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Reimagining the CHW Bone and Mineral Service within an Evolving Environment
Aim Statement: At 12 months 100% of patients within the Bone and Mineral Service will have a patient centred care planBackground to problem worth solving: Bone and Mineral Service at CHW provides state-wide diagnostic and management services for children with a wide range of B&M disorders.Over the last 5 years activity has increased 20 – 30%New treatments available for many patientsHow do we continue to provide patient cantered care with increasing demands and new treatment paradigms?
Team members• Sponsor/s (Guidance Team)
• Dr Joanne Ging• Prof Geoff Ambler
• Project Team • Team Leader – Craig Munns• Consumer – XLH families / OIF• Christie Wall Kate Moss• Andrew Biggin Myra Poon• Verity Pacey Richard McGee• Karissa Ludwig Aaron Schindeler• Sherel Levy
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Craig Munns Endocrinologist, CPD Diagnostics and Clinical Trials Lead [email protected] 9845 3200 ECLP Cohort 22
Maintaining Momentum by Keeping a Patient Focus1. Empowering the patient and family to take ownership
of their Patient Centered Care Plan2. ‘Champions’ within the B&M Service who are
responsible for specific aspects of the care plan3. Review Patient Centered Care Plans at weekly clinical
meeting4. Continue to gather feedback from local health care
providers5. Publication of clinical data 6. Publication of PREMS and PROMS
ResultsOutcome measures
Spreading the WordDone: Submitted to the ACI Innovation Exchange Wall & Pacey APEG ASM, Sept 19, Adelaide, ‘How to improve function in children with bone and mineral disorders’Planned:Munns ICCBH Fellow School, July 20, Salzburg, Austria on ‘Establishing a Bone and Mineral Service’APEG Bone Day May 20, Sydney, ‘Burosumab in the Clinical Setting’Publication of clinical dataPublication of PREMS and PROMSLHD Quality Award – Burosumab for children with XLH
Link to National Standard https://www.safetyandquality.gov.au/standards/nsqhs-standards
Literature review Imel EA, Glorieux FH, Whyte MP, Munns CF et al. Lancet, 2019 Jun 15;393(10189):2416-2427.Imel EA, Biggin A, Schindeler A, Munns CF. JBMR Plus, 2019. May 13;3(8):e10190.Agency for Clinical Innovation, ‘Patient Reported Measures 2017, Agency for Clinical Innovation, ‘Patient Reported Measures Formative Evaluation 2017’Chen, J., 2014, ‘Integrated Care – Patient reported outcome measures and patient report experience measures – a rapid scoring review’, NSW Agency for Clinical Innovation, Kenney, C., 2011, ‘Transforming Health Care: Virginia Mason Medical Center's Pursuit of the Perfect Patient Experience’, New York, N.Y. And others
Discussion• Increasing demands on clinical services require innovative
solutions.• Building a strong multidisciplinary team assists in developing
that a broad range of change ideas. • Engaging all team members in the project and empowering
them to undertake change ideas appears to increases the likelihood of success.
• The acceptance of patients, and internal and external health care providers with the changes was excellent and encouraging.
• The development of formal Patient Centred Care Plans will take further work.
Overall Outcome of Project:10/19 Change Ideas Achieved8/19 Change Ideas have made good progress1/19 Change Idea has not made significant progressFirst iteration of Patient Centred Care Plan developed
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NSQHS Standards:Standard 2: Partnering with ConsumersStandard 4: Medication SafetyStandard 5: Comprehensive CareStandard 6: Communicating for Safety
• 1 of 19 families moved GP due to difficulty with administration• Well accepted (phone call and face-to-face interviews)• 100% adherence with medications• Overall introduction much better than expected
• All planned telehealth visits completed • Well accepted (phone call and face-to-face interviews)