Early recognition and treatment of malnutrition in primary- and homecare

Points of interest concerning implementation

The program of this meeting

• Exchange experiences

• Malnourished and afterwards?

• Toolkit

• Point of interest concerning implementation

‘ Elevator Pitch’

• Use an attracting introduction• Should be 40 seconds maximum (=100 words)

– Introduce yourself– A concrete description of the project– The content of your request– Why is this person the one you are

requesting – What can participating bring him/her

• Finish with a question or invite the person to start a conversation with you (by provoked curiosity)

• Bring with passion, be convinced by yourself, be assertive and show courage

Types of persons involving the implementation of a renewal

EarlyMajority

Laggards

EarlyAdopters

Innovators

LateMajority

From: Rogers, Diffusion of innovation

Facilitate Inform Support Convince Oblige

With which general practitioner/healthcare team to start?

• Pioneer• Ambassador• Enthusiastic healthcare manager• Difficult general practitioner• Example team• ………..

Think, when not known yet, with which general practitioner(s) or healthcare teams you want to start

Project plan

Name project

Milestone2 Milestone 3 Results project

Action

ActionActio

n

Action

Action

Action

Action

Action

Milestone1

December January March April

Actions projectplan

• Name of the project• Formulate the goal (take wishes and

possibilities in consideration)• Determine milestones

– Chronological– Use past perfect

• Determine actions for each milestone (see checklist)

• Make a planning and distribute the tasks

N.B. Make, if necessary, preconditions

Use of different media

posters, pencils, cups, key-cords, advertisements, commercials,t-shirts, etc.

clinical education, lecture, presentation, video/DVD, article, brochure, etc.

training, personal advice, coaching, etc.

A B C

Interaction

When media of each categoryare used the result is more than A+B+C

Eff

ect

ivit

y

Vision Skills Stimulation Resources Plan of action

Plan of action

Plan of action

Plan of action

Plan of action

Resources

Resources

Resources

Resources

Stimulation

Stimulation

Stimulation

Stimulation

Skills

Skills

Skills

Skills

Vision

Vision

Vision

Vision

Renewal

Confusion

Stress

Insecurity

Delay

Frustration

False start

Ersösz

applyapply hearhear

knowknowunderstandunderstand

integrateintegrate

Stadia of changes

DecisionDecision

Preview

Reflection

Active change

Consolidation Relapse

PERMANENT EXIT

Information

Negotiation Recognition

Temporary exit

Stages Problems Interventions

Hear Not listening/readingNo contact colleagues

Summarized informationPersonal approach key personsBrochure

Know No needConsidering it as irrelevantNot enough knowledge

CasusConfrontation with (consequences) behaviorSummarized messageRepeat often

Understand

Too complexSee disadvantagesDoubts

Good instruction (materials)Easy measurementsReflectionDiscussionDiscuss resistanceEvidence basedConsult experts or experienced colleagues

Apply Insufficient resourcesLacking skillsNegative reactions

TrainingSupervisorInformal experimentAssess bottlenecksFitted solutionMake results visible

Integrate ForgetRelapseInsufficient results

RemindersRegular measurements and discussion of resultsResponsibility

Features of innovation

• Relative benefit: better than what is currently used?

• Compatibility: does it fit to current available things?

• Complexity: Hard to understand/use?• Divisibility: Can there be experimented?• Visibility: Are results visible?

Rogers, E. (1983). Diffusion of innovations. New York: Free Press.

Implementation Tips

• Method by means of project– Ambitious and concrete goals– Project groups (composition!)– Formation project leader– Connect to current developments (attention to

elderly/ageing)– Good preparation and time schedule

• Multidisciplinary approach– Agreements (LESA)– Evaluation

• Customize the products of the toolkit

• PR & communication

Points of interest for upcoming period

• How to get to the next step?• Which actions are you starting?• What resources do you need yourself?

• Next meeting• Assignment: First primary practices started

screening and you acquired experience with treatment plan malnutrition