HABIT GROUP Pain Naomi Faulknor , PGCert Rehab,BPHTY Clinical Services Manager- Habit Group Management Service
Habit Group (www.habitgroup.co.nz) WHO ARE WE? North Island coverage (national contracts in private work)
WHAT I’LL COVER The cost of chronic pain • What is pain • How does it impact vocational rehab • About the service • Who is it for, what to look out for • How to refer • Our team •
THE BURDEN OF CHRONIC PAIN
WHAT IS PAIN? IASP definition: “Pain is an unpleasant • sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage’” Each persons pain experience is • unique Biopsychosocial nature of pain •
WHAT IS PAIN https://www.youtube.com/watch?v=5KrUL8tOaQs
WHAT IS Pain is very normal and very amazing • The experience or feeling of Pain • PAIN? depends on your brains evaluation of danger and the likely benefit of protective behaviour versus safety Evidence of a disconnect between • structure and pain, pain is much more than nociception Back pain is so much more than pain in • the back
HOW DOES PAIN IMPACT VOCATIONAL REHABILITATION? Multi-faceted and client specific Impact on mood and motivation • Role of medications • Fatigue and sleeplessness • Physical capacity • Unhelpful thoughts and behaviours • Social situation •
Relatively new – established 1 • December 2016 Replaced 8 different services • Designed to improve clients THE ACC PAIN • MANAGEMENT outcomes and experience by SERVICE reducing the impact of pain following an injury Achieving great outcomes in the • first years of service
WHO IS THE SERVICE FOR? Those clients who have: • Persistent pain that is preventing them from undertaking their usual activities, including work • Significant pain related disability • Those at risk of developing pain-related disability following an injury
GP, Primary Healthcare –ACC covered injury or any other ACC funded –>50 short form health professional OREBRO ACC ELIGIBILITY ACC covered injury High risk on Rehab Progress Checklist OR Rehab advisor, Triage Manager, BAP or BMA approved
HOW TO REFER GP, Primary Healthcare or any other ACC funded health • professional – ACC covered injury – >50 short form OREBRO – http://www.habit.co.nz/rehabilitation/pain-management- service – http://www.habit.co.nz/rehabilitation/pain-management- referrals ACC • – ACC covered injury – High risk on Rehab Progress Checklist – OR Rehab advisor, Triage Manager, BAP or BMA approved
Good communication Right service, right time, first time KEY A tailored plan for every client SERVICE PRINCIPLES Multidisciplinary and collaborative Outcome-based services A value-based model of care
MDT/IDT Role of GP/other treatment providers THE TEAM Key worker role Other rehab services Add ons - IPM
QUESTIONS?
Case Study # 1 Considerations? Client goals Context/Influence/social situation Assumptions? Group work? Who is in the team? Who could be in the team? Health Optimisation approach
Case Study # 1 Considerations? Client goals Context/Influence/social situation Assumptions? Quantify – Depression, Anxiety, Stress Sleep Activity Current perception/thoughts of pain presentation (Validation model!) How is the family dynamic – Wife? Kids? Who would be in the team? To date – Psychology, Medical, Physiotherapist, OT Who could be in the team?
Case Study # 1 Who is in the team? Why, How, When, What Physiotherapist – does George want this at the moment? Psychologist – Consider the patient mosaic OT Medical involvement Pharmacist – medication reconciliation could be added + Smoking cessation Social Worker – family dynamic and options for support Counsellor – community Dietician – assist with constructing supportive approach to nutrition Cultural or health literacy support, community supports Health Optimisation approach Timeframes?? Ultimate outcome??
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