ORIENTATION SESSION

1. ORIENTATION SESSION Strengthening Chronic Disease Prevention & Management

2. PURPOSE OF THE MEETING Why the Tool is being introduced How it may be helpful to your group/committee Goals of the meeting

3. OUTLINE Regional Context How and Why the Tool was Developed What the Tool Looks Like Basic Concepts Critical Success Factors for Strengthening Chronic Disease Prevention & Management How the Tool Might Be Used

4. REGIONAL CONTEXT Add in appropriate info for your region: Regional strategies or goals for preventing chronic disease, risk factors and underlying determinants Framework or model guiding regional chronic disease prevention and/or management efforts Relevant stats or targets Eg. reducing number of new cases of type 2 diabetes by x % Eg. increasing % of population eating recommended daily fruits and vegetables Eg. increasing access to diabetes education and self-management program for high risk population group(s)

5. HOW AND WHY THE TOOL WAS DEVELOPED

6. CONTEXT The importance of reorienting health services towards health promotion, disease prevention, community-based care and chronic disease management has been repeated in every major health report and consultation in the past 10 years, including the Health Council of Canada’s 2006 annual report* *Health Council of Canada. 2006 Annual Report “Health Care Renewal in Canada: Clearing the Road to Quality.” Available online at: http://www.healthcouncilcanada.ca

7. CONTEXT Moving toward Integrated System for Chronic Disease Prevention and Management Addressing common risk factors Individual and population health approaches Intersectoral policy, building environments that support health Reducing inequities Improving system integration (policy, planning and program delivery levels)

8. CONTEXT Changing environment Wide range of disease-specific, risk factor-specific and age-specific strategies Efforts are underway to better align and better coordinate strategies and services along the full continuum to improve health outcomes to sustain health system

9. RESEARCH QUESTION “What are the critical success factors for integration of chronic disease prevention and management?”

10. METHOD/APPROACHEvidence-Based The Tool was developed through: Extensive multi-disciplinary research Peer-reviewed, indexed journal articles Grey literature (websites) Key Informants Focus Groups Four pilots

11. NS Chronic Disease Prevention Framework

12. INTERFACE: PUBLIC HEALTH AND PRIMARY CARE Limitations in: Infrastructure and capacity for both areas Interface: integration, coordination, communication Opportunities through renewal efforts in primary health care towards Disease prevention Health promotion Chronic disease management

13. RESEARCH RESULTS A collaborative planning and assessment tool Eight Critical Success Factors Guiding Questions for each

14. THE TOOL

15. AIMS TO: Engage planners and policy-makers in dialogue Promote information exchange Assess current policy, planning and practice Identify actions, roles and shared responsibilities for strengthening prevention and management of chronic disease

16. TARGETS: Policy-makers and planners With shared responsibility for preventing and/or managing chronic disease Working in: public health primary care home care and acute care non-governmental non-health sectors

17. WHAT THE TOOL IS NOT: NOT an accreditation-style tool NOT a prescriptive tool detailing what should be in place IS a resource to stimulate thinking about what better or promising practices “MIGHT” look like

18. WHAT DOES IT LOOK LIKE?

19. A TOOL KIT… Assessment tool, including worksheets and rating scales How-To Guide Case Studies

20. ASSESSMENT TOOL Purpose and Use of the Tool Ideas about who could use it Basic Concepts Intro to Critical Success Factors Worksheets with Guiding Questions

21. BASIC CONCEPTS CDPM Framework Building prevention into the health system Integration of CDPM Collaborative Action Capacity-building

22. INTEGRATED MODELS FOR CHRONIC DISEASE PREVENTION AND MANAGEMENT

23. NOVA SCOTIA’S Adopted & Adapted CDM Model COMMUNITY Build Healthy Public Policy HEALTH SYSTEM Self Management/ Develop Personal Skills Information Systems Create Supportive Environment Delivery System Design/ Re-orient Health Services Decision Support Strengthen Community Action Informed Activated Patient/ Family Prepared Proactive Community Partners Prepared Proactive Practice Team Activated Community Productive Interactions & Relationships Functional & Clinical Outcomes Population Health Determinants of Health

24. BUILDING PREVENTION INTO THE SYSTEM

25. Chronic Disease Prevention and Management Continuum TertiaryPrevention Prevent progression to complications and/or hospitalizations Prevent movement to at-risk group Prevent progression To established disease

26. INTEGRATING OF PREVENTION AND MANAGEMENT Better aligning strategies, vision and goals Linking individual & population-level approaches Shared planning to coordinate efforts and/or resources Mechanisms to support information-sharing, communication and coordination Service-level integration to improve comprehensiveness, continuity of care

27. COLLABORATIVE ACTION Shared responsibility for CDPM Range of stakeholders Building system capacity for CDPM requires collaborative action

28. CAPACITY-BUILDING Organizational development Workforce development Resource allocation Leadership Partnership development Reference: A Framework for Building Capacity to Improve Health, NSW Health, 2001.

29. CRITICAL SUCCESS FACTORS

30. CRITICAL SUCCESS FACTORS Common Values and Shared Goals Focus on Determinants of Health Public Health Capacity and Infrastructure Primary Care Capacity and Infrastructure Community Capacity and Infrastructure Integration of Chronic Disease Prevention and Management Monitoring, Evaluation and Learning Leadership, Partnership and Investment

31. Common Values and Goals Public Health Capacity/ Infrastructure Evaluation Monitoring Clinical-based Prevention (Primary Care) Population-based Prevention (Public Health) Integration Community Capacity/ Infrastructure Chronic Disease Management (1°, 2°, 3° care) Primary Care Capacity/ Infrastructure Focus on Determinants of Health Leadership, Partnership and Investment Learning

32. ASSESSMENT QUESTIONS Cues to help assess current capacity in the Critical Success Factors Where are we now in our practice? What opportunities are there to build capacity/improve practice?

33. WORKSHEETS AND RATING SCALES The assessment questions are also presented in worksheet format. The questions include a rating scale that outlines a possible range of practice for this component of the Critical Success Factor  Additional resources and a more complete description of each Factor is also provided in these sections of the Tool.

34. HOW MIGHT THE TOOL BE USED?

35. MULTIPLE APPROACHES No one right way to use the Tool Keep it manageable, e.g. Do an assessment of all eight critical success factors, but focus in on a particular risk factor, e.g. obesity Choose a few critical success factors to focus on Focus on a setting, e.g. workplace and choose the appropriate factors

36. HOW-TO GUIDE The Tool is meant to initiate and guide a process of engagement – it is neither a one-time event, nor an end it itself. To assist in this process, a series of how-to supports have been developed. Includes case studies