take minutes. This process is more about capturing
decisions and process after the discussion.
• Ensure that group decisions made on the matters listed above (A, B, & C) are
recorded accurately. It will be the role of the facilitator to check that the wording
reflects the decisions that were made by the group.
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22. Collaboration in Practice Participant’s Manual
Process
Before arriving at the workshop, your team should have selected ONE practice
guideline that is applicable to the population your primary health care team serves. The
guidelines provide evidence-based best practices and possible roles and responsibilities
that each member on your team might carry given their education and experience while
providing service for a patient/client/individual. You may also have invited a
patient/client/individual who is experiencing this issue and/or representatives of
community-based organizations that contribute to the health of the target population.
The team members listed on the guideline may need to be changed to reflect the reality
of who is currently on staff in your work site and based on who is here to participate
today. For example, you may have a health care professional that is not listed on the
outline. If that is the case, please add another column. If someone is missing today,
include a statement about what role / responsibility you expect that person to carry out.
If you have clients or community members present, add columns to reflect their roles
and responsibilities.
The goal of the exercise is for you to experience the process of negotiating ‘Who does
what’ for the patients/clients at your centre who are experiencing the disease / health
entity that you have selected.
Within the time provided, your team should complete the following tasks:
1) Begin with Page 1: “Activities of the Initial Visit” on the Clinical Protocol.
2) Answer a number of questions:
a) Which staff members need to be added to the Practice Guidelines for your
work site?
b) What activities on the list have shifted?
c) Who is doing the activities that have shifted?
3) Provide feedback on the decision-making process by answering these questions:
a) Did the process move the team any closer to deciding ‘Who does what’?
b) What did the process (negotiating / give and take) feel like?
c) What needs to happen for this process to work back at your work site?
If there is time and interest from the group, you can repeat Steps 2 and 3 with Page 2:
“Activities of the Follow-up Visit”.
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23. Collaboration in Practice Participant’s Manual
UNIT 7
Workplan for Collaboration
Clinical Protocol:
Action Target Date Responsibility Resources / References
Needed
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24. Collaboration in Practice Participant’s Manual
UNIT 8
Closing
Take time to think about some questions. Write your responses below.
What did you find surprising about today’s workshop?
What did not surprise you today?
Has your assessment of your skills as a collaborative practitioner changed after today’s
workshop?
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25. Collaboration in Practice Participant’s Manual
APPENDIX A
Building a Better Tomorrow Initiative (BBTI)
Training Module Evaluation Process
The trainer is responsible for coordinating the distribution, collection and return of a number of
evaluation instruments associated with the evaluation of this training module and the BBTI.
There are 3 evaluation tools which accompany the participant’s manual for this training module
and 1 evaluation tool which accompanies the trainer’s manual. These evaluation tools include:
Participant Manual Evaluation Tools
1. Participant Satisfaction Survey
The Participant Satisfaction Survey is an anonymous evaluation tool which is intended to
measure participants’ satisfaction/reaction to the training module. This survey is included at
the back of the participant’s manual. This survey should be completed by the participants
immediately after training completion. The trainer is responsible for reminding and
encouraging participants to complete the survey. The trainer is also responsible for
collecting the evaluation surveys and forwarding these to the evaluation consultant address
identified below.
2. Pre-Training Confidence Survey
The Pre-Training Confidence Survey is an anonymous evaluation tool which is intended to
measure participants’ confidence in skills and abilities related to the subject matter of the
training module. The Pre-Training Confidence Survey is included at the front of the
participants’ manual. This evaluation tool should be completed by the participants
immediately before the training begins. The trainer is responsible for reminding and
encouraging participants to complete this evaluation tool. The trainer is also responsible for
collecting the pre-confidence surveys along with the post-confidence surveys upon training
module completion, and forwarding these to the evaluation consultant address identified
below. Pre and post-confidence surveys are only to be collected together at the completion
of the training module.
Note: Trainers should receive a participant registration list for each module. This list should
identify a code # for each participant. Please instruct each participant to record their
individual code # on both the pre and post-confidence survey.
3. Post-Training Confidence Survey
The Post-Training Confidence Survey is an anonymous evaluation tool which is intended to
measure participants’ confidence in skills and abilities related to the subject matter of the
training module. The Post-Training Confidence Survey is included at the back of the
participants’ manual. This evaluation tool should be completed by the participants
immediately after training completion. The trainer is responsible for reminding and
encouraging participants to complete this evaluation tool. The trainer is also responsible for
collecting the surveys and forwarding these to the evaluation consultant address identified
below. Pre and post-confidence surveys are only to be collected together at the completion
of the training module.
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26. Collaboration in Practice Participant’s Manual
Note: Trainers should receive a participant registration list for each module. This list should
identify a code # for each participant. Please instruct each participant to record their
individual code # on both the pre and post-confidence survey.
Trainer Manual Evaluation Tool
1. Trainer Observation Form
The Trainer Observation Form is intended to record the trainer’s observations of the training
session, as well as observations on the effectiveness of the training process, subject matter,
ease of use of training support materials, and trainer support. The observation form is
included in the trainer’s manual. This survey is to be completed by the trainer after each
module which he/she facilitates and forwarded to the evaluator along with other participant
evaluation instruments.
Evaluation Consultant Return Address:
Building a Better Tomorrow Evaluation
c/o Centre for Collaborative Health Professional Education
Faculty of Medicine
Memorial University of Newfoundland
St. John’s, NL
A1B 3V6
For more information on the evaluation, please contact:
Vernon Curran, PhD
Director of Research and Development
Centre for Collaborative Health Professional Education
Faculty of Medicine
Memorial University of Newfoundland
St. John's, NL
A1B 3V6
Phone: 709-777-7542
Fax: 709-777-6576
Email: vcurran@mun.ca
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27. Collaboration in Practice Participant’s Manual
Building a Better Tomorrow Initiative (BBTI)
Evaluation Framework
Evaluator
Centre for Collaborative Health Professional Education
Faculty of Medicine
Memorial University of Newfoundland
Prince Philip Drive
St. John’s NL
Canada
A1B 3V6
Phone: 709-777-6912
Fax: 709-777-6576
Web: www.med.mun.ca/cchpe
Contact: Vernon R Curran vcurran@mun.ca
Evaluation of the Building a Better Tomorrow Initiative
Evaluation is an important aspect of the Building a Better Tomorrow Initiative (BBTI) and is
intended to foster improvement in the quality of training and education which is facilitated, while
also demonstrating the merits of the BBTI. There are two types of evaluation planned for the
BBTI - formative and summative. Formative evaluation refers to the systematic collection of
information for the purpose of informing and determining the quality of instructional materials
while they are in the design and development stages. Formative evaluation will occur on ‘pilot’
offerings of the BBTI training modules prior to full-scale delivery. This formative evaluation
will enable program developers to enhance the instructional activities and materials before they
are offered to the target audience. Summative evaluation occurs after an instructional program
has been developed and delivered to the learner. It is meant to collect information that enables
decision-makers to judge the impact or effectiveness of a program. Summative evaluation will
take place after the completion of each training module and on an ongoing basis over the course
of the BBTI. Figure 1 depicts the different types of evaluation which will be conducted for the
BBTI, as well as what stage they will be occurring.
Evaluation Framework
An evaluation framework refers to a plan for conducting an evaluation of a particular
instructional program or product. A well know evaluation framework in the adult education
literature is that of Kirkpatrick (1967). Kirkpatrick identified four levels of program evaluation
that increase in complexity in terms of behavioural changes and encompass outcomes related to
learner reactions, evaluation of learning, transfer of behaviour, and the impact of learning on the
organization or workplace. The four levels are not hierarchical, although within each level, it
becomes increasingly difficult to account for potentially confounding factors related to
educational interventions. This is particularly evident when examining results of impact that
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28. Collaboration in Practice Participant’s Manual
might typically occur over extended periods of time after the interventions and which may need
to be accommodated through longitudinal approaches to evaluation. For the purposes of the
BBTI evaluation a modified version of Kirkpatrick’s (1967) evaluation model, proposed by
Freeth, Hammick, Koppel, Reeves and Barr (2002), has been adopted. Table 1 provides an
overview of the levels of evaluation suggested by Freeth et al. (2002) and which encompass
Kirkpatrick’s levels of evaluation as well.
Table 1 Components of Freeth et al.’s (2002) Evaluative Framework
Evaluation Level Example Outcomes
Reaction Learners’ views of the interprofessional education
experience.
Modifications of attitudes & perceptions Changes in perception or attitudes towards the
value and/or use of interprofessional teams and
teamwork.
Acquisition of knowledge & skills Knowledge and skills related to interprofessional
collaboration.
Behavioural change Transfer of interprofessional learning to practice
settings and changed professional practice.
Change in organizational practice Impact and changes in health care organizations or
health care system.
Benefits to patients or clients Improvements in health or well being of patients or
clients.
This evaluation schema has been adopted as the basis of the evaluation framework for the BBTI.
This evaluation will also be complemented by an examination and monitoring of the health care
context or environment within which the BBTI is situated. This will provide a useful overview
of the health care setting, conditions and environment of the various provinces participating in
the BBTI. Table 2 provides a summary of the proposed evaluation framework for the BBTI
based on Freeth et al.’s (2002) modified model.
Table 2 Building a Better Tomorrow Evaluation Framework
Component (Evaluation Instrument/Method Summary
Level)
Participation • # of educational sessions Information collected by each
(modules) conducted project manager and later reported
• #s of participants in for Atlantic Canada.
educational sessions
Reaction (Satisfaction) Formative Evaluation (Pilot)
Focus Group
Focus group with participants Areas to be evaluated:
from each module ‘pilot’. • Subject Matter
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29. Collaboration in Practice Participant’s Manual
• Instructional Process;
Interview • Time;
Interview with each ‘pilot’ • Instructional Materials
module facilitator.
Participant Satisfaction
Survey
• addresses learning needs The Participant Satisfaction
• content Survey is an anonymous
• instructional process instrument and will be included in
• facilitation the participant manuals. This
• likes/dislikes survey is to be completed by
• commitment to change participants after each module,
collected by the trainer and
forwarded to evaluator for data
collection.
Trainer Observation Form
• observation of the training The Trainer Observation Form
process, subject matter, will be included in the trainer’s
trainer support, ease of manual. This survey is to be
use of the trainer’s completed by the trainer after each
manual module and forwarded to the
evaluator along with other
participant evaluation instruments.
Focus Group Focus group conducted 3 months
Focus groups with after initiation of training delivery
representative sample of across Atlantic Canada. Trainers
trainers from across Atlantic will be asked to comment on
Canada. support systems for trainers in
BBTI, as well as suggestions for
fostering training transfer.
Modification of Pre and Post Confidence
attitudes/perceptions Survey(s)
Measures perceived The Pre- and Post-Confidence
confidence. Surveys are anonymous
instruments and are to be included
in the participant manuals. Survey
items will be subject-specific to
area of training and identical items
will be appear on both Pre- and
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30. Collaboration in Practice Participant’s Manual
Post-Survey for same module.
Instrument(s) not to exceed 10
items. The Pre-Confidence
Survey is to be completed
immediately prior to module
commencement. The Post-
Confidence Survey is to be
completed immediately after the
module. The Post-Confidence
Survey will be combined with
Participant Satisfaction survey.
Instruments are to be collected by
the trainer and forwarded to the
evaluator for data collection.
Behavioural change Performance Change Survey
• Self-reported changes in The Performance Change
behaviour/performance Survey is an anonymous
instrument and will be forwarded
to all participants in each module
3 months after module
completion. Survey items will be
subject-specific to area of training.
Instrument not to exceed 10 items.
A return envelope will be
provided for participants to return
survey to the evaluator for data
collection.
Enablers/Barriers to Change
Interview
Interviews conducted with a Interviews conducted 3 months
sample of participants from after module completion. 15
each province to examine participants in training modules
enablers and barriers to from each province to be recruited
change. and interviewed by telephone.
Maximum 60 interviews across
provinces.
Change in Perception of Organizational
organizational practice Change
(Impact)
Focus Group
Focus group conducted in each Focus groups conducted at 6
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31. Collaboration in Practice Participant’s Manual
province with sample of months following training
participants in training module. completion. Participants invited
to comment on perceived and
actual changes in interprofessional
teamwork in primary health care
practice. Maximum of 12
participants per focus group per
province.
Interview
Interviews with a practice site Interviews conducted at 6 months
administrator from each site in following training completion.
each province in which a Administrators invited to
primary health team has been comment on perceptions of change
established. in interprofessional teamwork in
primary health care practice.
Maximum of 50 interviews across
provinces.
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33. Collaboration in Practice Participant’s Manual
Appendix B
Pre-Training Confidence Survey
Self-Assessment
Participant Code No. _____
The following statements describe some abilities that are related to primary health care. Please
rate your confidence in these areas on a scale of 1 = Low to 5 = High.
Ability Confidence
Low High
1. Defining collaboration accurately. 1 2 3 4 5
2. Summarizing the underlying principles of 1 2 3 4 5
collaboration.
3. Utilizing the correct primary health care terminology. 1 2 3 4 5
4. Applying a collaborative approach to your work 1 2 3 4 5
5. Summarizing the elements required to be a 1 2 3 4 5
collaborative practitioner.
6. Applying your understanding of roles and scope of 1 2 3 4 5
practice to your own work situation.
7. Defining a target population. 1 2 3 4 5
8. Describing collaborative practice. 1 2 3 4 5
9. Identifying the role of collaborative practice in primary 1 2 3 4 5
health care.
Are there other areas in which you would like to enhance or develop your abilities for working in
a collaborative practice?
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34. Collaboration in Practice Participant’s Manual
Post-Training Confidence Survey
Self-Assessment
Participant Code No.____
The following statements describe some abilities that are related to primary health care. Please
rate your confidence in these areas on a scale of 1 = Low to 5 = High.
Ability Confidence
Low High
1. Defining collaboration accurately. 1 2 3 4 5
2. Summarizing the underlying principles of collaboration. 1 2 3 4 5
3. Utilizing the correct primary health care terminology. 1 2 3 4 5
4. Applying a collaborative approach to your work 1 2 3 4 5
5. Summarizing the elements required to be a collaborative 1 2 3 4 5
practitioner.
6. Applying your understanding of roles and scope of 1 2 3 4 5
practice to your own work situation.
7. Defining a target population. 1 2 3 4 5
8. Describing collaborative practice. 1 2 3 4 5
9. Identifying the role of collaborative practice in primary 1 2 3 4 5
health care.
Are there other areas in which you would like to enhance or develop your abilities for working in
a collaborative practice?
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35. Collaboration in Practice Participant’s Manual
Participant feedback Survey
Please identify your profession/role:
Your Practice/Work Location (Site/Community):
Module Title:
Training Location: Date:
Strongly Disagree Neutral Agree Strongly
Disagree Agree
1. This training module addressed 1 2 3 4 5
my learning needs in this area.
2. The information which was 1 2 3 4 5
provided was applicable to my
practice/work.
3. My participation in this training 1 2 3 4 5
module has enhanced my
knowledge and skills in this area.
4. My participation in this module will 1 2 3 4 5
influence my practice/work in the
future.
5. The trainer was knowledgeable of 1 2 3 4 5
the subject matter being
presented.
6. The trainer presented the 1 2 3 4 5
information in a clear and concise
manner.
7. The trainer was enthusiastic and 1 2 3 4 5
responsive to participant’s
learning needs.
8. There was opportunity to interact 1 2 3 4 5
with other participants.
9. There was opportunity to interact 1 2 3 4 5
with the trainer.
10. The facilities were comfortable 1 2 3 4 5
and conducive for learning.
11. The module was well organized. 1 2 3 4 5
12. I would recommend this training 1 2 3 4 5
module to others.
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36. Collaboration in Practice Participant’s Manual
13. What did you like about this training module?
14. What changes or improvements could be made?
15. What aspects of your practice/work do you intend to change as a result of participating in
this training module?
a.
b.
c.
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37. Collaboration in Practice Participant’s Manual
APPENDIX C
SELF-ASSESSMENT: HOW AM I DOING?
Please take a moment to reflect on the characteristics of an effective collaborative practitioner.
The following table may be used as a self-assessment to monitor your progress as you
participate in this course. Use a scale of 1 – 5 where 1 is a skill or attitude that requires a
significant amount of work and 5 is a skill or attitude you have fully mastered. If you are
uncertain about your understanding of a skill before or after the workshop, enter “Don’t
Know” or “DK” beside the skill. First, complete the Pre-workshop Assessment by filling in the
left-hand or “Pre-Workshop Rating” column for each question. We will return to complete the
right-hand or “Post-Workshop Rating” column at the end of the module.
Characteristics of an Effective Collaborative Practitioner Pre-Workshop Post-
Rating Workshop
Rating
1. Do you utilize various staff members for their particular
expertise?
2. Are you able to define those areas that are distinct in
your role from the role of other team members with whom
you work?
3. Do you view part of your role as supporting the role of
others with whom you work?
4. Do you work through conflicts with your colleagues in an
effort to resolve them?
5. Do you believe that working as a team leads to outcomes
that we could not achieve alone?
6. Do you go through a process of examining alternatives
when making decisions with your colleagues?
7. Do you help your team members to address conflicts
directly with each other?
8. Are you optimistic about the ability of your colleagues to
work with you to resolve problems?
Post-workshop questions:
My strengths as a collaborative practitioner include:
Things I would like to work on include:
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38. Collaboration in Practice Participant’s Manual
APPENDIX D
Collaboration in Practice Exercise
Sample Guidelines / Protocols
The following Collaborative Practice Clinical Guidelines / Protocol for Diabetes,
Depression, and Hypertension and blank template (Diabetes) are provided as samples
for use in negotiating the roles and responsibilities of health providers on your team. As
such, the specific disease or illness can be replaced with any issue or problem your
team has an interest in for the purpose of coming to some understanding about who
does what, when it comes to dealing with a particular client/patient population you
serve.
The health care providers listed on the template and guidelines are also intended to be
changed or adjusted so they are based on the actual providers who participate on your
team, and may include family physicians, registered nurses, pharmacists, mental health
therapists, dietitians, occupational therapists, physiotherapists, social workers, a
relevant community organization and others, as appropriate. For example, you may
have a health care professional that is not listed on the outline. If that is the case,
please add another column. If a health care professional is included on the list, but not
part of your team, remove them from the list. If someone from your team is missing
from the negotiation process, leave them on the list and include a statement about what
role / responsibility you expect that person to carry out. If you have clients or
community members present, add columns to reflect their roles and responsibilities.
When using the templates back at your worksite, please consider involving a
client/patient as a team member in the process of negotiating roles and responsibilities.
34
39. SAMPLE
COLLABORATIVE PRACTICE GUIDELINES / PROTOCOL
Guideline : Diabetes Care (Non-pregnant adults) Approval Date: Page:1 of 3
Goal of Care- To improve Glycemic control to achieve: A1C to- ˜7.0% , Fasting BG/preprandial PG- 4.0-7.0 mmol/l, 2hr postprandial PG- 5.0-10.0
Administrative Staff Family Physician Care Registered Nurse Care Diabetic Educator
For: Management of patient For: all initial, ill and unstable For: follow-up of stable diabetes patients, initial education & For: all patients newly diagnosed with
scheduling, organizing chronic diabetes conditions, and annual identification of psycho- social concerns, q3/months & prn as diabetes? referrals for education/advice
disease (CD)clinic day, bringing the physicals & written referral to required/ requested as required/requested
CD team together for review of physician specialists as required/
patients scheduled, could be the requested
team manager for specific CD team
Initial Visit Initial Visit Initial Visit Initial Visit
-Collect demographic data S- history S-concerns re: medication, side effects, diet, # of Education patient & family re:
-Place into the chronic disease O-physical, Wt., BP, hypoglycemic events, social issues. -diabetes & complications etc.
register A-medical diagnosis O-Assess-ADLs, QOLs, social needs, -use of equipment to self-assess
-Note idiosyncrasies (days, times P-Baseline Lab.work: A1C, -Weight, B/P, U/A, Foot exam progress (CDA / pharmacies are
etc.) related to CD day scheduling. Random BG, Fasting BS, -A1C q3/12 & plasma glucose PG as recommended by compensated to teach BG monitor use,
-Gather patient medical-CD files for Microalbuminuria, Lipid profile, if 8 Diabetes Educator. not usually DEC)
team review of patients scheduled Te/Tg, U/A, Cr, A-identify problems -diet
for next CD clinic day. -medication P-refer as needed to: -exercise,
-Schedule patients for lab work -diet advice CF. physician prn & annually w Dentist prn -encouragement
(ensure results available for review -screening for sexual dysfunction CDECentre initially & prn
during next visit) -referral to: nurse if stable for f/u; CFoot care clinic prn * Perhaps referral if target A1C not
-Reminder calls to patients of -written referral to: CPsychosocial services prn attained within 6-12 mos.
appointments. endocrinologist- prn CHome care prn
-Recording data for program opthalmologist- annually CExercise program (ECG stress test prn) etc.
evaluation. urologist - prn -Assess: DEC teaching re insulin admin. & Glucometer use
-Advising clinicians of patient nephrologist - prn etc., compare BG meter readings with lab measurements of
problems related to known cardiologist - prn simultaneous venous FBG prn & at least annually.
hardships for families. gastroenterologist - prn -ketone testing during periods of acute illness.
(No money to purchase -provide sample meal plan with suggested substitutions until
medications/ treatments prescribed) seen by dietitian (i.e. AJust the Basics@ free CDA tool)
35
40. SAMPLE
etc. -emotional, social, economic concerns.
-next appointment,
-complete tracking form & record problems/ interventions/visit
in medical record.
Administrative Staff Follow-up Family Physician Follow-up Nurse Follow-up Visits (or phone) D.Educator Follow-up Visits (or
Visits Visits phone)
-Collect changes to demographic -referral from nurse S- problems & concerns As needed for specific concerns
data -as needed following acute illness O-review BS readings & meal plan, # of hypoglycemic
-Note new idiosyncrasies (days, -q3/12 & prn for unstable diabetes events, ADL issues (old & new), QOL issues, Social/
times etc.) related to CD day conditions emotional/ spiritual concerns, medication adjustment w/ client
scheduling. -annually for stable diabetes -assess: understanding of disease and treatment etc., use
-Gather patient medical-CD files for conditions made of suggested or prescribed referrals made from
team review of patients scheduled -annually- Microalbuminuria, practice,
for next CD clinic day. Cholesterol & TSH A- identify problems,
-Schedule patients for lab work -specify metabolic targets with P- provide support & encouragement, verification of
-Reminder calls to patients of client and team concerns, re-enforce useful information,
appointments. -next appointment,
-Recording data for program -record problems & visit in medical record.
evaluation.
-Advising clinicians of patient
problems related to known
hardships for families.
(No money to purchase
medications/ treatments prescribed)
etc.
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41. SAMPLE
Endocrinologist Care Opthalmologist Care Nutritionist/Dietition Care
For: prn for assessment & treatment For: prn and annually to assess for For: assessment of nutritional intake prn
advise re complications of diabetes diabetes retinopathy, est. appropriate on referral & for specific dietary problems
monitoring intervals
Initial Visit Initial Visit Initial Visit
S-Patient>s concerns Baseline data re vision and signs of S- meal problems, wt. control,
O-History & physical diabetes related retinopathy and other hypertension, hyperlipidemia, &
A-confirmation of Family Physician visual complications combination conditions
assessment, complications, O- assess nutritional state, shopping / food
P-Advise to patient & Family Physician re: prep. needs, economics issues re
-medication, food/shopping preferences etc.
-diet P-educate to prevent hyper-/hypo-
-prevention of complications glycemia and to intensify diabetes control
(carb counting, diet)
Endocrinologist Follow-up Opthalmologist Follow-up Nutritionist/Dietition Follow-up
-f/u re complication, prevention, Type 1 - annually -prn for acute concerns
Type ll - q 1-2 years -prn for acute
concerns
Glossary of terms-
A1C-glycosylated haemoglobin (reflects glycemia over 120 day life span of erythrocytes)
Postprandial PG- 2 hr. Post dinner
SMBG- self-monitoring of blood glucose
FPG or Preprandial PG- fasting or ac dinner
Resources: 2003 Clinical Practice Guidelines, CDA 2003 Clinical Practice Guidelines.
S = Subjective (what the patient/client tells you); O = Objective (what you see/hear/smell); A = Assessment (based on S & O); P = Plan (based on S, O & A)
37
42. SAMPLE
COLLABORATIVE PRACTICE GUIDELINES / PROTOCOL
Guideline: Depression Approval Date: Revised Date: Page: 1 of 3
Goal of Care- 9in symptoms, 9unnecessary contacts with health care system Personal goal- met & maintaining self-management of depression
Administrative Staff Family Physician Care Registered Nurse LPN Mental Health Staff
For: Management of patient For: Diagnosis, medication, refer For: Explains planned treatment For: assisting team to provide a For: Takes referrals from
scheduling, organizing chronic for education about depression & options/goals, engage client to determine plan of care for the client & health centre, takes part in
disease (CD)clinic day, care process, shared care, or goal & self management, assess ability to family, & maintaining the team management for client,
bringing the CD team together referral for counselling, explains self-manage, counsel or referral, registry communicates strategies for
for review of patients compliance. encourage compliance with medication,
behavioural modification &
scheduled, ? team manager for -?Manager of depression Program counselling
specific CD team -?Manager of depression register/clinic
follow-up, educates team,
Initial Visit Initial Visit Initial Visit Initial Visit Initial Visit
-Collect demographic data S - Self-identifies depression, S - Verbalizes reason for attending & -Administer & score PHQ-9 -According to referral request,
-Place into the chronic or if client symptoms indicate confirms reason for referral, questionnaire, -Assess degree of depression
disease register possible depression. O - History, physical/observation, -share educational resources (see attached),
-Note idiosyncrasies (days, O - History, physical exam, active listening, assess suicide risk, with client, answer questions, -assess suicide risk
times etc.) related to CD day assess response to recognition - Assess degree of depression using -Explain the care process & -consult or refer if suicide risk
scheduling. tools (attached); PHQ-9, & type of f/u needed, what client should expect,, high, if medication response
-Gather patient medical-CD Assess suicide risk.; -Assess ability to self-manage care, -Review side effects & when a inadequate.
files for team review of A -medical diagnosis using -assess support system, housing, clinician should be contacted,
patients scheduled for next PHQ scores to determine if financial issues, QOL, ADLs -schedule follow-up visits & What does hospital / community-
CD clinic day. depression is minor, mild, A - Identify problems to be addresses establish a system for based service look like? How
-Schedule patients for lab moderate or severe (see now & in f/u, maintaining compliance & does it fit?
work attached); P - Consult if suicide risk high, if monitoring response to
-Reminder calls to patients -Additional diagnosis; depression severe, treatment i.e. transportation,
of appointments. P - Tests to rule out other - Engage client in setting personal phone, e-mail, fax etc.
-Recording data for program diseases/ conditions; goals, family needs/goals,
evaluation. -Treat according to severity of -Explain treatment/care process,
-Advising clinicians of patient depression, i.e. watchful -Education re depression,
problems related to known waiting, counselling, -Plan f/u (see attached suggested
hardships for families. medication, hospitalization, or schedule f/u visit), community support
(No money to purchase combination; systems, educational, pleasure
38
43. SAMPLE
medications/ treatments -F/u by self, other clinician (see activities.
prescribed) etc. attached suggested schedule
f/u visit)
Administrative Staff Family Physician Follow-up Nurse Follow-up Visits LPN Follow-up Mental Health Staff Follow-up
Follow-up Visits Visits
-Collect changes to Use planned visit approach day Use planned visit approach day before Use planned visit approach day Uses planned visit approach
demographic data before visit: review goal of visit: review goal of treatment, review before visit: review goal of before visit: review goal of
-Note new idiosyncrasies treatment, review medical care, medical care, self-management goals, treatment, review medical care, treatment, review medical care,
(days, times etc.) related to self-management goals, problem-solving & follow-up plan. self-management goals, self-management goals,
CD day scheduling. problem-solving & follow-up S- Response to ATwo question problem-solving & follow-up problem-solving & follow-up
-Gather patient medical-CD plan. screen@, other issues, concerns, plan. plan.
files for team review of S- Response to ATwo question O- assess appearance, mood, -Repeat PHQ-9, -assess suicide risk
patients scheduled for next screen@, other response to counselling, medication, -Assess compliance to referrals, -assess support system
CD clinic day. complaints/concerns -assess self-management ability & medication, progress toward response
-Schedule patients for lab O- assess appearance, mood, progress to meeting personal goals, achieving personal goals, other -assess pleasure activities
work response to counselling, -assess compliance to treatment contacts with health care
-Reminder calls to patients medication, -assess compliance to treatment & system,
of appointments. -assess self-management referral to community programs, -Encourage compliance,
-Recording data for program ability & progress to meeting -assess understanding of test results, -degree of engagement in
evaluation. personal goals, -assess support system response, pleasure/sporting activities,
-Advising clinicians of patient -assess compliance to -Assess QOL & ADL -Arrange f/u visit according to
problems related to known treatment, -Assess suicide risk plan.
hardships for families. -review test results with client & A- Response to treatment,
(No money to purchase observe response, assess medication, re-assess degree of
medications/ treatments suicide risk, depression & response as needed,
prescribed) etc. A- Response to treatment, P- Consult or refer if response to
medication, re-assess degree treatment inadequate or degree of
of depression, assessed depression has increased,
P- Further testing to rule out -Re-affirm personal goals,
other diagnosis, -Re-affirm treatment procedure
-Consult or refer if required, -encourage compliance & self-
-Medicate as needed management,
-f/u according to response to -f/u visit according to response to
treatment. treatment (see attached suggested
39
44. SAMPLE
schedule f/u visit), & Agut@ feeling
Medical Internist/Specialist Other- Community Programs Other-
For: Consultation, commit to For: In collaboration with region- organize group
working with health centre activities, education, public education, self-help
collaborative, as consultant, groups, school health fairs, teacher education,
educator, evaluator of referrals, sporting activities, addictions
Initial Visit Identify community need for education related to
-According to referral request, specific issues to address understanding of
History, physical, depression, causes, support systems, barriers
-Assess previous treatments & to effective care,
response,
-Assess suicide risk
-Recommend treatment to
family physician, or follow-up by
self
Medical Internist/Specialist Follow-up Other Follow-up
Follow-up
-As requested by family Evaluation of effect of public education on self
physician, client; reporting of depression, attendance at public
activities, queries related to depression & care
process,
* ATwo Question Screen@- Questions: In the past month have you often been bothered by:
1. Little interest or pleasure in doing things.
2. Feeling down, depressed or hopeless.
If client answers yes to either consider asking more detailed questions i.e. PHQ-9.
Resource:
-The MacArthur Initiative on depression & Primary Care at Dartmouth & Duke, Depression management Tool Kit, V1.1 July, 2003.
-Health Disparities Collaboratives, Changing Practice Changing Lives, Depression.
S = Subjective (what the patient/client tells you); O = Objective (what you see/hear/smell); A = Assessment (based on S & O); P = Plan (based on S, O & A)
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45. SAMPLE
COLLABORATIVE PRACTICE GUIDELINES / PROTOCOL
Guideline : Hypertension Approval Date: Page: 1 of 3
Goal of Care- To maintain/ reduce blood pressure to 129/84 mmHg (normal 120/80) Personal Goal -
Administrative Staff Family Physician Care Nurse Practitioner Care Registered Nurse Care LPN Care Pharmacists Care
For: Management of patient For: Diagnosis, all For: Shared care for diagnosis For: Follow-up of clients For: Group care,
scheduling, organizing chronic hypertensive procedure, f/u hypertension, diagnoised, and receiving organizing hypertensive
disease (CD)clinic day, urgencies/emergencies, all at education, lifestyle, referral for weight treatment for non major organ clinic & education sessions
bringing the CD team together risk of Coronary heart disease control, referral, monitoring, hypertension involvement &
for review of patients (CHD), all Grade D (major education, of adults 19 years and according to management plan,
scheduled, could be the team organ involvement), annual f/u older. , education & identification of
manager for specific CD team. physicals & referrals from psycho- social concerns,
nurse, written referral to support, weight control,
physician specialists as
required/ requested.
Initial Visit Initial Visit Initial Visit Initial Visit Initial Visit Initial Visit
-Collect demographic data S- History, S- History, medication (prescribed & S-Concerns re: diagnosis, diet, As agreed by team to
-Place into the chronic -review medication other), social issues,medication, side meet objectives of the
disease register (prescribed & other), alcohol & O- Physical including meticulously effects, exercise, personal Health Centre
-Note idiosyncrasies (days, tobacco use, measure BP of all clients with risk goal. hypertensive program.
times etc.) re CD day O-Physical, Wt., BP, factors for CHD, diabetes, CHF, renal O-Assess- Weight, meticulous
scheduling. A-Begin investigations to disease, certain cultural heritages B/P measurement, U/A, ADLs,
-Gather patient medical-CD explain [ BP (African), Wt., U/A, CBC, blood QOLs, emotional/social needs,
files for team review of P-Baseline Lab.work: CBC, chemistry, fasting BS, fasting lipid A-Identify needs
patients scheduled for next blood chemistery, fasting Lipid profile, ECG, P-Refer as needed to:
CD clinic day. profile, fasting BS, ECG, Investigation of hypertensive episode CShort term plan to meet
-Schedule patients for lab -medication i.e. repeat BP measure twice in same personal goal
work (ensure results available -diet advice, visit if initial reading abnormal. If still CFamily physician prn &
for review during next visit) -referral to: NP assist with [consult with physician, (home self annually,
-Reminder calls to patients of diagnosis protocol; RN, if monitoring if necessary), f/u x 3-5 CPsychosocial services prn
appointments. stable for f/u; visits at monthly intervals before CExercise program etc.
-Recording data for program -written referral to specialist- if making final diagnosis (Follow CDietitian referral,
evaluation. drug therapy ineffective, guidelines for diagnosis). -complete tracking form &
-Advising clinicians of patient poorly tolerated, or A- Identify needs/problem record problems/next visit
problems related to known contraindicated, pregnancy & P- Refer to MD: if pregnant, child, -interventions/visit in medical
hardships for families. prn -Consult if BP remains [ after 3rd record.
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