A Package of Innovation for
Managing kidney disease in primary care
SELF-MANAGEMENT
FACILITATION SKILLS
TRAINING
Project supported by
Registered Office: Nene Hall, Lynch Wood Park, Peterborough PE2 6FZ.
Kidney Research UK is a limited company registered in England. Registered Company No. 905963
Registered Charity No. 252892. Registered Scottish Charity No. SC039245
Slide Set 3 (rev Sept2014)
1
A Package of Innovation for
Managing kidney disease in primary care
Learning outcomes
• To feel confident in facilitating
consultations where the goal is to enhance
the effectiveness of self-management of
early CKD
• To understand how to use CKD selfmanagement tools
• To understand what might be required in
running group education sessions (if time)
Project supported by
Registered Office: Nene Hall, Lynch Wood Park, Peterborough PE2 6FZ.
Kidney Research UK is a limited company registered in England. Registered Company No. 905963
Registered Charity No. 252892. Registered Scottish Charity No. SC039245
Slide Set 3 (rev Sept2014)
2
A Package of Innovation for
Managing kidney disease in primary care
Outline
• Understanding behaviour change
• The perfect consultation
• Overview of self-management
activities
Project supported by
Registered Office: Nene Hall, Lynch Wood Park, Peterborough PE2 6FZ.
Kidney Research UK is a limited company registered in England. Registered Company No. 905963
Registered Charity No. 252892. Registered Scottish Charity No. SC039245
Slide Set 3 (rev Sept2014)
3
A Package of Innovation for
Managing kidney disease in primary care
Overview and outcomes
Train
the
Practice
team
Discuss
project with
patients
and provide
materials
Improved
self management
Project supported by
Registered Office: Nene Hall, Lynch Wood Park, Peterborough PE2 6FZ.
Kidney Research UK is a limited company registered in England. Registered Company No. 905963
Registered Charity No. 252892. Registered Scottish Charity No. SC039245
Patientcentred
consultation
Slide Set 3 (rev Sept2014)
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A Package of Innovation for
Managing kidney disease in primary care
CKD management – how much
clinician time in one year?
Project supported by
Registered Office: Nene Hall, Lynch Wood Park, Peterborough PE2 6FZ.
Kidney Research UK is a limited company registered in England. Registered Company No. 905963
Registered Charity No. 252892. Registered Scottish Charity No. SC039245
Slide Set 3 (rev Sept2014)
5
A Package of Innovation for
Managing kidney disease in primary care
The reality of CKD self-management
3 hours /year of professional care
leaves
8030
8757 hours /year of self-care
Project supported by
Registered Office: Nene Hall, Lynch Wood Park, Peterborough PE2 6FZ.
Kidney Research UK is a limited company registered in England. Registered Company No. 905963
Registered Charity No. 252892. Registered Scottish Charity No. SC039245
Slide Set 3 (rev Sept2014)
6
A Package of Innovation for
Managing kidney disease in primary care
The person with CKD retains all the:
• Choices
• Control
• Consequences
Project supported by
Registered Office: Nene Hall, Lynch Wood Park, Peterborough PE2 6FZ.
Kidney Research UK is a limited company registered in England. Registered Company No. 905963
Registered Charity No. 252892. Registered Scottish Charity No. SC039245
Slide Set 3 (rev Sept2014)
7
A Package of Innovation for
Managing kidney disease in primary care
Current practice: how do you
usually encourage people to
help themselves?
Project supported by
Registered Office: Nene Hall, Lynch Wood Park, Peterborough PE2 6FZ.
Kidney Research UK is a limited company registered in England. Registered Company No. 905963
Registered Charity No. 252892. Registered Scottish Charity No. SC039245
Slide Set 3 (rev Sept2014)
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A Package of Innovation for
Managing kidney disease in primary care
Consultations and selfmanagement
Devise a four stage consultation
using only 4 of the 8 cards
provided
Project supported by
Registered Office: Nene Hall, Lynch Wood Park, Peterborough PE2 6FZ.
Kidney Research UK is a limited company registered in England. Registered Company No. 905963
Registered Charity No. 252892. Registered Scottish Charity No. SC039245
Slide Set 3 (rev Sept2014)
9
A Package of Innovation for
Managing kidney disease in primary care
Key aspects of behaviour change
1. Partnerships
2. Overcoming
barriers
3. Beliefs and
attitudes
4. Action
Philosophy of care
Project supported by
Registered Office: Nene Hall, Lynch Wood Park, Peterborough PE2 6FZ.
Kidney Research UK is a limited company registered in England. Registered Company No. 905963
Registered Charity No. 252892. Registered Scottish Charity No. SC039245
Slide Set 3 (rev Sept2014)
10
A Package of Innovation for
Managing kidney disease in primary care
The perfect consultation
(to promote self-management)
What does it look like?
•
•
•
•
Explore the problem or the issue (past)
Clarify feelings and meaning (present)
Develop a plan (future)
Commit to action (future)
Project supported by
Registered Office: Nene Hall, Lynch Wood Park, Peterborough PE2 6FZ.
Kidney Research UK is a limited company registered in England. Registered Company No. 905963
Registered Charity No. 252892. Registered Scottish Charity No. SC039245
Slide Set 3 (rev Sept2014)
11
A Package of Innovation for
Managing kidney disease in primary care
Simple interviewing skills
•Open ended questions
•Affirm the person
•Reflect what the person feels
•Summarise the key points
Project supported by
Registered Office: Nene Hall, Lynch Wood Park, Peterborough PE2 6FZ.
Kidney Research UK is a limited company registered in England. Registered Company No. 905963
Registered Charity No. 252892. Registered Scottish Charity No. SC039245
Slide Set 3 (rev Sept2014)
12
A Package of Innovation for
Managing kidney disease in primary care
The perfect consultation: what
does it look like?
Case study discussions
Project supported by
Registered Office: Nene Hall, Lynch Wood Park, Peterborough PE2 6FZ.
Kidney Research UK is a limited company registered in England. Registered Company No. 905963
Registered Charity No. 252892. Registered Scottish Charity No. SC039245
Slide Set 3 (rev Sept2014)
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A Package of Innovation for
Managing kidney disease in primary care
Patient-clinician interactions
Traditional interactions
Collaborative interactions
Information and skills are taught, based on
the clinician’s agenda.
Patient and clinician share their agendas and
collaboratively decide what information and
skills are taught.
There is a belief that knowledge creates
behaviour change.
There is a belief that one’s confidence in the
ability to change, together with knowledge,
creates behaviour change.
The patient believes it is the clinician’s role
to improve health.
The patient believes that they have an active
role to play in changing their own behaviours
to improve their own health.
Goals are set by the clinician and success is
measured by compliance with them.
The patient is supported by the clinician in
defining their own goals. Success is measured
by an ability to attain those goals.
Decisions are made by the clinician.
Decisions are made as a patient-clinician
partnership.
Based on Bodenheimer California Healthcare Foundation 2005:7
Project supported by
Registered Office: Nene Hall, Lynch Wood Park, Peterborough PE2 6FZ.
Kidney Research UK is a limited company registered in England. Registered Company No. 905963
Registered Charity No. 252892. Registered Scottish Charity No. SC039245
Slide Set 3 (rev Sept2014)
14
A Package of Innovation for
Managing kidney disease in primary care
Key priority:
Promoting self-management of CKD
BP control - taking tablets as prescribed
BP monitoring at home
Smoking cessation
Blood sugar control (if they have diabetes)
Diet: avoiding processed, high-salt, high-fat & foods
and low protein diets
• Medicines management
• Lifestyle modification: exercise / weight
• Education – Self-management activities
– Additional information resources
– Support groups
•
•
•
•
•
Project supported by
Registered Office: Nene Hall, Lynch Wood Park, Peterborough PE2 6FZ.
Kidney Research UK is a limited company registered in England. Registered Company No. 905963
Registered Charity No. 252892. Registered Scottish Charity No. SC039245
Slide Set 3 (rev Sept2014)
15
A Package of Innovation for
Managing kidney disease in primary care
Improving verbal
communication
Avoiding language barriers How do you tell people they have CKD?
Do you have a practice policy on these
issues?
Project supported by
Registered Office: Nene Hall, Lynch Wood Park, Peterborough PE2 6FZ.
Kidney Research UK is a limited company registered in England. Registered Company No. 905963
Registered Charity No. 252892. Registered Scottish Charity No. SC039245
Slide Set 3 (rev Sept2014)
16
A Package of Innovation for
Managing kidney disease in primary care
Project supported by
Registered Office: Nene Hall, Lynch Wood Park, Peterborough PE2 6FZ.
Kidney Research UK is a limited company registered in England. Registered Company No. 905963
Registered Charity No. 252892. Registered Scottish Charity No. SC039245
Slide Set 3 (rev Sept2014)
17
A Package of Innovation for
Managing kidney disease in primary care
Helping people to help
themselves…
• Individual consultations or
group education sessions
• Support groups
• Organisations providing
more information
Project supported by
Registered Office: Nene Hall, Lynch Wood Park, Peterborough PE2 6FZ.
Kidney Research UK is a limited company registered in England. Registered Company No. 905963
Registered Charity No. 252892. Registered Scottish Charity No. SC039245
Slide Set 3 (rev Sept2014)
18