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Overview of Community Health Worker Home Visit MOP CHW Working Group Asthma Guidelines Working Group 7.16.2014

CHW Working Group Asthma Guidelines Working Group 7.16.2014

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Overview of Community Health Worker Home

Visit MOP CHW Working Group

Asthma Guidelines Working Group7.16.2014

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CHW Working GroupThe CHW Working Group will guide the

activities of the CHW Coordinating Center at Sinai, ensuring the integrity of the CHW training, hiring and intervention process.

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CHW Working Group MembersName Role Institution

Helen Margellos-Anast

Chair Sinai

Cort Lohff Member CDPH

Molly Martin Member UI Health

Valerie PressNicole Woodrick

MemberMember

U of C

Jessica Ramsay CHW Trainer/ Intervention Director

Sinai

Kenneth Soyemi Member StrogerJanet Flores Member Lurie Children’s

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CHW Working GroupResponsibilities

Assist with Year 1 focus groups Finalize the home visit intervention protocol, building off of

existing protocols (Sinai’s, Molly’s, etc.) Participate in the identification, selection and development of

appropriate education and support materials to be provided to clients

Development of ED discharge packet Participate in the recruitment of CHWs Train CHWs Supervise CHWs Develop Quality Assurance activities and protocols Monitor intervention progress Consult with Asthma Guidelines Working Group

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List of Documents for DiscussionComponents of overall CHW Home Visit MOP

CHW Home Visit ProtocolTeach to Goal MOP (Medication Use)Home Environmental MOP

Home Trigger Assessment Home Environmental Checklist Patient Educational Handouts - Triggers

CHW Curriculum

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CHW Home Visit ProtocolGuides CHWs as they complete the asthma

education portion of each home visit, ensuring a certain level of consistency

Follows the proposed home visit schedule: Visit 1: 2-3 days post ED dischargeVisit 2: 2 weeks post ED dischargeVisit 3: 1 month post ED dischargeVisit 4: 3 months post ED dischargeVisit 5: 6 months post ED discharge

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CHW Home Visit ProtocolVisit # Timing of Visit Focus

1 2-3 days post ED CHICAGO Trial overview, asthma basics, medication purpose and use, 504 plan

2 2-weeks Home environmental walk-through, triggers and avoidance strategies, green cleaning techniques

3 1-month Review of asthma basics, medication purpose and technique, Asthma Action Plan (AAP)

4 3-months 2nd home environmental walk-through, triggers, review of medication use

5 6-months Reinforcement of all education provided, final home environmental walk-through

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At all visits:Behavior Change Plan, outline specific short-

term goals for family to work towards by next visit, will be collaboratively created. Reviewed and updated at each visit

Referrals will be made as necessary (e.g., complex housing issues, social services, etc.)

Medication technique will be assessed and re-taught as needed Home Visit Inhaler Assessment and Education

Protocol: Teach To Goal (TTG) Checklists

CHW Home Visit Protocol

SHS
Valerie to go over this - started next slides, will ask her to fill in

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Teach to Goal MOPOverview of TTG

Tailored, pt-centeredDevice technique

checklistsObjective measuresMDI/Diskus/Twisthaler/

Turbohaler/ NebulizerTTG @ each visitPatient/Parent

Additional infoCleaning techniqueMedication dose tracking

sheet

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Home Environmental MOPCreated in partnership with Asthma

Guidelines WGOutlines specific procedures to be taken by

CHWs to address triggers identified during the Home Environmental Assessment (HEA)

HEA – thorough walk-through of the home environment conducted by CHW – emphasis on child’s bedroom, kitchen, living room and overall cleaning techniques and frequency

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Home Environmental MOPHEA to be conducted at 2-week, 3-month &

6-month visitsMOP focuses on primary triggers:

cockroaches, rodents, tobacco smokeSecondary triggers: mold and dust mites

Begins with shortened overview of protocol and education points for each trigger, then refers to pages with further detail on procedures to address each trigger

All other triggers included in appendix

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Home Environmental MOPPatient Educational Handouts – Triggers

One for each of the primary and secondary triggers

Provide overview of: Why each is a trigger What to look for/pictures of trigger Advocates for allergy testing Action steps to avoid trigger

Will also have other patient handouts regarding other triggers (CHW WG to finalize)

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CHW CurriculumCHW “bible” of information – does not

include proceduresUsed as a guide for the CHW training process

– all topics in the curriculum are covered in training

Supplements the CHW MOP – acts as a reference for more detailed information on all educational topics covered in home visits

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CHW CurriculumDivided into 8 sections, Asthma and CHW

Core Skills:CHW BackgroundAsthma BasicsAsthma Education and DevicesMotivational InterviewingPatient Self-Management and Goal SettingPatient Documentation: How to write case

notesCollaborating with Medical Professionals

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For discussionLayout of the CHW MOP

Suggestions for making it more user-friendly?Frequency of Home Environmental Checklist

Currently at 2-week, 3-month and 6-month visits – ok?

Provision of spacersWill we be providing spacers at home visits or

will this happen at ED discharge?Others?Comments/suggestions?

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Questions/Comments?