Publication
Right Care, Right Place, Right Time - Citizen empowerment for optimising patient quality of life
From Department of Health
Published on
Last updated on
From Department of Health
Published on
Last updated on
Many Sláintecare Integration Fund projects have a focus on prevention and on empowering people and communities to be more engaged in their own health and wellbeing. The innovation and best practice that all these projects represent will be of great value to the work underway in every county to implement Healthy Ireland as a key part of the Sláintecare vision.
Engagement with and empowerment of citizens in defining and co-designing the kind of health service they envisage and need for the growing population is a cornerstone of the development of the health service.
Maria McEnery - Cancer Prevention Officer
Skin Cancer is one of the most preventable cancers, but rates are increasing year on year, with 13,000 cases reported this year. Maria McEnery is Cancer Prevention Officer with the National Cancer Control Programme, and she joined us on Webinar 13 to tell us about Skin Cancer Prevention.
Maria works with a wide range of partners to implement the National Skin Cancer Prevention Plan. She works with government departments, government agencies, healthcare professionals, NGOs and patient representatives to reduce the rise in incidence of skin cancer. Increasing awareness of skin cancer prevention, and improving behaviours when it comes to skin cancer prevention are the aims of Maria’s work.
There are four main target groups of the programme, due to their increased risk or developing skin cancer.
The annual SunSmart campaign targets the population in general about the risks of exposure to UV rays between April and October every year.
Monitoring and evaluating the effectiveness of the plan is also key to Maria’s work, to ensure they are reaching the correct audiences. While Behavioural Change takes a long time, the programme carried out a pre and post campaign evaluation of their annual campaign this year. The preliminary results show that people are more likely to use sunscreen and avoid the sun when it is at its strongest between 11 and 3pm.
They have also built really strong relationships with a lot of their key stakeholders.
Maria reminds audience members of the 5 Ss 5 Ss
Maeve McKeon, Self-Management Support Co-ordinator, CHO Area 1
Maeve McKeon, Living Well Self-Management Support Coordinator for CHO1 joined us on Webinar 13 to give us some background, and update us on the progress to date. Living Well is a six-week Chronic Disease Self-Management Programme (CDSMP) delivered by trained peer facilitators, who are also managing a chronic condition themselves. Six Community Health Organisations received Sláintecare Integration Funding to deliver the programme in their areas.
It is designed for adults, aged 18 years and over, who are living with one or more long-term health conditions (e.g. asthma, COPD, diabetes, heart disease, stroke, arthritis, multiple sclerosis, depression, Crohn’s disease, etc.), or for carers of someone with a long-term health condition.
The aim of Living Well is to enhance the capacity of the individual to manage the impact of their condition on their life, and thereby to enhance their quality of life.
Living Well focuses on developing self-management skills including action planning, decision making, problem solving, health behaviour change, as well as exploring the social and emotional aspects of living with a long-term health condition. These core skills are essential for an individual to become a successful self-manager, and a partner in their healthcare, thereby improving their health outcomes.
Living Well successfully pivoted to online to face the challenge of Covid-19. This has proven very successful. 1225 participants have participated in the programme since August 2020, with over 120 programmes delivered online. Completion rates of online courses are 92% compared to 75% of in-person courses. Maeve mentions however that online is not the preferred model of delivery for all participants, and this is something to keep in mind for future programmes.
Satisfaction levels with the project are at 94%, and participants have had very positive experiences with the programme, as borne out in some of their feedback comments:
“Our facilitators had a very respectful, caring approach, they brought their own life experience and health issues to the table which put us all on the same level and gave authenticity to their position”.
Trinity College Dublin is a research partner in the project, and preliminary evaluation results show very positive outcomes for programme participants so far. There have been increased:
The Living Well coordinators are now working on a business case to upscale and embed the programme so that people can access Living Well more equitably across all 9 CHO areas. The interim results have been very important to developing that case.
Optimising well-being and empowering people to live independently with advancing illness
Professor Karen Ryan, UCD Clinical Professor, Consultant in Palliative Medicine
Professor Karen Ryan, UCD Clinical Professor and Consultant in Palliative Medicine joined us on webinar 13 to discuss Rehabilitative Palliative Care, a new Sláintecare pilot service run between St Francis Hospice and the Mater Hospital. It provides care that integrates the hospital and community elements of palliative care.
Professor Ryan began by explaining that palliative care not only focuses on a patient’s last weeks of life, but aims to optimise their quality of life so that they can live well until the end.
The service aims to create a positive impact on patients’ lives, optimising their quality of life, and reduce their length of stay in hospital. It provides an opportunity for patients who are in the general hospital environment to be discharged in to the community with the support of Occupational Therapy in the Mater Hospital and Physiotherapy in the community, allowing them to live well at home. The project team also comprises two researchers to assist in the evaluation
Developing the working relationship between community and hospital has been vital to the integrated nature of the service. Communication and integration of services has been improved and the 'silos' of hospital and community broken down by virtue of working across boundaries and transitions of care. Technology and digital communications have also been very important.
It has allowed an in-depth insight in to their patients, and allowed for a seamless handover of information between different team members. This was appreciated by patients, who felt a sense of security that their case had been discussed by their wider care team.
Designing a service that is responsive to patients needs, with specialist case management approach and individual care plans also make this a very patient-centred service. That means providing a service that is delivered in the right place and at the right time. The community-based specialist palliative care physiotherapist can visit patients at home, ensuring that patients can receive services even if they are too unwell to leave their own home.
The project is now analysing their evaluation results, and hope to make a submission in terms of service planning for continuation of the service.