Low Back Pain Presentation Prepared By Alberta Medical
Low Back Pain Presentation Prepared By: Alberta Medical Association December 9, 2015 1
Objective Describe Choosing Wisely unique value. Provide overview of More Is Not Always Better patient campaign Highlight Low Back Pain as a priority topic, with a call to action! 2
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“More Is Not Always Better” Choosing Wisely is a physician-driven campaign to promote healthy patient and physician conversations about tests, treatments and procedures. 4
Patient Poster Campaign
More Is Not Always Better A 30 second silent video which can be played on waiting room TV screens. http: //www. vimeo. com/Choosing. Wisely. Canada 6
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Patient Communication More is not always better philosophy and approach 62% of Canadians agree that there is a significant amount of unnecessary care in the health care system 92% of Canadians believe patients need more support to know which services are really necessary for their health 68% of Canadian family physicians agree that more tools are needed to help them make decisions about which services are inappropriate for their patients 8
Patients want it I’ve always done this New tests are good $$ Fear of litigation Referring doctor wants it Better to get a test than “do nothing” 9
Better Conversations 10
Better Conversations; Tips for Providers 1. Provide clear recommendations, stating relevant clinical considerations. 2. Elicit patient beliefs/questions 3. Provide empathy and partnership 4. Confirm agreement on plan of action, overcome barriers. 5. Plan for follow-up 11
Choosing Wisely National Resources Item Usage Poster – General messages Display in all patient areas Posters- Topic specific Display in selected patient areas Video – 30 second silent Display on screens Tent card Four questions patients are encouraged to ask Pamphlets - specific topics Print as needed and hand out to support conversation Physician recommendations Reference for evidence Physician CWA Quality In development, including Improvement Project Charter baseline measures, intervention planned, and results 12
Choosing Dissemination National materials PLUS • • • PLP Data Support TOP CPGs CME Supports Requested: EMR Supports Intervention Planning 13
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National Societies with Low Back Pain Recommendations 16
CWA Low Back Pain Partnerships Project Alberta Partnership Spine Access Alberta • Bone & Joint SCN PRIHS I project to demonstrate, in two sites, a new multi-disciplinary team service delivery model to support low back pain care. CWA Demo Project • Implementation of a new L-Spine Order Form • Working in collaboration with 3 Primary Care Networks to gather input and plan interventions based on their context. 17
CWA Demonstration Project; Physician and Patient Input through 3 PCNs • Low Back Pain; o Physician interviews using Cognitive Task Analysis (U. of Alberta) o Patient focus groups (Pa. CER – U. of Calgary) • Next steps: review themes, plan PCN level improvements. 18
• Healthy scripting • Team process improvement • Digital pamphlets • HUTV • PCN website resources • Inter-disc. team services and roles • Self management group supports Care Coordination • KT events (CPG and data) • Pamphlets Care Options • EMR support Informed Patients Physician/Team Potential Interventions • Specialist /specialty referral review • Improve referral process • Team process improvement 19
Making the Best Decisions Patients rely on their physicians to recommend the right tests and procedures based on their specific clinical needs. Doctors should use their knowledge, clinical judgement, and the best available evidence to guide their decisions, and they should speak with their patients about the appropriateness of specific tests and treatments. Physicians are called upon to use healthcare resources prudently, exercise appropriate judgment, and help their patients make informed decisions about their medical care. - Striking the Proper Balance, CMPA, Sept. 2014 20
Alberta Provincial Partnerships 21
How can you get involved? A. B. C. D. E. F. Display “More is Not Always Better” Have healthy conversations Give Low Back Pain pamphlets Get Low Back Pain data Talk to your peers to improve processes Sign up for the Challenge 22
- Slides: 22