Presentation slides Frailty: building understanding, empathy and the skills to support self-care
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Frailty: building understanding, empathy and the skills to support self-care Guest speaker:Dr Dawn Moody, Director - Fusion48 An opportunity to learn about some innovative approaches to making the health and care workforce 'Fit for Frailty'* (*British Geriatrics Society 2015). Learning outcomes: To explore the Frailty Fulcrum as a tool for holistic assessment and management of frailty To hear how Virtual Reality is being used to build empathy for older people living with frailty To learn about the impact of a county-wide, multi-agency, multi-professional training an toolkit for care professionals working with older people Resources:www.fusion48.net
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Presentation slides Frailty: building understanding, empathy and the skills to support self-care
- 1. www.england.nhs.uk Long Term Conditions Lunch & Learn Frailty: building understanding, empathy and the skills to support self care With Dawn Moody Director, Fusiion48 31 March 2016
- 2. www.england.nhs.uk LTC Framework Commitment to Carers Frailty Health Ageing Guide Fire Service as an asset Care Homes Quick Guides Care & Support Planning Navigating Health & Social Care Self Care Ambitions for End of Life Care Our Declaration Delivery Models Planning for Change: • Capitated Budget • Contracting • Simulation Modelling Patient and Service Selection Planning for Change: Workforce Whole Population Analysis; Understanding your population LTC Dashboard LTC Toolkit
- 3. www.england.nhs.uk Long term conditions resources Simulation model Unbundling recovery simulation model
- 4. www.england.nhs.uk 7 Using behavioural change to open minds #A4PCC – Action for Person- Centred Care Person with long term condition o Make a declaration at www.engage.england.nhs.uk/survey/ltc -declaration o Tell your teams about our work o Encourage them to make a declaration o Ask them to feed back thoughts and ideas o Use our hashtag – #A4PCC – when you see work that is relevant to person-centred care for people with LTCs o Let us know of any events, activities or social media opportunities that we can join forces with you
- 5. www.england.nhs.uk Long Term Conditions Lunch & Learn Frailty: building understanding, empathy and the skills to support self care With Dawn Moody Director, Fusion48 31 March 2016
- 6. Frailty: building understanding, empathy and the skills to support self-care 31st March 2016 Dr Dawn Moody An opportunity to learn about some innovative approaches to making the health and care workforce ‘fit for frailty’. @Fusion48net @Moody_D_K #frailty
- 7. www.frailtytoolkit.org 7 What are the aims of the session? • To explore the Frailty Fulcrum as a tool for holistic assessment and management of frailty • To hear how Virtual Reality is being used to build empathy for older people living with frailty • To learn about the impact of a county-wide, multi-agency, multi- professional training and toolkit for care professionals working with older people 7
- 8. www.frailtytoolkit.org 8 What we are going to cover • The importance of supported self-care for people with frailty • An introduction to the Frailty Fulcrum • FrailSIM - a Virtual Reality experience to build empathy • Integrated training & person centred case studies • The Frailty Toolkit App.
- 9. www.frailtytoolkit.org 9 What is ‘Frailty’? A state of reduced resilience and increased vulnerability A state which minor events can trigger disproportionate adverse outcomes in health, wellbeing or functional ability Related to, but distinct from, ageing, comorbidity and disability Delivering safe, effective & consistent care to people with frailty is the greatest challenge facing the NHS in 2016 and beyond.
- 10. www.frailtytoolkit.org 10 What is self-care? Regulatory Preventative Reactive Restorative Self-care Recovery & rehabilitation Health & well- being Daily Living Diagnosing & dealing with symptoms
- 11. www.frailtytoolkit.org 11 Supported self-care What’s required: 1. Engaged, informed individuals and carers. 2. Professionals who recognise the central role of the person in their own care and are committed to partnership working. 3. Care systems and services that are organised in ways that enable individuals, carers and professionals to work together. ‘Supported Self-care’ is the process of assisting people to manage their own care in a way that helps to improve their quality and experience of life.
- 12. www.frailtytoolkit.org 1212 Empowerment CapabilityMotivation Enable individuals to develop skills in self-care and to use technology and equipment. Understand the emotional, behavioural and relationship factors Moving from ‘recipients of care’ to equal partners in care Principles of supported self-care
- 13. www.frailtytoolkit.org 13 Ten components of care for older people 13 Shift to prevention and pro- active care: 1. Age well and stay well 2. Live well with one or more LTC 3. Support for complex co- morbidities / frailty
- 14. www.frailtytoolkit.org 1414 Person- centred partnership Engaging Family and Support Networks Effective communications Supporting Choice and Managing Risk Maintaining skills and confidence Deploying assistive technology Signposting and providing information Skills for supported self-care
- 15. www.frailtytoolkit.org 15 What we are going to cover • The importance of supported self-care for people with frailty • An introduction to the Frailty Fulcrum • FrailSIM - a Virtual Reality experience to build empathy • Integrated training & person centred case studies • The Frailty Toolkit App.
- 17. www.frailtytoolkit.org 17 What we are going to cover • The importance of supported self-care for people with frailty • An introduction to the Frailty Fulcrum • FrailSIM - a Virtual Reality experience to build empathy • Integrated training & person centred case studies • The Frailty Toolkit App.
- 19. www.frailtytoolkit.org 19 The role of simulation in training o Simulation Based Medical Education is believed to be superior to the traditional style from the viewpoint of the active and adult learning theories o Generally used to simulate patient / person for practitioner to practice on e.g., mannequins, role play, actors o Simulation suits allow practitioners to experience some aspects of an individual’s situation e.g., Age Simulation, Obesity simulation o Suits tend to be difficult to scale up and easily change the environment
- 20. www.frailtytoolkit.org 20 The basic idea for FrailSIM 1. Create a virtual living space, building in clues about the person’s situation and interest 3. Develop a scenario that gives the user simple tasks to do to experience life as “Victor” 2. Develop an avatar that can have different levels of frailty-related impairments
- 21. www.frailtytoolkit.org 21 The learning goals 1. “Virtually” walk in the shoes of an older person with frailty to increase understanding of their situation and help develop greater empathy 2. Promote observational skills and develop greater awareness of clues in the environment about an individual and their situation. 3. Deploy novel assistive technology to support training goals and thereby mirror one of the skills for supported self-care
- 22. www.frailtytoolkit.org 22 Key facts from FrailSIM to date (1) 320+ individuals 40+ roles 50+ organisations 93% of participants rated it ‘good’ or ‘excellent’ in terms of helpfulness in building empathy / walking in the shoes of an older person with frailty Poor, 2 Fair, 5 Neutral, 17 Good, 106 Excellent, 192 Helpfulness in building empathy / walking in shoes of an older person with frailty
- 23. www.frailtytoolkit.org 23 Key facts from FrailSIM to date (2) Nursing, 115 Allied Health Professional, 51Care Worker, 32 Social Worker, 28 Health Care Assistant, 22 Support Worker, 15 Other, 57 Mix of staff groups par cipa ng in FrailSIM 14.6 Average number of years participant had worked in the health & care sector 27% Of participants rated themselves as 5 out of 5 for familiarity and comfort using smart phones What words would you use to describe the VR experience to a colleague? 85% of participants were female
- 24. www.frailtytoolkit.org 24 What we are going to cover • The importance of supported self-care for people with frailty • An introduction to the Frailty Fulcrum • FrailSIM - a Virtual Reality experience to build empathy • Integrated training & person centred case studies • The Frailty Toolkit App.
- 25. www.frailtytoolkit.org 25 Training event design principles
- 26. www.frailtytoolkit.org 26 Mid Notts Transformation Programme (inc. PACS vanguard) Open to all… 26 Domiciliary Care providers Care Homes Primary & Urgent Care Community & Mental Health services Acute services Nottingham University Hospitals Sherwood Forest Hospitals City Care County Health Partnerships 226 Practices 85 Nursing Homes 131 Residential Homes 100 Provider “locations” South Notts Transformation Programme Health Education England Skills for Care Nottinghamshire Healthcare East Midlands Ambulance Service Age UK British Red Cross Nottinghamshire Care Homes Association Nottingham Community & Voluntary Service Carers Trust Dentistry, Pharmacy, Optometry OOHs Providers Fire & Rescue Service Housing Associations
- 27. www.frailtytoolkit.org 27 Multi-agency, multi-professional to support person along journey of care Open to all Table planning to ensure multi-agency MDTs on the day Lots of interaction through doing work together Quiz as Ice breaker Sharing cases through Fulcrum exercise Help & hinder: roles within the wider system (and shared frustrations) Home and hospital-based case scenarios Time and space for networking over lunch and at breaks
- 28. www.frailtytoolkit.org 28 Putting the older person with frailty at the centre of the training Case introduced through VR simulation Care planning exercise starts with video using actors for Vic & Kath plus memorabilia Victor’s story “Voice of” cards available for both stories plus additional input from facilitators Case introduced through hospital-based MDT role- play Care planning exercise starts with video using relatives’ voice over of Nirmala & Baldev’s story Nirmala & Baldev’s story
- 29. www.frailtytoolkit.org 29 Outline of the day Outline Timings Session 0915 - 0930 Overview of the day 0930 - 0950 Team quiz: Concepts & Consequences of Frailty 0950 - 1100 Understanding frailty 1100 - 1115 Break 1115 - 1230 Frailty & Supported self-care 1230 - 1245 Introducing the Frailty Toolkit App: Learning Zone & Enabling Zone 1245 - 1330 Lunch 1330 - 1345 Overview of the afternoon’s programme 1345 - 1515 Supported self-care along journeys of frailty - Case-based scenarios, Part 1 1515 - 1530 Break 1530 - 1615 Supported self-care along journeys of frailty - Case-based scenarios, Part 2 1615 - 1635 Presentation of supported self-care plans 1635 - 1650 Introducing the Frailty Toolkit App: Development Zone & Feedback 1650 - 1700 Recap of the day and close
- 30. www.frailtytoolkit.org 30 Evaluation of outcomes of training 6.0 8.3 Pre-event - cohort 3 month - cohort Confidence in suppor ng older people with frailty to self-care (out of 10) +37% 92% of participants rated the training ‘very effective’ or ‘effective’ 1 On a scale of 1 - 10 how well do you think you have achieved your goals from the training? 10 7.8
- 31. www.frailtytoolkit.org 31 Three biggest challenges for training programme Reaching 700+ primary care and social care providers! Trust in Special Measures unable to release staff for training
- 32. www.frailtytoolkit.org 32 Development of shorter training modules • 2 hour sessions • …. 1. Raising awareness of frailty and supported self-care 2. Case-based multi- agency, multi- professional team experience
- 33. www.frailtytoolkit.org 33 What we are going to cover • The importance of supported self-care for people with frailty • An introduction to the Frailty Fulcrum • FrailSIM - a Virtual Reality experience to build empathy • Integrated training & person centred case studies • The Frailty Toolkit App.
- 34. www.frailtytoolkit.org 34 Toolkit as an App: basic functionality 34 ‘Web-based application’ that is platform agnostic: works on Apple or Android devices, desktop or laptop Basic log in functionality set up as part of registration process for training event Consistent ‘look and feel for ease of usability Clear structure of drop down and expandable menus and sub-menus, lists and features Search function and ‘tagged’ content for ease of navigation Access to videos without leaving application Links to external content available Localisation of content in key menus (e.g., directory of services / resources) Highly scalable for increased numbers of users
- 35. www.frailtytoolkit.org 35 Add to home screen for ease of access 35
- 37. www.frailtytoolkit.org 37 What is available now? 1. Home: Welcome page, latest additions 2. My profile: Change profile, log out, bookmarks 3. Concepts & consequences: Contextual reports and background information 4. Learning Zone: A range of modules covering frailty and supported self-care theory & principles 5. Enabling Zone: Supported self-care planning templates 6. Development Zone: Additional training & education resources 7. Case studies: 3 examples of person centred care to bring the theory to life plus a service innovation 8. Directory of resources: Links to helplines, support and assistive technology relevant to clients and their families 9. About the Toolkit: Background to the development and contacts
- 38. Frailty: building understanding, empathy and the skills to support self-care Dr Dawn Moody dawn@fusion48.net An opportunity to learn about some innovative approaches to making the health and care workforce ‘fit for frailty’. @Fusion48net @Moody_D_K #frailty
Editor's Notes
- Jane to lead
- Jane to lead
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- DM: Firstly the reach and mix of participants: 300+ health and care professionals from more than 20 organisations Multi-professional with over 40 different roles across all major staff groups Secondly ‘hot feedback’ on the day of training 92% of participants rated the training “very effective” or “effective” Around 90% of participants were “likely” or “very likely” to download, recommend or share the Toolkit and Training Round-table networking and multi-agency working were the “best things about the events” Length of intensity of the day was an issue for a small proportion of participants, especially at venues with less space and natural light
- DM: Firstly the reach and mix of participants: 300+ health and care professionals from more than 20 organisations Multi-professional with over 40 different roles across all major staff groups Secondly ‘hot feedback’ on the day of training 92% of participants rated the training “very effective” or “effective” Around 90% of participants were “likely” or “very likely” to download, recommend or share the Toolkit and Training Round-table networking and multi-agency working were the “best things about the events” Length of intensity of the day was an issue for a small proportion of participants, especially at venues with less space and natural light
- Jane to lead
- Thirdly: 3 month follow up survey. In the pre-event work people were asked to rate themselves on a 10 point scale. 3 months later to rate themselves on the same scale. Across all 6 areas, respondents reported higher levels of confidence and understanding at the 3- month point. Understanding of frailty and self care and confidence in supporting people with frailty to self care. Also in understanding n roles of other people and organisations, in confidence in sign posting people to most appropriate services and in working with families and carers. Also mention the comments The final dimension of the evaluation is the data analytics of the toolkit usage, which is currently a work in progress but shows interesting early results.
- DM Needless to say there have also been some challenges. Awareness of training – ambitious project with tight timescales and reaching out to 700 + primary and social care providers to raise awareness significant challenge. Access to training – frontline staff, both in fragmented community services and also in big providers e.g. in special measures Access to toolkit - technology challenges – out of date technology restricting access – IE8 well out of date and unsupported but still browser of choice in many organisations!
- An innovative and interactive 2-hour session designed to build understanding and empathy for older people with frailty. Using the ‘real life’ case-based scenarios, a practical experience of working in a multi-agency, multi-professional environment to support older people living with frailty to self-care.
- Jane to lead