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Health Promotion and Wellness: Relevance and Implementation Strategies

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Relevance and Implementation Strategies Circle of Life www.CircleofLife.net Trends in Health Care Wellness and health promotion Disease management Complementary ... – PowerPoint PPT presentation

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Title: Health Promotion and Wellness: Relevance and Implementation Strategies


1
Health Promotion and WellnessRelevance and
Implementation Strategies
  • Circle of Life
  • www.CircleofLife.net

2
The Circle of Life
Self-Inquiry Assessment Form
3
Trends in Health Care
  • Wellness and health promotion
  • Disease management
  • Complementary medicine
  • Parish nursing
  • Cluster services

4
Methodology
  • Provide opportunities that are
  • Experiential
  • Relevant
  • Life inspiring
  • Community building
  • Leverage practical, applied spirituality
  • Tools
  • Support
  • Assistive Accountability

5
Utilization Frequency and Cost
COST
Medical Care
Prevention and Health Enhancement Programming
Self Care and Citizen Self Reliance
FREQUENCY
6
What are the most important complementary
services?
  • Those that are safe, effective at a minimal cost
  • Group health improvement activities -
  • - group education
  • - support group, study group
  • - exercise
  • - mind/body - Yoga, Tai Chi, Qigong, meditation
  • Counseling or coaching - nutrition, informed
    choice
  • Proactive triage - nurse on phone, demand
    management

7
Medical visits - 75 could be handled through
self-care, 25 require contact with a provider
(no visit), 10 require an office visit
(physician or nurse practitioner).
Health Decisions, Demand Management
Donald Vickery, MD
  • Of the 1 trillion in annual expenditures 33
    is spent on care deemed to be avoidable.
  • Piper Jaffray Research,
  • Health Care Information Systems Industry,
    6/97

8
Pressures in the System
  • Challenge of Chronic Illness
  • Negative Drug Reactions
  • Iatrogenic Incidences
  • Major of disease is behavioral
  • Immense media attention
  • Anti-aging and longevity
  • Alternative and complementary medicine

9
Chronic IllnessJAMA, C. Hoffman, et al,
November, 1996
  • 1970 - 21 family caregivers/85 year old
  • 1987 - 76 of direct medical expenses
  • 1996 - 7 of 10 admissions are for chronic illness
  • 1996 - 99 million, 45 of population, 470
    billion
  • 2020 - 134 million, 60 of population, 685
    billion
  • 2030 - 6 family caregivers/ 85 year old
  • Integration of complementary services that are
    safe and effective may help to resolve some of
    this challenge.

10
Adverse Drug Reactions
  • JAMA April, 1998, Lazarou, et al
  • 1998 Major Causes of Death -
  • Heart disease
  • Cancer
  • Adverse drug reactions
  • 5,000,000 drug complications/year
  • 200,000 deaths/year
  • 4 Billion in medical costs per year

11
Medical Error - Iatrogenic Illness
  • 1988 Rand Corporation -
  • 25 of heart, stroke, pneumonia deaths
  • 1991 Time Corp-
  • 80,000/year 2x annual auto deaths
  • 1994 JAMA, 2721851-1857 - Leape, et al
  • 180,000 deaths per year
  • 1997 Harris Poll - 100 million have experienced
    or know someone who has

12
1999 - 2000 Congressional Hearing Medical
ErrorInstitute of Medicine
  • At least 44K to 98K deaths per year due to
    adverse medical events
  • More iatrogenic deaths than motor vehicle
    accidents, breast cancer, or AIDS
  • Medical mistakes cost between 17 billion and
    29 billion per year

13
An Act of Congress Created The Office of
Alternative Medicine (OAM)
  • It was then upgraded to
  • The National Center for Complementary and
    Alternative Medicine

14
Complementary and Alternative Medicine - CAM
  • The Economics
  • 13 Billion, 1991
  • 54 Billion, 1997

15
Between 1990 and 2000
  • The budget of NCCAM was increased 3000

16
White House Commission on Complementary and
Alternative Medicine Policy
  • Added a new area to its investigation on
    self-care and self-healing because a strong theme
    in their testimony regarded personal health
    improvement through personal action.

17
The House Task Force on Guiding Principles for
Health Care
  • Two Key principles
  • Health Creation
  • Self-Healing and Self- Managed Care

18
Health Futurists
  • Strongest move
  • Health Improvement as a key to Integrative or
    Complementary Medicine
  • Cost Pressures
  • Alternative Therapies are Cost Shifting
  • Self-Care is Cost Cutting

19
70of disease is preventable

Healthy People 2000, DHHS, 1991,
91-50213
National Center For Health
Statistics, DHHS, 1992, 92-1232
  • 8 of 9
  • causes of disease are
  • preventable
  • New
    England Journal of Medicine, Fries, Koop, et al,
    329321-325, 7/93

20
Chain of Causation
  • 10 Leading Causes of Death 9 Actual Causes of
    Death Root Causes of Death
  • 1. Heart Disease Tobacco Lack of information
  • 2. Cancer Diet/activity patterns Lack of life
    skills
  • 3. Cerebrovascular disease Alcohol Lack of
    connection
  • 4. Accidents Microbial agents External
    internal stress
  • 5. COPD Toxic agents Low self-esteem
  • 6. Pneumonia Firearms Hopelessness
  • 7. Diabetes Sexual behavior Anger and
    frustration
  • 8.. Suicide Motor vehicles Powerlessness and
    fear
  • 8. Liver disease and cirrhosis Illicit use of
    drugs Economic despair
  • 10. HIV/AIDS Meaningless existence
  • Columns 1 2 -- Journal of the American
    Medical Association, McGinnis and Foege,
    2702207-2212, 11/93
  • Column 3 - Health Action

21
  • 10
  • Leading
  • Causes
  • of
  • Death
  • Heart disease
  • Cancer
  • Cerebro-vascular disease
  • Negative drug interactions
  • Accidents
  • Medical error
  • COPD, Pneumonia flu
  • Diabetes
  • Suicide
  • Liver disease

22
  • 9
  • Actual
  • Causes
  • of
  • Death
  • Tobacco
  • Diet/activity patterns
  • Alcohol
  • Microbial agents
  • Toxic agents
  • Firearms
  • Sexual behavior
  • Motor vehicles
  • Illicit use of drugs

23
  • Root
  • Causes
  • of
  • Death
  • Lack of information
  • Lack of lifestyle skills
  • Lack of connection
  • External internal stress
  • Economic despair
  • Meaningless existence
  • Low self-esteem
  • Hopelessness
  • Anger and frustration
  • Powerlessness and fear

24
In 1990 and 97, Eisenburg, 1
  • 34/56 of Americans used unconventional health
    care methods
  • 400/800 million visits to unconventional
    providers13.7 billion was spent
  • 72/35 of respondents did not inform their
    medical doctor
  • New England Journal of Medicine, Eisenburg et al,
    1/93
  • JAMA, Eisenburg, et al, 11/97

25
In 1990 and 97, Eisenburg, 2Some of the
therapies studied
  • Relaxation meditation practices
  • Weight-loss programs
  • Mega-vitamin and herbal supplements
  • Self-help and support groups
  • Therapeutic imagery spiritual healing
  • Bio-feedback and hypnosis
  • Chiropractic
  • Acupuncture
  • Massage
  • New England Journal of Medicine, Eisenburg et al,
    328246-252, 1/93

26
In 1990 and 97, Eisenburg, 3The less frequently
discussed points
  • Only 10 of respondents used actual treatment
    provided by medical or licensed providers
    (Chiropractic, Acupuncture, Massage)
  • Most utilized unconventional methods were health
    improvement activities - Yoga, Tai Chi,
    meditation, support groups, etc
  • New England Journal of Medicine, Eisenburg et al,
    328246-252, 1/93 and 97

27
Archives of Internal MedicineStress Heart
DiseaseBlumenthal, et al, October, 1997Duke,
National Heart Lung and Blood
  • Current annual stats, 13.5 million, 117billion
  • 107 patients - 3 groups - Standard tx,
    exercise, support
  • 33 in group support and stress management
  • 74 reduction in risk for second cardiac event
  • Standard tx - 30 second event
  • Standard tx plus exercise - 21 second event
  • Standard tx plus group support -9 second event

28
Ornish Programfor Recovery from Heart Disease,
Prostate Cancer, etc.
  • Nutrition
  • Exercise
  • Stress Mastery
  • Group Support
  • 88 avoided future procedures, no additional
    adverse event rates compared to controls
    safe/effective.
  • Cost to franchise 30K to 100K, cost per
    participant 3K to 15.

29
How?
  • The Circle of Life program
  • - Personal Health Assessment
  • Self-Enhancement
  • System (PHASES)

30
The Circle of LifePersonal Health Assessment
Self-Energizing System
  • The Circle of Life system has 7 phases
  • 1. Assess, self inquiry, data capture Assessment
    Phase
  • 2. Evaluate, discuss findings Exploration Phase
  • 3. Develop healthy living program Personal
    Planning Phase
  • 4. Individual implementation Action Phase
  • 5. Support and accountability Support Phase
  • 6. Re-evaluation, measure outcome Re-evaluation
    Phase
  • 7. Course correction Re-design Phase

31
  • Who
  • provides
  • coaching
  • Support
  • Group
  • facilitation
  • Health educators
  • Parish nurses
  • Ministry professionals
  • Social services
  • Counselors, therapists
  • Occupational therapists
  • Physical therapists
  • Human resources staff
  • Health consultants
  • Citizens, lay-persons

32
  • Diet nutrition
  • Exercise fitness
  • Stress mastery
  • Health care self-care
  • Relationships family
  • Work and career
  • Financial health
  • Humor, play creativity
  • Environment nature
  • Emotions self-esteem
  • Life purpose service
  • Spirituality intuition
  • Circle
  • Assesses
  • Supports
  • Action in
  • 12 Areas

33
Rich opportunities are already in most hospitals
  • 1. Physical therapy department
  • 2. Health education department
  • 3. Comprehensive cancer
  • 4. Cardiac rehabilitation
  • 5. Diabetes services
  • 6. Rehabilitation medicine

34
Comprehensive Delivery
The Public
Consultation
Consultation
Self Inquiry
Personal Plan
Diagnosis
Diagnosis
Personal Action
Treatment
Treatment
Group Support
Health Promotion
Conventional Medicine
Complementary Medicine
35
Monday Morning
  • Begin to craft, from resources within
  • the organization, programs and delivery
    pathways that maximize health improvement and
    complement already agreed upon clinical
    protocols.
  • If necessary target this strategy in just one
    or two departments or at one or two diagnostic
    categories.
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