A Self-Management Support Community of Practice as a Knowledge Translation Strategy Helena Jung & Kelly Sharp GF Strong Rehabilitation Centre

Disclosures We are unable to identify any potential conflict of interest and have nothing to disclose…

Learning Objective To learn how a community of practice facilitates clinicians’ knowledge, skills, and confidence in the use of self- management support strategies in an acute rehabilitation setting.

Outline Background Our Story Needs Assessment Community of Practice Quality Improvement Project Lessons Learned

At GF Strong… Chronic condition: “any ongoing management over a period of years or decades” (WHO, 2005)

Definitions Self-Management (SM): “Tasks that an individuals must undertake to live well with one or more chronic conditions.” Self-Management Support (SMS): “Systematic provision of education and supportive interventions, by health care staff (and others), to increase patients’ skills and confidence in managing their health problems” Health Council of Canada (2012)

Self-Management GF Strong Needs Assessment Community of Practice Quality Improvement Project Next Steps of GF Strong

Self-Management GF Strong Needs Assessment Community of Practice Quality Improvement Project Next Steps of GF Strong

Community Of Practice “a group of people who share a concern, set of problems, or a passion about a topic, and who deepen their knowledge and expertise in this area by interacting on an ongoing basis.” (Wenger et al., 2002) 9

SMS Community Of Practice Survey Quantitative 20 questions, based on 5 point confidence rating scale Related to clinicians’ ability to facilitate SMS using SMS tools average scores: Qualitative Based on 4 open-ended questions: 1.What did you learn from the experience of being involved with the SMS Community of Practice? 2.What are your ongoing learning needs? 3.What tools/components of SMS did you find useful and plan to incorporate in your practice? 4.What ideas do you have in bringing SMS to your team, program, and GF Strong as a whole centre? N=8 N=10

Self-Management GF Strong Needs Assessment Community of Practice Quality Improvement Project Next Steps of GF Strong

Self-Management GF Strong Needs Assessment Community of Practice Quality Improvement Project Next Steps of GF Strong

So far…. Our Lessons Learned General: Staff engagement Need for Evaluation Management support Plan for attrition Patient perspective Community of Practice: Coordinator(s) to facilitate Input from content experts Ongoing sharing

Key Message “Coming together is a beginning; keeping together is progress; staying together is success.” Henry Ford

Acknowledgements Karen Anzai Caroline Marcoux GFS SMS Community of Practice members Susan Barlow Dr. Brad Hallam Chris Palmer Patrick McGowan Maylene Fong

Helena Jung, BSc OT, MRSC GF Strong Educator GF Strong Rehabilitation Centre Kelly Sharp, BSc OT, MRSC (candidate) Community Intervention Coordinator GF Strong Rehab Center

References 1.Bandura, A. (1977). Self-efficacy: Toward a Unifying Theory of Behavioral Change. Psychological Review, 84(2), Health Council of Canada. Self-management support for Canadians with chronic health conditions: A focus for primary health care [Internet]. Health Council of Canada; May 2012 Available from: conditions-hcc-report/ 3.Heidi S, Renninger KA. The Four-Phase Model of Interest Development. Educ Psychol. 2014; 41(2): Wenger E, McDermott R, Snyder WM: Cultivating Communities of Practice: A Guide to Managing Knowledge. Boston, MA: Harvard Business School Press; World Health Organization. Preparing a health care workforce for the 21st century: The Challenge of Chronic Conditions. Switzerland: World Health Organization; 2005 [cited 2014 Mar 1]. Available from:

Expanded Chronic Care Model: Integrating population health promotion Barr, 2003

5 A’s Delivery Model (Glasgow et al., 2002; Whitlock et al., 2002). ASSESS Building rapport through open-ended questions Agenda bubbles* Readiness Change Scales Decisional Balance COPM Wellness checklist* ADVISE Information from assesment Ask-Tell-Ask Closing the loop AGREE Agenda bubbles* Action plan Wellness checklist* ASSIST Problem solving Reviewing action plan Reviewing wellness checklist ARRANGE Follow-up Link-up

Resources Knowledge Translation Canada: CCMI: The Centre for Collaboration, Motivation and Innovation Self- management BC: BC Ministry of Health - Self-Management Support: A Health Care Intervention: Management/PDF/Self- Management%20Support%20A%20health%20care%20intervention% pdf Management/PDF/Self- Management%20Support%20A%20health%20care%20intervention% pdf Registered Nurses’ Association of Ontario – Strategies to Support Self-Management in Chronic Conditions: Collaborating with Clients: conditions-collaboration-clients conditions-collaboration-clients 20