presentation slides frailty: building understanding, empathy and the skills to support self-care
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www.england.nhs.uk
Long Term Conditions Lunch & Learn
Frailty: building understanding, empathy and the skills to support self care
With Dawn MoodyDirector, Fusiion48
31 March 2016
www.england.nhs.uk
LTC Framework
Commitment to Carers
Frailty
Health AgeingGuide
Fire Service as an asset
Care Homes Quick Guides
Care & Support Planning
Navigating Health& Social Care
Self Care
Ambitions for End of Life Care
Our Declaration
Delivery Models
Planning for Change:• Capitated Budget• Contracting• Simulation Modelling
Patient and Service Selection
Planning for Change:Workforce
Whole Population Analysis;Understanding your population
LTC Dashboard LTC Toolkit
www.england.nhs.uk
Long term conditions resources
Simulation modelUnbundling recovery simulation model
www.england.nhs.uk
7
Using behavioural change to open
minds
#A4PCC – Action for Person-Centred Care
Person with long term
condition
o Make a declaration at www.engage.england.nhs.uk/survey/ltc-declaration
o Tell your teams about our worko Encourage them to make a declarationo Ask them to feed back thoughts and
ideaso Use our hashtag – #A4PCC – when
you see work that is relevant to person-centred care for people with LTCs
o Let us know of any events, activities or social media opportunities that we can join forces with you
www.england.nhs.uk
Long Term Conditions Lunch & Learn
Frailty: building understanding, empathy and the skills to support self care
With Dawn MoodyDirector, Fusion48
31 March 2016
Frailty: building understanding, empathy and the skills to support self-care
31st March 2016Dr Dawn Moody
An opportunity to learn about some innovative approaches to making the
health and care workforce ‘fit for frailty’.
@Fusion48net@Moody_D_K
#frailty
www.frailtytoolkit.org 7
What are the aims of the session?
• To explore the Frailty Fulcrum as a tool for holistic assessment and management of frailty
• To hear how Virtual Reality is being used to build empathy for older people living with frailty
• To learn about the impact of a county-wide, multi-agency, multi-professional training and toolkit for care professionals working with older people
7
www.frailtytoolkit.org 8
What we are going to cover
• The importance of supported self-care for people with frailty
• An introduction to the Frailty Fulcrum
• FrailSIM - a Virtual Reality experience to build empathy
• Integrated training & person centred case studies
• The Frailty Toolkit App.
www.frailtytoolkit.org 9
What is ‘Frailty’?
A state of reduced resilience and increased vulnerability
A state which minor events can trigger disproportionate adverse outcomes in health, wellbeing or functional ability
Related to, but distinct from, ageing, comorbidity and disability
Delivering safe, effective & consistent care to people with frailty is the greatest challenge facing the NHS in 2016 and beyond.
www.frailtytoolkit.org 10
What is self-care?
Regulatory Preventative
Reactive Restorative
Self-care
Recovery & rehabilitation
Health & well-beingDaily Living
Diagnosing & dealing with symptoms
www.frailtytoolkit.org 11
Supported self-care
What’s required:
1. Engaged, informed individuals and carers.
2. Professionals who recognise the central role of the person in their own care and are committed to partnership working.
3. Care systems and services that are organised in ways that enable individuals, carers and professionals to work together.
‘Supported Self-care’ is the process of assisting people to manage their own care in a way that helps to improve their quality and experience of life.
www.frailtytoolkit.org 1212
Empowerment
CapabilityMotivation
Enable individuals to develop skills in self-care and to use technology and equipment.
Understand the emotional, behavioural and relationship
factors
Moving from ‘recipients of care’ to equal partners in care
Principles of supported self-care
www.frailtytoolkit.org 13
Ten components of care for older people
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Shift to prevention and pro-active care:
1. Age well and stay well2. Live well with one or more
LTC3. Support for complex co-
morbidities / frailty
www.frailtytoolkit.org 1414
Person-centred
partnership
Engaging Family and Support Networks
Effective communications
Supporting Choice and Managing Risk
Maintaining skills and confidence
Deploying assistive
technology
Signposting and providing information
Skills for supported self-care
www.frailtytoolkit.org 15
What we are going to cover
• The importance of supported self-care for people with frailty
• An introduction to the Frailty Fulcrum
• FrailSIM - a Virtual Reality experience to build empathy
• Integrated training & person centred case studies
• The Frailty Toolkit App.
www.frailtytoolkit.org 16
Frailty Fulcrum
www.frailtytoolkit.org 17
What we are going to cover
• The importance of supported self-care for people with frailty
• An introduction to the Frailty Fulcrum
• FrailSIM - a Virtual Reality experience to build empathy
• Integrated training & person centred case studies
• The Frailty Toolkit App.
www.frailtytoolkit.org 18
www.frailtytoolkit.org 19
The role of simulation in training
o Simulation Based Medical Education is believed to be superior to the traditional style from the viewpoint of the active and adult learning theories
o Generally used to simulate patient / person for practitioner to practice on e.g., mannequins, role play, actors
o Simulation suits allow practitioners to experience some aspects of an individual’s situation e.g., Age Simulation, Obesity simulation
o Suits tend to be difficult to scale up and easily change the environment
www.frailtytoolkit.org 20
The basic idea for FrailSIM
1. Create a virtual living space, building in clues about the person’s situation and interest
3. Develop a scenario that gives the user simple tasks to do to experience life as “Victor”
2. Develop an avatar that can have different levels of frailty-related impairments
www.frailtytoolkit.org 21
The learning goals
1. “Virtually” walk in the shoes of an older person with frailty to increase understanding of their situation and help develop greater empathy
2. Promote observational skills and develop greater awareness of clues in the environment about an individual and their situation.
3. Deploy novel assistive technology to support training goals and thereby mirror one of the skills for supported self-care
www.frailtytoolkit.org 22
Key facts from FrailSIM to date (1)
320+ individuals40+ roles
50+ organisations
93%of participants rated it ‘good’ or ‘excellent’ in terms of helpfulness in building empathy / walking in the shoes of an older person with frailty
www.frailtytoolkit.org 23
Key facts from FrailSIM to date (2)
14.6Average number of years participant had worked in the health & care sector
27%Of participants rated themselves as 5 out of 5 for familiarity and comfort using smart phones
What words would you use to describe the VR experience to a colleague?
85% of participants were female
www.frailtytoolkit.org 24
What we are going to cover
• The importance of supported self-care for people with frailty
• An introduction to the Frailty Fulcrum
• FrailSIM - a Virtual Reality experience to build empathy
• Integrated training & person centred case studies
• The Frailty Toolkit App.
www.frailtytoolkit.org 25
Training event design principles
Integration
Individuals
Innovation
www.frailtytoolkit.org 26
Mid Notts Transformation Programme (inc. PACS
vanguard)
Open to all…
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Domiciliary Care providers
Care Homes
Primary & Urgent Care
Community & Mental Health services
Acute servicesNottingham University
HospitalsSherwood Forest
Hospitals
City Care
County Health Partnerships
226 Practices
85 Nursing Homes
131 Residential Homes
100 Provider “locations”
Nottingham City Council Nottinghamshire
County
Council
South Notts Transformation Programme
Nottingham City CCG (inc. Care Home Vanguard)
Nottingham North & East CCG
Rushcliffe CCG (inc. MCP vanguard)
Nottingham West CCG
Newark & Sherwood CCG
Mansfield & Ashfield CCG
Health Education EnglandSkills for Care
Nottinghamshire Healthcare
East Midlands Ambulance Service
Age UKBritish Red Cross
Nottinghamshire Care Homes Association
Nottingham Community & Voluntary Service
Carers Trust
Dentistry, Pharmacy, Optometry
OOHs ProvidersAdult Social Services
Adult Socia
l Servi
ces
Fire & Rescue ServiceHousing Associations
www.frailtytoolkit.org 27
Multi-agency, multi-professional to support person along journey of care
Open to all
Table planning to ensure multi-agency MDTs on the day
Lots of interaction through doing work together
Quiz as Ice breaker
Sharing cases through Fulcrum exercise
Help & hinder: roles within the wider system (and shared frustrations)
Home and hospital-based case scenarios
Time and space for networking over lunch and at breaks
www.frailtytoolkit.org 28
Putting the older person with frailty at the centre of the training
Case introduced through VR simulation
Care planning exercise starts with video using actors for Vic & Kath plus memorabilia
Victor’s story
“Voice of” cards available for both stories plus additional input from facilitators
Case introduced through hospital-based MDT role-play
Care planning exercise starts with video using relatives’ voice over of Nirmala & Baldev’s story
Nirmala & Baldev’s story
www.frailtytoolkit.org 29
Outline of the day
Outline Timings Session0915 - 0930 Overview of the day0930 - 0950 Team quiz: Concepts & Consequences of Frailty0950 - 1100 Understanding frailty
1100 - 1115 Break
1115 - 1230 Frailty & Supported self-care1230 - 1245 Introducing the Frailty Toolkit App: Learning Zone & Enabling Zone
1245 - 1330 Lunch
1330 - 1345 Overview of the afternoon’s programme1345 - 1515 Supported self-care along journeys of frailty - Case-based scenarios, Part 1
1515 - 1530 Break
1530 - 1615 Supported self-care along journeys of frailty - Case-based scenarios, Part 21615 - 1635 Presentation of supported self-care plans1635 - 1650 Introducing the Frailty Toolkit App: Development Zone & Feedback1650 - 1700 Recap of the day and close
www.frailtytoolkit.org 30
Evaluation of outcomes of training
+37%92%
of participants rated the
training ‘very effective’ or
‘effective’
1
On a scale of 1 - 10 how well do you
think you have achieved your goals
from the training?
10
7.8
www.frailtytoolkit.org 31
Three biggest challenges for training programme
Reaching 700+ primary care and social care providers!
Trust in Special Measures unable to release staff for training
www.frailtytoolkit.org 32
Development of shorter training modules
• 2 hour sessions
• …. 1. Raising awareness of frailty and supported self-care
2. Case-based multi-agency, multi-professional team experience
www.frailtytoolkit.org 33
What we are going to cover
• The importance of supported self-care for people with frailty
• An introduction to the Frailty Fulcrum
• FrailSIM - a Virtual Reality experience to build empathy
• Integrated training & person centred case studies
• The Frailty Toolkit App.
www.frailtytoolkit.org 34
Toolkit as an App: basic functionality
34
‘Web-based application’ that is platform agnostic: works on Apple or Android devices, desktop or laptop
Basic log in functionality set up as part of registration process for training event
Consistent ‘look and feel for ease of usability Clear structure of drop down and expandable
menus and sub-menus, lists and features Search function and ‘tagged’ content for ease
of navigation Access to videos without leaving application Links to external content available Localisation of content in key menus (e.g.,
directory of services / resources) Highly scalable for increased numbers of users
www.frailtytoolkit.org 3535
Add to home screen for ease of access
www.frailtytoolkit.org 36
Search function
www.frailtytoolkit.org 37
What is available now?1. Home: Welcome page, latest additions
2. My profile: Change profile, log out, bookmarks
3. Concepts & consequences: Contextual reports and background information
4. Learning Zone: A range of modules covering frailty and supported self-care theory & principles
5. Enabling Zone: Supported self-care planning templates
6. Development Zone: Additional training & education resources
7. Case studies: 3 examples of person centred care to bring the theory to life plus a service innovation
8. Directory of resources: Links to helplines, support and assistive technology relevant to clients and their families
9. About the Toolkit: Background to the development and contacts
Frailty: building understanding, empathy and the skills to support self-care
Dr Dawn [email protected]
An opportunity to learn about some innovative approaches to making the
health and care workforce ‘fit for frailty’.
@Fusion48net@Moody_D_K
#frailty