The Good Life Club

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Good Life Club Project System change to embed
self-management. Jill Kelly
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Today.

• Briefly describe project model
• Description of Transition Phase of program
• Highlight learnings

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3 year Demonstration Project

• Telephone coaching by Allied Health Practitioners
  general practice nurses
• Promotion of Multi-disciplinary care
  planning/self-management plan
• Client Website www.goodlifeclub.info
• Club activities
• Client newsletter
• email newsletter

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Transition Phase 2 years

• Action Plans to embed CDSM
• Organisational support
• Train the Trainers Flinders Uni model
• Regional Practitioners network
• Stanford course leader
• training

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• Central Administration, Co-ordination and
  Development
• Leadership for capacity building initiatives
• Source of expertise in chronic Condition
  self-management
• Central marketing role
• Promoting chronic Condition self-management to
  GPs other health providers
• Facilitating skills training for Allied Health
  Practitioners and volunteers
• Evaluation dissemination of evidence and
  results
• Financial administration
• Engaging other stakeholders eg. Dept of
  Veteran Affairs, Council of the Ageing

• Embedding Telephone coaching for chronic
  Condition in partner agencies
• Flexible models of delivery in fitting with
  structure of organisation.
• Support for the organisational change management
  process
• PDSA

GLC Club activities Integrate more fully with
existing activities in community. Activities
Branded" as GLC "endorsed" to create a common
identity across community
Facilitate training at Regional level Stanford
model Flinders Uni model Health Coaching
Building capacity in general practice e.g.
chronic illness clinics coaching for
PNs. Pilot initiatives to match current chronic
condition initiatives e.g MBS items
Organisational capacity building .skills
training for AHP Change management
support Regional Practitioners Group
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SUSTAINABILITY PROJECTS

• Trialled different models of coaching
• Barriers and facilitators identified
• Facilitators
• Supportive and proactive management
• Consultant approach
• Organisational and health professional behaviour
  change supported
• Regional Practitioners Group at team leader
  level
• PDSA cycles

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Sustainability Projects

• Follow-up telephone coaching 4 months post
  diabetes education group
• Using the Wagner Assessment in Chronic Illness
  Care tool
• Division establish self-management in 2 Asthma
  Clinics in general practice
• Establish Volunteers in Chinese Good Life Club
• Trial Flinders Uni CDSM tool in SRS
• Action planning in Diabetes Education group
• Acute sector planned to establish use of
  Flinders Uni tools

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What worked

• Small grants for Action Plans
• PDSA cycles
• Regional practitioner group at Team Leader
  level
• Training Stanford, health coaching/motivational
  interviewing
• Good Life Club Trademarked
• Promoting evaluation HEI-Q
• support to Chinese Health Foundation of
  Australia
• Consultant/leader at regional level
• Regional Practitioners Group at Team Leader
  Level

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What didnt work.

• Difficult engaging some Managers/Team leaders
• Engaging acute health/HARP
• Flinders model implementation
• Difficult to plan for sustainability
• Context no DHS policy or for CDM
• Lacked broader principles elements of Wagner
  model of CDM

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Whats happening now

• Two resources being developed
• Development of a practical guide to implementing
  self-management and chronic disease systems
• 2. Research and develop an Information Package on
  nurse-led chronic disease clinics in General
  Practice

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More Information

• www.goodlifeclub.info
• (see Health Professionals/Resources)
• Australian Journal of Primary Health
• Vol. 9 23 2003