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Zarah Von Schober

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  • OS23 - Engaging Patients Through Digital Health (ID 28)

    • Event: e-Health 2017 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical
    • Presentations: 2
    • Coordinates: 6/07/2017, 08:30 AM - 10:00 AM, Room 203CD
    • OS23.01 - Mobile Diabetes/Wound Care Self-Management in a Community Care Model (ID 69)

      Zarah Von Schober, Clinical Quality, Bayshore HealthCare Ltd.; Mississauga/CA

      • Abstract
      • Slides

      Purpose/Objectives: Wound care management is a challenge for Canada’s healthcare and community home care systems. Wounds are common manifestations of several chronic conditions and can cause pain, infections, hospitalizations, and decreased quality of life. With chronic condition rates increasing by 14% annually, the burden of wound care management is expected to proliferate. It is estimated that half of the care delivered by community care involves the management of wounds. Wounds cost the system ~$4 billion annually, accounting for ~3% of total healthcare expenditures. The application of eHealth from clinical settings into community care through the unification of neoteric principles of eHealth, the dogma of community self-management care, and deep-rooted best practice guidelines can curb the growing burden of wound care management from the individual level to the systemic. Through the Registered Nurses’ Association of Ontario (RNAO) and Canada Health Infoway, Bayshore Home Health (Bayshore), embarked on the RNAO Nurse Peer Leader Network (RNAO-PLN) project to promote the adoption of advanced clinical e-functions to support clinician and client (patient) engagement in evidence-based wound care management. Being an innovative leader, Bayshore, with QoC Health, developed: (1) the Bayshore Client Self-Management App to empower clients to build self-efficacy/confidence to manage their diabetes and wound care, improve their quality of life, and be able to effectively communicate with their healthcare team; and (2) a Clinician Decisional Support Portal for health coaches to engage and support clients.

      Methodology/Approach: The project utilized co-design (“think-aloud”) methodology and engaged in usability testing to gain insights to improve the usability, navigation, and intuitiveness of the solutions. QoC Health’s experienced co-design facilitators, conducted the sessions, engaging with expert clinicians, Clinical Practice Leaders, strategic senior leaders and Bayshore clients. Recognizing the importance of aligning eHealth technologies to organizational practices, Bayshore extensively engaged with its Clinical Practice Leaders to develop a new service delivery model that optimally and meaningfully embeds the technology into practice and in the lives of clients.

      Finding/Results: The eHealth tools will be deployed in an 8-month pilot, October 2016, with clients of the Bayshore Barrie branch. The objectives of the pilot are to improve: (1) clinician and client engagement in self-management; (2) client health outcomes; (3) clinician ability to provide proactive care; (4) client ability to identify when to seek care; and (5) health system efficiencies related to wound care management.

      Conclusion/Implication/Recommendations: We anticipate the RNAO-PLN project will result in improvements to wound care management in a community care setting at both the client and systemic levels; with learnings that are easily transferable to other areas of healthcare and patient populations.

      140 Character Summary: Bayshore and QoC Health created a Self-Management App and Clinician Portal to engage/support clients to manage diabetes/wound care and link with the care team.

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    • OS23.04 - Patient Engagement Strategies for Self-Management of Wound Care: Comparative Analysis (ID 355)

      Zarah Von Schober, Clinical Quality, Bayshore HealthCare Ltd.; Mississauga/CA

      • Abstract
      • Slides

      Purpose/Objectives: Increasingly, healthcare providers understand that patients with chronic conditions derive great benefits from being actively engaged in their care. And, patients feel empowered when they have the knowledge, skills and confidence to self-manage the physical and emotional aspects of their chronic conditions. Engaging patients and assisting them to actively participate in their care is known as self-management support. While it is recognized that healthcare providers should promote patient engagement to facilitate self-management support, this has not been integrated into clinicians’ routine practice in Canada. This presentation will share the strategies taken across two varied healthcare settings, (i.e. community care and ambulatory care) to optimize patient engagement and self-management support for individuals with diabetes-related foot ulcers with the common objective of promoting earlier wound healing. It will also discuss the results of a comparative analysis of the findings from each setting and the lessons learned.

      Methodology/Approach: Both healthcare organizations integrated evidence-based wound care order sets related to the assessment and management of people with diabetes-related foot ulcers within their health information system. In addition, they each implemented strategies to engage patients diagnosed with diabetes-related foot ulcers and provide supports to facilitate their self-management of their condition. Patients in the ambulatory care setting used a web-based tool to assess their knowledge of diabetes and foot care and to identify self-management goals in collaboration with their healthcare provider. They used an electronic goal calendar to track their progress over time. In contrast, patients in the community care setting used a wound care App to identify self-management goals in collaboration with their health coach and to track their progress. Patients were able to communicate with their health coaches through the App, as needed.

      Finding/Results: There was successful adoption of the evidence-based order sets in both care settings by more than 300 clinicians. The order sets facilitated knowledge translation and evidence-based decision-making at the point-of-care resulting in reduced variation in wound care management at each site. Preliminary results from the participating organization suggest that there was a significant difference in the patient experience of the self-management support in both settings resulting from the differences in the technology and the accessibility of the health coaches. Overall, the order sets improved efficiency in wound care management and the patient engagement increased self-management support for patients with diabetes and foot ulcers.

      Conclusion/Implication/Recommendations: This initiative highlights the significance of implementing evidence-based wound care order sets and the benefits of patient engagement strategies that facilitate self-management of chronic conditions across multiple healthcare sectors. The evidence-based order sets optimized wound care management while patient engagement was facilitated through technology that empowered them to self-manage their conditions.

      140 Character Summary: This presentation compares technology-enabled patient engagement strategies aimed at increasing self-management in individuals with diabetes and foot ulcers.

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