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Chronically Devoted 2.0

Interprofessional teams at four health centres run by the county council in Sörmland have together with chronically ill patients improved healthcare.

Background

Based on patients’ needs, four health centres in Sörmland have worked together with chronically ill patients to improve their healthcare.  The health centres Skiftinge, Linden, Bagaregatan and Fröslunda have participated in the project and each health centre has focused on a chronic condition or disease: COPD, high blood pressure or diabetes. The project is based on experiences from the pilot project for person-centred care (2013) and Chronically Devoted (2015).

Goal

The goal of the project was to develop the staff’s understanding of, and ability to use, patients and their families as a continuous resource in healthcare. Another aim was for the patients who participated in the project to feel that they were being listened to and that they were given an opportunity to contribute to the development of person-centred care.
The goal of the solutions that developed was to contribute to more person-centred processes for people with a chronic diagnosis.

Implementation

For one year, the health centres gathered information from their patients, including feedback, wishes and needs. A total of 121 patients participated in various types of activities, such as keeping a diary, being interviewed or attending an open house, cooking classes, information meetings, patient advice and film-making. The health centre staff also collected quotes in connection with patient visits, vaccination meetings and health checks. The material gathered was analysed and compiled into a few general insights:

  • that patients want more knowledge about self-care
  • that patients want greater accessibility and continuity
  • that the way they are treated by staff is important
  • that people who are chronically ill are rarely asked about their mental health

Result

The initiative has resulted in several different ideas that have also been tested. Bagaregatan health centre focused on COPD and developed a structured process for people who receive a COPD diagnosis, ‘The COPD Lock’. Fröslunda health centre focused on high blood pressure and developed a program, ‘The Blood Pressure Boat’, for lifestyle changes for people with high blood pressure. At the Linden health centre, they focused on diabetes and developed a diabetes school with a cooking group where you can learn how to prepare healthy meals. Linden health centre also developed the concept ‘PT Guide and Exercise Menu’, which offers concrete support for lifestyle changes. Skiftinge health centre also focused on diabetes and created a multidisciplinary diabetes team and conversation support for the care visits called ‘My Diabetes’.

In addition to these ideas, the project also produced three reflection films that invite you to reflect on person-centred care from different perspectives.

Links

In connection with the reorganisation of Region Sörmland, the links have not found a new home yet. For the time being, we will refer you to the contact person of the project, Linda Lännerström.

Project Info

  • Status: Completed
  • Theme: Close care, Person-centred care, Policy and culture
  • Lab environment: Region Sörmland
Linda Lännerström
Linda Lännerström
Operations Developer