Case Studies: Public Health

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Changing practice to improve the outcomes of public health self-management programs.

HealthChange Associates has been engaged by all Australian State based public health services to upskill professionals who need to promote client self-management.

Background: 

The Agency for Clinical Innovation (ACI) is a key pillar of NSW Health that aims to bring patients, clinicians and managers together to support the design and implementation of innovation in healthcare.

The Musculoskeletal Network focuses on improving the experience and delivery of healthcare for people who have a range of musculoskeletal conditions in NSW. 

How they use HeathChange® Methodology(HCM): 

Between 2013 and 2021, The ACI sponsored over 300 clinicians across NSW, who work in their main programs, to attend HCM courses. These are: 

  • Osteoarthritis Chronic Care Program (OACCP), 
  • Osteoporotic Refracture Prevention (ORP) services 
  • Management of Acute Low Back Pain 

Impact: 

The Osteoarthritis Chronic Care Program (OACCP) compared their results to the previous year after implementation of HCM training: 

  • Improved ability of patients to self-management: Surgical deferrals due to poor self-management reduced from 51% to 34% 
  • Reduced cardiac-related deferrals due to poor self-management alone declined from 29% to 10% 
  • High levels of patient engagement: Telephonic follow up with patients showed high levels of engagement and continued effective self-management, many avoiding surgery altogether 

Impact: 

 The Osteoarthritis Chronic Care Program (OACCP) compared their results to the previous year after implementation of HCM: 

  • Improved ability of patients to self-management: Surgical deferrals due to poor self-management reduced from 51% to 34% 
  • Reduced cardiac-related deferrals due to poor self-management alone declined from 29% to 10% 
  • High levels of patient engagement: Telephonic follow up with patients showed high levels of engagement and continued effective self-management, many avoiding surgery altogether 

Outcome

Network Manager, Robyn Speerin (2017) has “seen a significant change of attitude and practice that moved from clinician-led decision-making regarding a person’s care plan to a collaborative decision-making with a clear focus on the person’s daily activities.” The network can now demonstrate how they implement key elements of the Chronic Disease Model of Care and show how they focus on people as partners. 

Since 2021, ACI no longer routinely sponsors training for clinicians in these programs due to changes to funding arrangements.