WA Horrible Stoutness MODEL OF Consideration.

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WA Grim Corpulence MODEL OF Consideration THE Master plan Displayed by: Educator Jeff Hamdorf Ms Karina Moore Wellbeing Systems Branch Plot What is the master plan? We should take a gander at horrible heftiness Synergistic restorative methodologies Effect on Endless Malady
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WA MORBID OBESITY MODEL OF CARE THE BIGGER PICTURE Presented by: Professor Jeff Hamdorf Ms Karina Moore Health Networks Branch

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Outline What is the master plan? Let’s take a gander at dismal corpulence Synergistic restorative methodologies Impact on Chronic Disease Using the master plan model to oversee better. WA wellbeing systems and system procedures Model of consideration improvement WA sullen heftiness model of consideration highlights

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Global Prevalence of Obesity

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Projected Prevalence of Obesity by 2025

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Estimating verifiable changes in physical action levels Australian pioneers 150 years back were 2.3 times more dynamic than today’s office specialists, with vitality uses equal to strolling 8 - 16 Km all the more every day Egger GJ et al. Med J Aust 2001

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DIET versus EXERCISE (Great Britain)

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What’s so bleak about Obesity? Ischaemic stroke Depression coronary illness Respiratory malady Congestive heart disappointment Gallbladder sickness Type 2 diabetes Dyslipidaemia Cancer (bosom, endometrial, colon, prostate) Hormonal variations from the norm and pregnancy intricacies Osteoarthritis Hyperuricemia and gout

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2.5 2.0 Mortality Ratio + drugs ± CBT 1.5 Diet/Lifestyle 1.0 Very Low Very High Moderate Low Moderate High 0 20 25 30 35 40 BMI Obesity and Mortality Risk + Surgery Gray DS. Med Clin North Am . 1989;73(1):1–13.

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Treatment Team Surgeon Physician Dietitian Psychiatrist/analyst Exercise physiologist Outpatient Nurse

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Physician Endocrinologist or essential consideration doctor Supervise examinations Optimize reversible co-morbidities Role in postliminary

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Role of the Dietitian Initial appraisal Portion sizes, decisions, “smart shopping” Supervise way of life alteration Post operation postliminary

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Psychologist Problem-illuminating abilities Coping methodologies Goal setting Monitoring Skills Social aptitudes

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Surgeon Team pioneer Co-ordinate arrangement Select surgery to suit patient Supervise stringent postliminary

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NIH Consensus Conference 1991 Surgery is the main approach that gives steady, perpetual weight reduction for beyond husky patients Surgery demonstrated in patients with: BMI of 40 or over BMI of 35-40 with noteworthy co-dreariness reported dietary endeavors insufficient

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40 - 60 mL pocket Restriction + satiety Adjustable Gastric Band Minimal access (100%) Low grimness Negligible mortality Adjustable Readily reversible

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LAGB versus RYGB EWL O’Brien, Dixon Brown ANZJS 2004

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Collated Outcomes LAGB 7 - 10 x more secure than detour surgery Perioperative intricacy rate 1-2 % Mortality immaterial (0.3%) Late bleakness (2 - 3%) Issues Late prolapse/slippage Erosion Port sepsis

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Co-Morbidity Control Type 2 diabetes Remission at 1 yr in 64%, enhanced 26% Hypertension 60% normotensive off meds, 33% enhanced Better control of asthma, GORD, lipids, OSA Significant change in QOL measures

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A Healthy Future for West Australians 2004 - Health Reform Committee inspected WA administration conveyance A Healthy Future for Western Australians (2004) 86 suggestions to guide wellbeing change Recommendation 23 Health Networks to bolster incorporated models of consideration

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What are Health Networks? A gathering of intrigued individuals and associations including wellbeing experts, patients, non-government associations, carers, shoppers and others, meeting up to talk, think, arrange and create wellbeing approach and administrations over the State

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Why Health Networks? A superb method for fashioning new associations with a much more extensive scope of individuals and associations to: Plan better approach Ensure better coordination and mix of administrations Increase cooperation, organizations, correspondence and responsibility crosswise over WA Health Clinician-drove and clinician drew in

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What Can Health Networks Offer? Expanded center upon patient/patient trip Engagement of partners Facilitation of correspondence Breaking down of storehouses Coordinated weight on organization Commitment to a dream

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Who Is Involved? Chief General State Health Executive Forum Executive Director Health Policy and Clinical Reform Health Network Lead SHEF sub-panel Health Network Leads Forum Health Network Exec Advisory Group Non-government association, private part, research bunch, scholastic, indigenous wellbeing, group/customer/carer, republic segment & state segment agents Health Networks Branch Working & reference bunches

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What Networks Do? Execution Performance pointers over the framework are driven by the Health Networks POLICY Health Networks lead and encourage the advancement of confirmation based arrangement PLANNING Strategic and operational getting ready for wellbeing and wellbeing administration conveyance is educated by Health Network counsel Working together to make a sound WA PROTOCOL Health Networks give chances to create frameworks and work rehearses that enhance clinical ability and support best utilization of both physical and scholarly assets PEOPLE Health Networks give partners with chances to authority. Chances to enhance clinical workforce bolster, showing and preparing are recognized and exhorted upon PRIORITIES Health Networks adjust to the DOH (WA) Strategic Intent, concentrating on the advancement of wellbeing and wellbeing

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16 Networks so far… Infections and Immunology Injury and Trauma Mental Health Musculoskeletal Health Renal Diseases Respiratory Medicine Neurosciences & the Senses Women’s & Newborns Acute Care Aged Care Cancer & Palliative Care Cardiovascular Health Child & Youth Services Digestive Health Endocrine Falls Prevention

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Network Processes Tools for cooperation and engagement Workshops & discussions Model of Care Development Policies and Guidelines Endorsement – best confirmation, clinical master and government and customer/carer

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Vision The right nurture the correct individual at the opportune time in the ideal spot with the right group. Model of Care characterizes: Health consideration administrations needed to fulfill everything purchaser needs in the proper setting. Standards, rules and criteria for social insurance administrations. Coordination of human services administrations in a consistent way along the whole care continuum (confirmation based pathways). Center Enablers Health Networks (GPs, Consumers, and so forth) Prevention & Promotion Initiatives (eg ABHI) Early Detection & Intervention Frameworks (eg National Service Improvement) Integration & Continuity of Care Strategies (eg Ambulatory Care) Self Management Care Continuum Severe Fragility & Environmental Condition Advanced Conditions Advanced Conditions Healthy High Risk High Risk Early Symptoms Early Symptoms

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Think tank to Workshop Think Tank on Obesity-February 2007 Aim: To build up a mutual vision for an organized methodology on corpulence Morbid Obesity Workshop - November 2007 Aim: to cultivate enthusiasm for the improvement of a common vision for dismal weight administration in WA.

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Expert Reference Groups – Feb 08 Comprehensive essential look after the administration of horrible heftiness The part of General Practice under the watchful eye of the excessively fat Surgical intercessions for treatment of dreary corpulence Health consideration administrations, hardware and office issues/activities

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Model of Care Recommendations Develop and bolster a multidisciplinary group methodology Integrated Health advancement and aversion systems Promote dismal stoutness as a ceaseless sickness Surgery ought to be suitably credentialled Implement surgical rules Develop a statewide database with national capacity Promote administration in a noble way Develop transport rules

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From approach to patient Policy Development Model of Care Health Networks Health Care Services Required Guidelines and Criteria Integrated Pathways Translation to Refinement of Clinical Service Framework Planning – Strategic Development of Proof of Concept physical connection Service Model AHS in discussion with Health Networks Workforce Infrastructure Information & Communications Technology Equipment and Resources WA Health Translation to neighborhood setting Planning – Operational Deployment Local Implementation Model AHS Eg Multipurpose Health Care Facilities Telehealth Community Health Care Practitioners Metropolitan Rural Community

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Morbid Obesity – the master plan Thank you Contact Prof Jeff Hamdorf or Ms Karina Moore by means of: Department of Health (WA) Health Network Branch PO Box 8172 Perth WA 6849 (08) 94892800 Email: healthpolicy@health.wa.gov.au Link to the web adaptation of the Morbid Obesity Model of Care: www.healthnetworks.health.wa.gov.au - ‘Models of Care’

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