Community of Practice Stories

Listen to what health professionals who use HealthChange® Methodology have to say

 
Leanne Cleeland, HealthChange® Peer Leader. Registered Nurse, Early Intervention in Chronic Disease Coordinator and Chronic Disease Worker at Benalla Health  Connecting Care in the Community (NSW CDM Program) How the Access and Referral Call Centre uses  HealthChange® Methodology

Acute Care Nurse

One of my most rewarding experiences has been working with a patient on Acute Care who was admitted with respiratory distress related to his morbid obesity and other chronic health conditions. The patient was denied admission to the bariatric clinic for medical reasons and due to his acute medical conditions and co-morbidities he was told by the Bariatric surgeon that there is nothing we can do for you at this time.

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The staff were told that the patient will most likely die in two years if he doesn‘t make any changes. Consequently I was asked by the charge nurse in the hospital to come see the patient and see if I could assist with some behaviour change and lifestyle recommendations.

Prior to our meeting the client was completely sedentary, needing oxygen at 7 L/min, having large meal portions and was feeling overwhelmed‖and hopeless. He confessed to thinking “daily life would be better if I was dead”. I met with the patient for an initial consult and was able to use the HealthChange Approach to work with him and create a personal self-management plan.

I then followed up in one week and was able to see significant changes and improvements for the patient. He was actually doing what we had talked about (I was shocked to see this kind adherence based on his past experiences in our system).

After two weeks, and three short consults he was walking 2-4 times a day. He had decreased his meal portions to medium size, was food journaling, had decreased use of his respiratory medication, oxygen decreased to 5L/min. He had implemented strategies for stress management (use of journaling and distraction techniques-drawing and colouring), lost 14 lbs, and was able to identify a variety of improvements to his overall well-being such as “I can breathe easier.” He said “I am sleeping better and  I am generally feeling better overall.”

Even more surprising was that my colleagues, including the rural physicians, took notice and were coming up to me asking “how did you get him to do all this?”. In fact two of the physicians asked me if I could come work with some of their more difficult patients and create this behaviour change. After only four short consults the patient is now self-regulating with the behaviour changes and is 40lbs lighter, only needing 4L of oxygen, and he reports that he feels like a new man with a new lease on life.‖

It is impossible for me to put into words the transformation this patient has gone through in such a short period of time. It is so empowering for me to see the difference the HealthChange Approach has made for this patient and ultimately how it has changed me as a clinician. I have become so much more efficient and effective in how I do my job and I am FINALLY seeing patients adhere to the behaviour changes that could potentially save their lives.

Canadian HealthChange® Trainer:

"My first 2 weeks in January were jammed with scheduled appointments. Lots of opportunities to embed the HealthChange® Methodology into my practice. Now into my 3rd week, here is how a consult went"

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Leah (not her real name) has multiple chronic conditions and complexities challenging her health. She wanted to tell me her 'whole story'. Hoping for some sense to be made of it, she allowed for me to ask many detailed questions as we had agreed upon in setting the scene for this appointment - about her daily habits and health behaviours. Collaboratively, we approached the decision line but there was a barrier. Her confidence was low in setting a goal, even though we had prioritised what she wanted to work on. So using decisional balance we dug down and found her intrinsic motivator to be her desire to 'not feel lonely'. The 'hold up' was situational, and finally identified as possible depression.

So Leah's plan is to make an appointment with her [GP] to discuss depression, which has never been addressed previously. Leah was relieved and left smiling and asking to come back.

In my career, I have patiently listened to my patients and often the plan was positive, in that rapport has been established, to make another appointment, progress was in the future. Now my patients will benefit from my expanded practise of being consistent and systematic for more predictable outcomes.

I feel great about having the framework to guide me efficiently through my consults. We have a word in Alberta for corralling elusive critters, "Yahoo!" :) Linda

Research and Programs using HealthChange® Methodology

Alberta Health Services Train the Trainer Collaboration

Alberta Health Services Chronic Disease Management Services has piloted and evaluated a HealthChange® Clinician Peer Trainer Program (train the trainer) for health care providers within their chronic disease management services.

 

 click here or image to download document


HealthChange Australia and Melbourne University Research Collaboration

Physiotherapy Department

Kim L Bennell, Thorlene Egerton, Caroline Bills, Janette Gale, Gregory S Kolt, Stephen J Bunker, David J Hunter, Caroline A Brand, Andrew Forbes, Anthony Harris and Rana S Hinman, 11 Dec 2012. Addition of telephone coaching to a physiotherapist-delivered physical activity program in people with knee osteoarthritis: A randomised controlled trial protocol.  BMC Musculoskeletal Disorders, 13:246

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HealthChange Australia was invited by Melbourne University to collaborate on a research project investigating the addition of telephone coaching to a physiotherapist-delivered physical activity program in people with knee osteoarthritis. The trial is registered with the Australian New Zealand Clinical Trials Registry reference: ACTRN12612000308897 and the protocol paper has been published and can be viewed at http://www.biomedcentral.com/1471-2474/13/246

The aim of the randomised controlled trial is to investigate the effect of a health service intervention comprising a limited number of physiotherapy visits together with telephone coaching designed to increase uptake and sustainability of physical activity behaviour and hence improve health outcomes in people with painful knee osteoarthritis. The intervention will be compared to physiotherapy alone which is known to lead to short-term improvements in pain and physical function.

HealthChange Australia provided training and skill development for the telephone coaches delivering the behaviour change support intervention. HealthChange® Methodology is being used to guide the coaching telephone conversations. Participants receiving the coaching intervention also received written material to support behaviour change developed by HealthChange Australia.

Final results after the one year follow up are expected to be released later this year.

Centre for Eye Research Australia

Personalised Eye Consultations (PEC) Study

Download newsletter and study description
Download PEC Doctor Patient Brochure

Ottawa Regional Cancer Foundation Cancer Coaching

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The Ottawa Regional Cancer Foundation is transforming cancer care in Eastern Ontario, Canada, with the opening of the country's first Cancer Survivorship Centre empowering survivors to be active participants in their health and wellbeing through and beyond cancer. Services at the Maplesoft Centre are available without referral and without cost to those diagnosed with cancer, their families and caregivers. Through individual and group coaching, tailored programs and relevant workshops individuals come to discover their personal needs and concerns, gain new knowledge and understanding of the impacts of cancer and identify and select strategies that are customised to their unique situation. The Cancer Foundation's Maplesoft Centre offers a safe and welcoming environment that encourages the exploration of options and where the survival of integrity, autonomy and dignity are always possible.  
For more information about the Cancer Foundation, please visit www.ottawacancer.ca

ACT HeartLink Program

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HeartLink is a program being conducted in ACT general practices to improve outcomes for patients identified as having a high risk of developing cardiovascular disease. HeartLink is a collaboration between ACT Medicare Local, the University of Canberra and the Heart Foundation and is funded by the ACT Health Directorate. Six general practices have been recruited to participate in HeartLink which is taking a comprehensive approach to the prevention of cardiovascular disease through systemic absolute risk identification and coordinated support for lifestyle change for patients. HeartLink commenced in July 2011 and is a 3 year program.  
What does HeartLink do? Working with the 6 pilot practices HeartLink is: Taking a comprehensive approach to the prevention of CVD through systematic absolute risk identification and coordinated management of patients found to be at high risk. Working closely with general practice and community based lifestyle modification program and service providers to improve support for patients who are found to be at high risk of developing CVD. Engaging Lifestyle Advisors to work with patients to support their lifestyle change. GPs will be able to refer high risk  patients to a Lifestyle Advisor funded by the project. The patient will be provided with behaviour change support for up to 12 months, undertaking around 6 sessions with their Lifestyle Advisor. Practice Nurses from HeartLink practices and the project Lifestyle Advisors have undertaken health behaviour change workshops facilitated by HealthChange Australia. The HealthChange ® Methodology has been adopted as the health behaviour change approach for the program. For further information contact Tanya Clancy at ACT Medicare Local: t.clancy@actml.com.au

HIPP Study (Excessive weight gain during pregnancy: piloting a prevention program)

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Researchers from three Universities (Dr Skouteris and Professor McCabe, Deakin University; Professor Milgrom, University of Melbourne; Dr Herring, Temple University, USA) and practitioners from Health Coaching Australia (Janette Gale, Dr Vanessa Cook and Rebecca McPhee) have joined forces to pilot test a novel intervention to prevent excessive gestational weight gain and postpartum weight retention in women who are pregnant for the first time; this intervention adopts a Health Coaching methodology to assist women with weight management during pregnancy. It has two components. (1) The first component involves two one-on-one sessions with a Health Coach that a) promote patient adoption of healthy lifestyle behaviors for the purpose of weight management, and b) address mood management and body image issues that commonly arise during pregnancy. (2) The second component involves two educational group sessions (10 women in a group), led by a Health Coach, that augment the one-on-one sessions; the aim is to provide new mothers with additional information related to healthy behaviours and mood, and to support and assist them in initiating, maintaining, and achieving their weight management goals. The program will commence at 18 weeks gestation and continue until 32 weeks gestation.

Pregnant women between 12-17 weeks gestation are invited to take part. For further details about this pilot study, please call Dr Helen Skouteris on 03 9251 769903 9251 7699 or email: helens@deakin.edu.auTo access the article on the research protocol of this study, published on BMC Public Health please follow the following link: http://www.biomedcentral.com/1471-2458/12/78

Goulburn Valley Health: Self Management Network 

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The Self Management Network aims to assist clinicians at GV Health to embed self management principles and practices into usual care. An important function of the Network is to support clinicians who attended the HealthChange Core Training Part 1 (CT1), (2-day workshop) to practise the new skills learnt to build their confidence and review current tools to reflect new skills learnt.
• GV Health Self Management Network: Terms of Reference
• Presentation delivered at the Australian Health Coaching Network: Embedding Health Coaching into Practice
Tips for setting up a Health Coaching network. For more information please contact tracey.forster@gvhealth.org.au