Outcomes that matter to patients Mel Tinsley Program Manager and Dr Hester Wilson GP October 2016 Welcome and introductions PHN staff and guests The ACI acknowledges the traditional owners of the land on which we meet tonight We pay our respects to Elders past and present and extend that ID: 583182
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Patient Reported Measures
Outcomes that matter to patients
Mel Tinsley, Program Manager and Dr Hester Wilson, GP
October 2016Slide2
Welcome and introductions
PHN staff and guests Slide3
The ACI acknowledges the traditional owners of the land on which we meet tonight. We pay our respects to Elders past and present and extend that respect to other Aboriginal peoples present here today.
AcknowledgementSlide4
Learning objectives
At the end of the session participants will be able to
Explain what patient-reported measures (PRMs) are and how they could benefit patients, clinicians and their clinical serviceDescribe how PRMs can lead to improve patient centred care and engagementWork
through the proposed process steps for implementing PRMs in their clinical setting Slide5
BackgroundSlide6
Integrated care
*reproduced with permission by Canterbury District Health BoardSlide7
What are Patient Reported Measures?
Patient Reported
OUTCOME
Measures
Patient Reported
EXPERIENCE
Measures
Capture the patient’s perspectives about how illness or care impacts on their
health and well-being
Capture the patient’s perception of their
experience with health care or servicesSlide8
Video PRM in NSW Health introSlide9
Why Patient Reported Measures?
What patient’s value
What clinicians’ value
ICHOM Standard Set for Coronary Artery Disease (2013)Slide10Slide11
The world over Slide12
What does PRMs in NSW look like?
Proof of Concept
Chronic and Complex ConditionsCo-design
Question sets
Real time feedback
Supporting
Ground up
innovation
Implementation support
Capability Development
Spread & sustainability
CONSUMERSSlide13
Clinician and patient benefits
Video – Matt PRM Module 3 section 4 Video – Mary PRM Module 3 section 3Slide14
What do they mean to patients and clinicians?
“I was able to sit and reflect on things that had been happening in my life… It gave me the words and started the conversation with my doctor about things I wanted to talk about”
“I thought that I knew my patient, I thought I had a good rapport, but when they filled in the PRMs I realised that I didn’t know about some key areas”
“ I liked the fact that I could sit down and do the questions in my own time and then my physio would talk to me about them and what it meant for me”
“ If only I had these results all the time for all my patients, I would be able to see what they were really coming in for and address that first” Slide15Slide16
Where to next
LOS
$$
AccessSlide17
Patient Reported Measures
Outcomes that matter to patients
Mel Tinsley, Program Manager and Dr Hester Wilson, GP
October 2016Slide18
Video – Practice example
Hills Family practice
In practice PRM Module 3 section 2 Slide19
What are PROMs and how might they be useful to us in GP?
Susan is a 68
yo woman who has been attending your practice for years. She cares for her sick daughter and has multiple health issues of her own.BMI 31
NIDDM poorly controlled
Hypertension
Osteoarthritis
Previous breast cancer
Previous AMI and TIA
Tobacco smoker
What are the important issues?Slide20
What are the important issues for Susan?
Using the Promis10Slide21
Using the DASS21Slide22
ScoringSlide23
Clinical use of PRMs
Mike age 56Asthma as a child
Long term tobacco smokerAnxietyBMI 35Recurrent exacerbations of COPD
Lives with his wife, Son and 2 grandchildren 40kms outside townSlide24
The promis10
1. general health – good (3)
2. QoL – fair – (2)#
3. Physical health – fair – (2)*
4. Mental health – good – (3)#
5. Satisfaction with social activities – very good –(4)#
6. Ability to carry out social roles – good – (3)*
7. Ability to carry out everyday activities – a little – (2)
8. How often bothered by emotional problems – rarely (4)#
9. Fatigue – severe – (2)*
10. Pain – 2 - (4)*
Overall score 39(50) physical health 11, mental health 13Slide25
The promis10 - Mike
1. general health – good
2. QoL – fair
3. Physical health – fair
4. Mental health – good
5. Satisfaction with social activities – very good
6. Ability to carry out social roles – good
7. Ability to carry out everyday activities – a little
8. How often bothered by emotional problems – rarely
9. Fatigue – severe
10. Pain – 2 Slide26Slide27
How might you implement PROMs into your practice?
Who? (staff and pts)
When?How?Managing results?Confidentiality?Slide28
PREMs
ACI PREM
RACGP PREM to go with 5th standards currently being developed
www.racgp.org.au/your-practice/standards/standardsdevelopment/Slide29
RACGP
22
detailed questions
across 6 domains
Appointments, staff, facilities, access and availability
Communication (interpersonal and professional)
Provision of information
Privacy and confidentiality
Continuity of care
demographicsSlide30
Evaluation Slide31
Next steps
PHN Closing remarks and next steps Slide32
Thank you and questions
Melissa Tinsley
Program ManagerPatient Reported Measures
Agency for Clinical Innovation
Melissa.tinsley@health.nsw.gov.au
+ 612 9464 4649
https
://
www.aci.health.nsw.gov.au/resources/integrated-care/aci/patient-reported-measures