riwc_para_a112 the heart manual
TRANSCRIPT
The Heart Manual DepartmentThe Heart Manual Department
www.theheartmanual.comwww.theheartmanual.com
NHS LothianNHS Lothian
RI ConferenceRI ConferenceEdinburgh, October 2016Edinburgh, October 2016
Aim:Aim:
a) a) To provide an overview of the Heart Manual To provide an overview of the Heart Manual ServiceService
b) How the Heart Manual works and its evidenceb) How the Heart Manual works and its evidence
c) Highlight new developments and collaborationsc) Highlight new developments and collaborations
The Heart Manual Service
HM Facilitator Training (n = 1500)
HM Website(700 hits/month)
Audit and Research
Patient Involvement HM
Group
Department’s Portfolio
Collaborations
Lothian Health Board
Intellectual Property Rights
Trademarked
The Heart Manual (HM)
Service
Edinburgh Health and Social Care Partnership
Cancer Manual (2014-2016)
Stroke Workbook
HM Programme Revascularisation
Edition (n = 4000 p.a.)
HM Programme MI Edition (n = 12000 p.a.)
Book
Digital
TIA Manual (2014 )
Book
Digital
Exeter University (2012 – 2017) Heart Cycle (2010 - 2013) Queens University Belfast (2014 ) Taunton H/C Trust (2014 – 2016)Peking UniversityHospital (2016-
Heart Failure Manual 2012-17
* Map of use -
Appendix
In use
In development/ trial
Shared IPR
a) a) The Heart Manual ServiceThe Heart Manual Service
Intellectual Property Rights (IPR) / copyright sit with LHBIntellectual Property Rights (IPR) / copyright sit with LHB
The department’s portfolio includes:The department’s portfolio includes: MI edition(2016)- digitally formatted MI edition(2016)- digitally formatted Revascularisation edition (2015)-digitally formattedRevascularisation edition (2015)-digitally formatted Stroke Workbook (2011)Stroke Workbook (2011) Cancer manual (2016) Cancer manual (2016) Training/support of facilitators-from Scotland, rest of United Training/support of facilitators-from Scotland, rest of United
Kingdom and further afield-e.g: Canada, SingaporeKingdom and further afield-e.g: Canada, Singapore
www.theheartmanual.com
HM users
Canada
HEART MANUAL (HM) HEART MANUAL (HM) (UK AND ABROAD)(UK AND ABROAD)
[email protected] Heart Manual DepartmentAdministrative Block, Astley Ainslie Hospital, 133 Grange Loan, Edinburgh, EH9 2HL
Canada
Republic of Ireland
Beijing
Singapore
Cayman Islands
The Heart Manual Service contd.,The Heart Manual Service contd., Strong evidence base-3 RCTs (1994, 2007,2009)Strong evidence base-3 RCTs (1994, 2007,2009) 330 citations of HM in journals (1990-2015)-as an excellent 330 citations of HM in journals (1990-2015)-as an excellent
example of a facilitated, sustainable & comprehensive resource.example of a facilitated, sustainable & comprehensive resource.
HM facilitators n=1500 HM facilitators n=1500 15,000 manuals per annum 15,000 manuals per annum
Recent collaborations include:Recent collaborations include: 2010-132010-13 Philips Heart Cycle-Heart Failure telehealth -Europe Philips Heart Cycle-Heart Failure telehealth -Europe 2012-172012-17 NIHR grant/National collaboration-HF manual NIHR grant/National collaboration-HF manual 2013-162013-16 Cancer Manual-in collaboration with Taunton NHS Cancer Manual-in collaboration with Taunton NHS 2014 -2014 - TIA /Healthy Brain Manual-in collaboration with QUB TIA /Healthy Brain Manual-in collaboration with QUB
Traditional approachesTraditional approaches Hospital or community Hospital or community
based classes effective based classes effective and useful for those who and useful for those who like groups and can like groups and can access the classesaccess the classes
However more people However more people returning to work quickly returning to work quickly after an event, after an event, intervention or diagnosis intervention or diagnosis
More flexible delivery More flexible delivery approaches neededapproaches needed
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Heart Manual MI and Heart Manual MI and Revascularisation EditionsRevascularisation Editions
Part 1:Part 1: Your Heart Condition: the factsYour Heart Condition: the facts Read during hospital stay, CDRead during hospital stay, CD’’s s
Part 2:Part 2: The 6 weekly facilitated home programme, The 6 weekly facilitated home programme,
Week 1 Getting home - getting betterWeek 1 Getting home - getting better Week 2 Feeling better, smokingWeek 2 Feeling better, smoking Week 3 Making progress, dietWeek 3 Making progress, diet Week 4 Getting better all the time, weightWeek 4 Getting better all the time, weight Week 5 Feeling more like yourself, exerciseWeek 5 Feeling more like yourself, exercise Week 6 The endWeek 6 The end……and the beginning, blood pressureand the beginning, blood pressure
Daily Daily –– Relaxation, Walking, Exercise and Activity record Relaxation, Walking, Exercise and Activity record
Part 3:Part 3: Facts and advice to aid recoveryFacts and advice to aid recovery
Evidence baseEvidence base
AnxietyAnxiety DepressionDepression QoLQoL Health perceptionHealth perception Exercise knowledgeExercise knowledge SmokingSmoking Exercise levelsExercise levels Cost effectivenessCost effectiveness
BPBP CholesterolCholesterol Cardiac symptomsCardiac symptoms Programme AdherenceProgramme Adherence Self-reported behaviourSelf-reported behaviour GP visitsGP visits Hospital re-admissionsHospital re-admissions
Lewin et al (1992) Dalal et al (2007)Lewin et al (1992) Dalal et al (2007)Taylor (2007) Jolly (2007, 2009)Taylor (2007) Jolly (2007, 2009)
Henwood & Barnes (2008) Henwood & Barnes (2008)Dalal et al (2010,2015)Dalal et al (2010,2015)
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Think, Do, EmpowerThink, Do, Empower
Heart Manual programme : Heart Manual programme : -explores & challenges misconceptions, -explores & challenges misconceptions,
normalising experiences, normalising experiences, -develops strategies for dealing with stress-develops strategies for dealing with stress
-Helps people -Helps people do do something about their something about their condition –condition –
- planning, goal setting, self-monitoring - planning, goal setting, self-monitoring
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Heart Manual TrainingHeart Manual Training
2 day Heart Manual 2 day Heart Manual Facilitator CourseFacilitator Course
1 day Health Care 1 day Health Care Support Workers Support Workers coursecourse
1 day Update day1 day Update day
2 day Trainers course2 day Trainers course
Facilitation of the Heart ManualFacilitation of the Heart Manual
Heart ManualMI or Revascularisation
Editions/Hard copy or Digital
Hospital facilitationSpec nurse or
trainedfacilitator
Phone follow up
Home visit
Clinic review/Specialist ax
Phone follow up
Home visitSpec nurse or
trained facilitator
Clinic settingSpec nurse or
trained facilitator
Discharge to GP/Practice nurse
Referral to specialistService for 1:1
Community Cardiac
Rehab class
Stand alone Exercise class e.g. BACPR
Instructor or local gym
Community facilitation
HOWTHE CANCER MANUALEVOLVED…
Support patients Support patients living with & living with & beyond cancerbeyond cancer
Address frequently Address frequently asked questionsasked questions
Help support & Help support & encourage positive encourage positive behavioural behavioural changes changes
Be facilitated by Be facilitated by specially trained specially trained cliniciansclinicians
A RESOURCE TOA RESOURCE TO
In summary…..In summary…..
The Heart Manual embraces self-management as it….The Heart Manual embraces self-management as it…. Enhances health consultationsEnhances health consultations Reduces GP consultationsReduces GP consultations Improves hospital readmission ratesImproves hospital readmission rates Reduces in patient staysReduces in patient stays Reduces outpatient visitsReduces outpatient visits Provides understanding for the familyProvides understanding for the family Improves medication compliance and Improves medication compliance and
managementmanagement Reduces A & E attendanceReduces A & E attendance
Jones (2007), DoH (2006), (2007), (2008) Dalal (2010,2015)Jones (2007), DoH (2006), (2007), (2008) Dalal (2010,2015)1616
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“The Manual more than met my expectations, and I still refer to it now – six months after my heart attack”
“The sections on risk factors helped me make informed decisions with regard to my lifestyle”
“My facilitator has always been understanding, informative and supportive”
“All the feelings and fears I had, I found they were common and it explained why we feel like this”
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Thank youThank [email protected]@nhslothian.scot.nhs.uk
www.theheartmanual.comwww.theheartmanual.com