CSIRO Publishing blank image blank image blank image blank imageBooksblank image blank image blank image blank imageJournalsblank image blank image blank image blank imageAbout Usblank image blank image blank image blank imageShopping Cartblank image blank image blank image You are here: Journals > Australian Journal of Primary Health   
Australian Journal of Primary Health
http://www.latrobe.edu.au/aipc/
  The issues influencing community health services and primary health care
 
blank image Search
 
blank image blank image
blank image
 
  Advanced Search
   

Journal Home
About the Journal
Editorial Board
Contacts
Content
Online Early
Current Issue
Just Accepted
All Issues
Special Issues
Sample Issue
For Authors
General Information
Instructions to Authors
Submit Article
For Referees
Referee Guidelines
Review Article
Annual Referee Index
For Subscribers
Subscription Prices
Customer Service
Print Publication Dates

blue arrow e-Alerts
blank image
Subscribe to our email Early Alert or RSS feeds for the latest journal papers.

red arrow Connect with us
blank image
facebook   youtube

 

Article << Previous     |     Next >>   Contents Vol 16(4)

Top tips for embedding chronic condition self-management support into practice

Sharon Lawn

Flinders University, GPO Box 2100, Adelaide, 5001 SA, Australia. Email: sharon.lawn@health.sa.gov.fau

Australian Journal of Primary Health 16(4) 334-343 http://dx.doi.org/10.1071/PY09070
Submitted: 20 September 2009  Accepted: 29 July 2010   Published: 3 December 2010


 
PDF (296 KB) $25
 Export Citation
 Print
  
Abstract

Organisational change aimed at service improvement continues to be a challenging process for many health services, managers and teams. Current imperatives to develop service models responsive to the growing demands of chronic conditions on health systems suggest that reflection on core change principles is warranted.

Dominant themes for progress in embedding chronic condition self-management (CCSM) support into practice settings arose from content analyses of case studies from health professionals who have attempted to implement CCSM support into their health services after undertaking specific training (The Flinders Program of CCSM). This included in-depth interviews with 10 trainers accredited to deliver training in this CCSM care planning approach to the workforce, formal reflections from 47 postgraduate students (currently in the health workforce) enrolled in a dedicated CCSM program at Flinders University and a consensus forum with accredited trainers. Emergent themes were then considered in the context of existing organisational change and CCSM literature.

Long understood principles of effective change management continue to be important, including leadership support, clear vision, team cohesion, effective people management and shared values. However, interdependence of these and other factors seems to be most important. Organisational change that builds capacity for CCSM support is possible, given a clearer understanding of where efforts will have the most positive impact on change.



References

Ashford G, Patkar S (2001) The positive path: using appreciative inquiry in rural Indian communities. Department of International Development, Bangalore. Available at http://www.iisd.org/pdf/2001/ai_the_positive_path.pdf [Verified 23 September 2010]

Bate P, Mendel P, Robert G (2008) ‘Organizing for quality: the improvement journeys of leading hospitals in Europe and the United States.’ (Radcliffe Publishing: Oxford, UK)

Bronfenbrenner U (1979) ‘The ecology of human development: experiments by nature and design.’ (Harvard University Press: Cambridge, MA)

Davies HTO, Nutley SM, Mannion R (2000) Organisational culture and quality of health care. Quality in Health Care 9, 111–119.
CrossRef | PubMed |

Emmons KM, Viswanath K, Colditz GA (2008) The role of transdisciplinary collaboration in translating and disseminating health research: lessons learned and exemplars of success. American Journal of Preventive Medicine 35, S204–S210.
CrossRef | PubMed |

Flinders Human Behaviour and Health Research Unit (2009) The Flinders program for chronic condition management (incorporating self-management). Flinders University, Adelaide. Available at http://som.flinders.edu.au/FUSA/CCTU/self_management.htm [Verified 23 September 2010]

Green LW (2008) Making research relevant: if it is an evidence-based practice, where’s the practice-based evidence? Family Practice 25, i20–i24.
CrossRef | PubMed |

Greenhalgh T, Robert G, Bate P, Kyriakou O, Macfarlane F, Peacock R (2004) How to spread good ideas: a systematic review of the literature on diffusion, dissemination and sustainability of innovations in health service delivery and organisation. National Coordinating Centre for NHS Service Delivery and Organisation R&D, London. Available at http://www.sdo.nihr.ac.uk/files/project/38-final-report.pdf [Verified 23 September 2010]

Hatch MJ (1993) The dynamics of organizational culture. Academy of Management Review 18, 657–693.
CrossRef |

Health NSW (2002) ‘Easy guide to clinical practice improvement: a guide for healthcare professionals.’ (NSW Health: Sydney) Available at http://www.health.nsw.gov.au/resources/quality/cpi_easyguide_pdf.asp [Verified 23 September 2010]

Hroscikoski MC, Solberg LI, Sperl-Hillen JM, Harper PG, McGrail MP, Crabtree BF (2006) Challenges of change: a qualitative study of chronic care model implementation. Annals of Family Medicine 4, 317–326.
CrossRef | PubMed |

Improving Chronic Illness Care (2009) Practice change. Available at http://www.improvingchroniccare.org/index.php?p=ACIC_Survey&s=35 [Verified 23 September 2010]

Institute Healthcare Improvement (2008) Integrating chronic care and business strategies in the safety net. Prepared by Group Health’s MacColl Institute for Healthcare Innovation, in partnership with RAND and the California Health Care Safety Net Institute, under contract no./assignment no. HHSA2902006000171. AHRQ publication no. 08-0104-EF. Agency for Healthcare Research and Quality, Rockville, MD. Available at http://www.ahrq.gov/populations/businessstrategies/ [Verified 23 September 2010]

Johnson A, Paton K (2007) ‘Health promotion and health services: management for change.’ (Oxford University Press: Melbourne)

Kendrick M (2006) Leadership, alliances and change. Interaction 20(2). Available at http://www.kendrickconsulting.org/pubs.asp?pid=0&ctid=15&cid=0&tr=SITEMENU [Verified 23 September 2010]

Kilbourne AM, Irmiter C, Capobianco J, Reynolds K, Milner K, Barry K, Blow FC (2008) Improving integrated general medical and mental health services in community-based practices. Administration and Policy in Mental Health 35, 337–345.
CrossRef | PubMed |

Kotter JP (1995) Leading change: why transformation efforts fail. Harvard Business Review 73, 59–68.

Kubina N, Kelly J (2007) ‘Navigating self-management: a practical approach to implementation for Australian health care agencies.’ (Whitehorse Division of General Practice: Melbourne)

Lawn S, Battersby M (2009) ‘Capabilities for supporting prevention and chronic condition self-management: A resource for educators of primary health care professionals.’ (Flinders University for the Australian Government Department of Health and Ageing: Adelaide) Available at http://som.flinders.edu.au/FUSA/CCTU/default.htm [Verified 23 September 2010]

Leggat SG, Dwyer J (2005) Improving hospital performance: culture change is not the answer. Healthcare Quarterly 8, 60–68.
| PubMed |

Litaker D, Ruhe M, Flocke S (2008) Making sense of primary care practices’ capacity for change. Translational Research; the Journal of Laboratory and Clinical Medicine 152, 245–253.
CrossRef | PubMed |

May C (2006) A rational model for assessing and evaluating complex interventions in health care. BMC Health Services Research 6, 86
CrossRef | PubMed |

May CR, Mair F, Finch T, MacFarlane A, Dowrick C, et al (2009) Development of a theory for implementation and integration: Normalization Process Theory. Implementation Science 4, 29
CrossRef | PubMed |

McDaniel RR, Driebe DJ (2001) Complexity science and health care management. Advances in Health Care Management 2, 11–36.
CrossRef |

McMillan E (2004) ‘Complexity, organizations and change.’ (Routledge: London)

Neuman WL (2003) ‘Social research methods: Qualitative and quantitative approaches.’ 5th edn. (Allyn & Bacon: Boston)

Newman S, Steed L, Mulligan K (2009) ‘Chronic physical illness: Self-management and behavioural interventions.’ (McGraw Hill/Open University Press: Berkshire, UK)

Schön D (1983) ‘The reflective practitioner.’ (Basic Books: New York)

Seidl D, Becker KH (2005) ‘Niklas Luhmann and organization studies.’ (Copenhagen Business School Press: Copenhagen)

Strauss A, Corbin J (1990) ‘Basics of qualitative grounded research: grounded theory procedures and techniques.’ (Sage: Thousand Oaks, CA)

Tilley N (2000) Realistic evaluation: an overview. Founding Conference of the Danish Evaluation Society. Denmark, September 2000. Available at http://evidence-basedmanagement.org/research_practice/articles/nick_tilley.pdf [Verified 23 September 2010]

Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A (2001) Improving chronic illness care: Translating evidence into action. Health Affairs 20, 64–78.
| PubMed |


   
Subscriber Login
Username:
Password:  

 
    
Legal & Privacy | Contact Us | Help

CSIRO

© CSIRO 1996-2013