Clinical

Improving Health

All healthcare practitioners have a role to play in health improvement activities and they should be embedded in all aspects of daily practice. Depending on individual circumstances, your role will vary from providing simple advice to supporting changes in behaviour.

It is important that you include health improvement in your assessment and treatment plans for all patients/clients.

Improving health

This activity can be split into 2 stages.

1.   There is a wide range of information available on public health. The following links provide highly resourced information on public health in Scotland. Go to 1 or 2 of these sites and read about areas of health that you routinely deal with. You will find this by using the tabs on the webpage, or using the search function.

Scottish Public Health Observatory

Health Scotland

Scottish Health and Care Experience Programme

Scottish Government: Improving Health in Scotland

Record information that refers to health issues that you routinely deal with.

2.  Reflect on how this information can influence the care that you and your team provide.

Your profession’s contribution

All healthcare professionals have a role in contributing to improving health. For work settings and professional groups there are specific policy documents, which help guide this contribution.

Access the relevant document for your profession and identify what you can do to contribute to improving health in your patient/client group.

 

Progress in improving health

As the Scottish Government state:

Scotland's health is improving. However, there are still many challenges to overcome to tackle the country's poor health record.

There are a wide range of initiatives which focus on health improvement and the Improving Scotland's Health webpage gives details of these.

Go to this page and identify an area of work that is pertinent to the patient/client group that you work with.

  • what are the key issues that you have found?

In line with what you have read, what actions can be taken to improve the health of the patient/client groups that you have identified by:

  • you as an individual practitioner
  • your team
  • the wider multi-professional team
  • working in partnership with other agencies

Discuss any plans that you think could be taken forward with your mentor and portfolio entry.

Public health in Scotland

This activity can be split into 2 stages.

Use the ScoPHO community profile information for your Health Board area (scroll down the page for an interactive map And access the 'Spine Chart Pack').

Use this information to:

1.  identify key/priority areas for action in your work setting

2.  identify the factors that impact on the care provided by you and your team

Record this information for the next activity.

Improving health in your Board area

Looking at the information you reviewed in the above activity examine the information you have seen from a health improvement perspective

  • how does the information about health issues compare with Scotland's average?
  • identify the top 3 priorities for improving health in your Health Board area

Record the key information that you have found for your portfolio and for the following activity.

Local health improvement initiatives

Find out about any local health improvement action plans by discussing this with your mentor or contacting departments where there is a focus on health improvement, searching the intranet and internet. If you plan to complete the 'Who works in health improvement?' activity, you may be able to combine them.

Health improvement and your patient/client group

This activity can be split into 2 stages - 1 for each patient/client.

All practitioners have a responsibility for health improving the health of the patient/client group. However, the approach and aims may vary depending on the group you work with. As a newly qualified practitioner, you need to familiarise yourself with the parts of your role that involve improving health.

Think about 2 of the patients/clients that you provide care for:

  • what are the priority areas that you and your team could focus on when thinking about supporting health improvement for this group?
  • look at the Improving Scotland's Health website and find out what is happening nationally in relation to these aspects of health improvement.
  • what local resources can you access that focus on your priority areas?

Discuss how you could put some of what you have found into practice with your mentor and write an entry for your portfolio.

Health improvement and the wider context

As part of wider multi-professional and multi- agency teams, it is important that you gain insight and knowledge about the range of health improvement activities that can impact on your patient/client group.

To find out more, it may be possible for you arrange to spend time with, or to speak to, a member of the multi-professional team and/or another agency your clinical team work with.

Telehealth

Telehealth is the provision of health services at a distance using a range of digital technologies. Examples of telehealth include video consultations to support diagnosis and management, clinical networks and health professional education. (Scottish Centre for Telehealth and Telecare)

With your mentor or another colleague, discuss how telehealth and telecare are or could be used in your work setting and the benefits for patients/clients, families and friends, staff and other carers. Use one of the following resources to inform your discussion.

Patient Stories resources

Telehealth community of practice

Telecare practice guides

The Scottish Centre for Telehealth website contains examples of how telehealth and telecare are being put into action in Scotland.

Health improvement activity

You may want to complete this activity in several stages.

Over the course of your first year as a registered practitioner you can plan, develop and implement approaches which promote health and wellbeing in your patient/client group. You will be able to use the information you have gathered in the previous activities when you are doing this. You may also wish to work with a colleague in completing this activity - and potentially one from another profession.

You should:

  • Using your local health improvement plan (find this on your intranet) and in agreement with your mentor select a patient/client group where there is a need for health improvement activity.
  • Plan, develop and implement the approach you have chosen. You may find it useful to draw on to help you prepare your patient/client education session.
  • When you have completed the session, reflect upon this experience and record your reflections for your portfolio.

You can:

  • draw upon your own experience (including your undergraduate/preregistration clinical experience and learning)
  • discuss how they would prepare and plan for this activity with colleagues from the same or other professions

You should also consider whether their health improvement approach has benefited them in any way (e.g. they may have lost weight, increased their exercise, continued breast feeding, reduced their risk of stroke or coronary heart disease

Resources

  • information you have gathered in other activities in this section
  • your colleagues in the multi-professional and multiagency team have a wealth of experience, and often from a different perspective. They can give you insight into what they feel works and what does not and can tell you how they prepared and planned for a similar activity
  • see the resources section of this unit

Improving Health Scenarios

Here are six scenarios based in practice, choose one which has resonance for you and explore solutions to the issues highlighted.

You could

  • work through the scenario yourself with input from your mentor:
  • work through the selected scenario with a peer group
  • write up your thoughts/plans or discussions and put it in your portfolio

Scenario 1
You have seen a patient/client at home following a myocardial infarction. You have advised them on some lifestyle changes but have returned 6 weeks later to find that they have not changed her lifestyle.

  • why do you think they have not made changes to their lifestyle?
  • are there other strategies and/or health and social care professionals you might call upon to help you?
  • what is your course of action now?
  • how are you going to focus your plans, taking into account the patient/client's perspective?

Scenario 2

A 40-year-old patient/client has been diagnosed with Type 2 diabetes.

  • what are the key areas where it may be appropriate to provide a programme of health improvement advice and support?
  • which multi-professional/ multiagency groups could be involved in this health improvement programme
  • what would be their role?

Scenario 3
Having assessed a patient/client, you feel that their motivation to change their lifestyle is very limited due to their work and home life.

  • what could you do to help them increase their motivation
  • what of their lifestyle could they change
  • what aspects could be changed but would present challenges?
  • what aspects would they be unable to change?
  • what other factors in their life influence their ability to make changes to their lifestyle?

Scenario 4
A parent has approached you about improving the diet of their children:

  • which other members of the multi-professional team could help?
  • what resources are there that could be useful?
  • are there other agencies that could help?

Scenario 5
A pregnant woman explains that she does not want to breast feed as she feels that bottle feeding is much more convenient for her.

  • discuss the reasons for this decision with her.
  • can you give any health improvement advice?

Scenario 6

A patient/client arrives at the surgical pre-assessment area, and requires stenting in his/her right leg due to peripheral vascular disease. He/she had been advised to stop smoking before surgery but admits to you that they have not managed this (although have cut down).

  • discuss how they have managed to cut down and what they think the next steps could be.
  • what resources and/or other professionals could you involve to help them stop smoking?
  • what can you and your team do to support them?

Scenario 7
A 22-year has recently been diagnosed with a major mental health problem has been referred for "lifestyle issues". They have gained weight as a side-effect of medication and are now embarrassed about taking part in physical and outdoor activities.

  • what information would you elicit from them?
  • what advice would you give them about exercise and lifestyle?
  • how best could this be delivered and followed-up?
  • which other members of the multi-disciplinary and multiagency team could be involved?

Are you up to date with the latest guidance?

The SIGN Guideline Management of Obesity will be useful for you.

Portfolio - improving health

Reflecting on the activities you have completed, identify the health improvement skills that you require to develop in order for you to carry out your post safely and effectively e.g. knowledge of guidelines, information giving skills, supporting behaviour change techniques.

With your NHS KSF reviewer agree your Personal Development Plan for the next 6 months and decide on dates for reviewing your progress in this area with your mentor. Also, add an alert to your Flying Start portfolio and /or make a date in your diary to revisit Improving Health.