Using HCM to implement the Chronic Care Model

The CareFirst Team and HealthChange representatives collaboratively developed:

• Clinician scripts for recruitment, initial and review consultations
• Consistent Health Literacy messages
• Patient education materials
• Staff skills to apply HCM after course completion
• A program specific Train the Trainer program
• A Patient-Centred Care Plan and consultation documentation for data collection
• A structure for ongoing skills development and a community of practice

Impact:

Results of the 6-month pilot program were evaluated in 2018:

• Improved participants’ clinical and health-risk indicators
• Improved participants’ self-reported quality of life
• Increased participants’ self-management capability
• Reduced hospitalisation risk
• Better disease control
• Accepted as a feasible model of care

Medibank has continued the national rollout of the CareFirst Program since June 2016.

“There is evidence that participants made changes to their health risk behaviours and as a result saw clinically significant improvements in blood pressure and quality of life, increased their ability to self-manage their condition and developed the confidence to continue with the changes they had made.”

Download the 2018 report: https://unsworks.unsw.edu.au/fapi/datastream/unsworks:51355/SOURCE2?view=true