The Challenge

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How might we all maintain wellbeing and thrive as we age? read the brief

Winning idea

More than just a doctor's visit, a bridge to wellness (updated Aug 15)

We propose to reshape a doctor's visit by creating a Wellness Team made up of students and senior volunteers to serve as wellness coaches for aging community members.


We are in a health delivery crisis that may not be solved with more medications or procedures but needs to be addressed on the personal level. Using the doctor visit as the main point of contact, we propose to reshape this experience for seniors by creating a program to train both students and senior volunteers as wellness coaches that will be a mobile team visiting clinics and hospitals.

This is building on student passion and idealism combined with peer to peer support given from seniors to other seniors.  These two will form a team.

Training Wellness coaches in pairs:

Student Wellness Coach | Senior Wellness Volunteer (pairs)

Program Goals:
1. Enhance the health outcomes for seniors (reduce depression, increase interaction)
2. Boost compliance by senior role model
3. Reduce cost by empowering seniors with preventive care and wellness
4. Boost Competencies in Systems based practice and Professionalism

Learning Goals: By the end of this program, you will be able to…
1. Practice empathy skills
2. Apply motivational interviewing skills
3. Inform patients how to navigate complex health care system
4. Seniors will connect with others and share knowledge and experiences

There are three phases in this program:

1. Pre-program: preparation, education for the program which include practice with Standardized Patients, empathy training, team building and toolkits both physical and online.

2. During the session: student and senior paired as coaches, interviews and activities with patients and doctors in clinics and hospitals.

3. Post-program: evaluation of program, granting certificates, gathering feedback on teams and program, prepare to train the next participants

Scenario:

Any student can sign up to study in the Wellness Coach program. This is targeted at health care students will also include other students (business,technology, humanities and more).  The strength of this program is teaming up the student and the senior. This pair will then interact with the health care practitioners, doctors, nurses and other healthcare providers.

A day in the life of a student and senior Wellness Coach would look like this. The student and senior are given specialized training in empathy, interviewing skills and how to connect the senior with what they need. They have a mobile workstation in the traditional health system that includes a place to rest, take notes, and keep their belongings. They wear a uniform and a badge. The badges show their areas of expertise and borrowing from the boy/girl scouts, they can deepen their knowledge and skills.

Toolkit:

1. Badges: mastery and levels of expertise
2. Video tutorials on Motivational Interviewing
http://www.motivationalinterview.org/
3. Insurance Cheat Sheet: used to direct and connect patient and healthcare
4. Map showing services in local area (physical maps to hand out and online maps)
5. Empathy: skills training guides in empathy and interviewing
"PEARLS" 
http://icre2011.files.wordpress.com/2011/11/amin.pdf
6. Role Play  
The student coach and the senior volunteer will follow a course of role play.
They will take turns playing a Standardized Patients (people follow a script and p
retend to be patients with certain ailments).  Everyone on the team will follow the video and script to practice interviewing and delivery care for the most common encounters they are expected to face.

How might your idea scale and spread to reach as many people as possible?
We plan to develop this program at UCSF to test the ideas, then roll it out to affiliates around California. Each group of coaches (students and seniors) will also teach the next group so this knowledge will grow. We will evaluate this pilot and share it with others at regional meetings (WGEA in the west) and national meetings (AAMC).
How might your idea attract and involve partners from health care, business, government, nonprofit or other sectors?
Mayo Clinic may be interested in partnering and running this at their affiliates also. We can then collect data and share results. We also see partnering with medical schools, nursing schools and other health care educators. Some partners would be Geriatric divisions in hospitals, senior centers, assisted living centers, Meals on Wheels and other organizations like the Community Living Campaign (time bank of shared skills and resources). We also hope to tap into senior communities and create strong teams. There are two projects here we plan to leverage: Ageing Empathy Exercise http://www.openideo.com/open/mayo-clinic/ideas/ageing-empathy-exercise/ Caregivers Wellness Kit http://www.openideo.com/open/mayo-clinic/ideas/caregivers-wellness-toolkit/
How might you design an early experiment or prototype to further develop your idea?
This will be integrated into our existing Foundations of Patient of Care course which is where students go to clinics and engage with patients. This program can be used at Mayo Clinic and other health care clinics and hospitals. At UCSF, we plan to use our medical students to start (150 students) as the starting point for students. We would like to add many different types of students as this develops (business, technology, humanities) to provide a diverse range of ideas and points of view. We plan to develop a Standardized Patient case to train students in how to be effective wellness coaches before they head out into the community. We plan to create a toolkit both for the senior volunteers and the clinics who offer this program.

Evaluation results

1

How well does this idea enable people to maintain wellbeing and thrive as they age?

Really well. There's clear value in this idea for people of all ages
This idea is getting there but the connection to healthy ageing isn't quite clear
Not so well – there were other ideas that provide more real value for people as they age
2

Does this idea outline a clear mechanism or strategy that would enable it to scale and spread around the world?

Yep – it's really clear how this idea would get diffused and adopted by people from all over
Seems like the mechanism for diffusion still needs some fleshing out
No, it doesn't really look like it takes scale and spread into account.
3

How attractive is this idea for partners from health care, business, government, nonprofit or other sectors to get involved?

This idea is ready for partnership! It's easy to see how and why different sectors would want to get involved
There's some opportunity for partners here but it would need more refinement to really attract other organisations or people
It's not clear to me how or why partners would be motivated to get involved
4

How easy would it be to pilot an early version of this idea for continued iteration and learning?

Really easy – ways that we might test this idea in a pilot are already springing to mind
A pilot would be doable – but we'd need to spend quite a bit of time to figure out how to do it
An early pilot doesn't seem too easy at this point
5

Overall, how do you feel about this concept?

It rocked my world
I liked it but preferred others
It didn't get me so excited

Team

Comments

Join the conversation and post a comment.

Matt Ridenour

January 13, 2014, 07:11AM
Well done Christian! Focusing on the human interaction / connection aspect as a pathway to wellness is so important - you really hit the nail on the head. Your "wellness circle" with 6 different aspects shows great insight as well . Curious : were you inspired at all by Kaiser Permanente's THRIVE and "Total Health Environment" guidelines? They have identified creating spaces / experiences that contribute to overall health and wellness within their facilities in a manner that closely resembles yours. Also -if contributing to wellness of aging patients interests you - I lead a Beatles Choir that sings at Laguna Honda Hospital - you're ALWAYS welcome to join! It's a blast.

Ashley Jablow

September 12, 2013, 19:41PM
Hi Christian and team – congrats on your winning concept! If you're interested in pursuing your idea further, you might want to check out the Knight News Challenge. They're focusing on the topic of health and the winning entries will receive grant funding to bring ideas to life. You can check it out here http://kng.ht/1aunB0h. Congrats again!

OpenIDEO

September 05, 2013, 21:49PM
We're excited that many OpenIDEO collaborators on this challenge have been talking about prototyping their ideas going forward. Awesome! If you take things further, be sure to let us know at key milestones via our Share Your Story feature: http://bit.ly/action-stories so we might help celebrate your progress and inspire others to transform ideas into action and social impact.

Vikram Lokhande

September 01, 2013, 07:24AM
Congratulations Christian! It is one super idea.
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Christian Burke

September 03, 2013, 18:11PM
thanks, truly a team effort.

Paul Reader

August 30, 2013, 04:52AM
Great result Christian! I will be interested to hear of progress in the implementation of this idea.

Cynthia Ashe

August 29, 2013, 17:54PM
Congratulations on your winning idea!
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Christian Burke

September 03, 2013, 18:10PM
thanks Cynthia !

Cynthia Ashe

August 28, 2013, 21:49PM
I love that you propose to pair senior volunteers with health care students to create a wellness team. This creates an authentic learning opportunity for the student and leverages the senior coach's unique attributes -- i.e. the desire to give back and the time to do it. The combination of peer support and youthful exuberance could have a powerful impact on senior patients and help to support the efforts of the health care team.

T. Annie Nguyen

August 23, 2013, 02:58AM
Great concept and glad to hear it's in the works already with Foundations of Patient of Care! I saw that you want to leverage the Caregiver's Wellness Toolkit, which I think is great. I think there are opportunities for the wellness coordinator to not only empathize and be a coach to seniors, but also to caregivers. Many times caregivers are the ones that deal with scheduling, assisting in care and learning the system so it makes sense to leverage caregivers if they are part of the relationship.

I would also suggest thinking about how much time students have to dedicate to the program as well as a particular individual, which could be tested. It's nice to you are expanding the program out beyond just medical students because I know some and they really are limited with their time unfortunately, but training in empathy in all fields is important. Look forward to hearing more!
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Christian Burke

August 26, 2013, 22:24PM
Hi Annie, thanks for the feedback. Leveraging the caregivers is a great plan and nicely integrates into this project. I like your toolkit.

Yes, the time constraint for students is huge, we were thinking of ways to work with that (doing fewer total hours spread out over a several months or other ways to group the hours for more convenient time commitment). thanks !

Ashley Jablow

August 19, 2013, 16:44PM
I'm excited about the updates you've made here, Christian and team! Nice job.
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Christian Burke

August 19, 2013, 22:26PM
thanks Ashley ! our team is truly loving this challenge and discussing all the other interesting ideas.

Meena Kadri

August 20, 2013, 01:52AM
Great to hear, Christian. And hopefully they'll join in and assess all of the Top 20 ideas once our Evaluation round starts tomorrow :^)
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Christian Burke

August 20, 2013, 21:54PM
looking forward to it, thanks Meena

Mike Horrigan

August 18, 2013, 04:07AM
What if we change the conversation from age to ability. We can improve our ability. Its easy to test. There is no stretch or exercise which is going to make you even one day younger, but if with some measurements that would test the mind and body in areas such as flexibly, mental aptitude, technological strength and outlook. We give assign a score which is either higher or lower than average for a person their age. 100 would be average.You could then address areas which need work or areas of strength that could be improved more. For instance, if someone scores well in flexibility but could use some help with memory there are mental exercises which can improve that. Putting people on a path of self improvement could only improve their outlook and life. Also it could be a great point of pride and fun and competion. Even as they age if they work to improve their "Bimini index"- ( my term, healing water PDL was looking for to cure aging.) I think this could be used a measuring stick in your program.




Sent from my iPad

Paul Reader

August 18, 2013, 04:22AM
Interesting points Mike - I'm in my 60's so to some people I am already in the ageing category and physically I have some limitations but I expect to continue to contribute to OpenIDEO for a long time to come. Similarly there are others much older than me who have a greater capacity to contribute while, on the other hand, there are others much younger who are more restricted. There is a continuum of capability (and ages) where we can both contribute and receive assistance.
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Christian Burke

August 19, 2013, 22:36PM
Mike and Paul, interesting idea: going from an age number to ability number. I find this very motivating. In this proposal, this could help everyone by showing folks of any age how they can support others (wellness coaches: coach where you are strong,) and also folks of any age can learn how to get support where they need it.

Paul Reader

August 20, 2013, 02:50AM
There is a natural fit here with both of T. Annie Nguyen's concepts and the ideas from Lynn Liss and Karoline K. Obviously both inputs and outputs depend heavily on circumstance and as Meena has pointed out an age-independent outlook promotes the mobility of ideas across generations.
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Christian Burke

August 12, 2013, 18:35PM
thanks for the comments everyone, we are working to include this across traditional and alternative clinics and medical centers:
how else might we expand this?

Nick Dawson mentions training a new type of worker, what would that look like?

Beth Sanders

August 08, 2013, 17:55PM
Hello! Congrats on making it to the top 20! We were in the earlier phase of OpenIDEO -- I just wanted to say that http://www.lifebio.com would like to collaborate with you. Our web/iPad platform could be one tool that the student volunteers could use to get to know the seniors they are meeting. It helps build relationships by giving them the right questions to ask...and it's good for people's health too. For your testing phase, we can make this tool available -- call anytime to 937-303-4576 or email us at info@lifebio.com.
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Christian Burke

August 09, 2013, 19:18PM
Hi Beth, interesting platform, we'll check it out. thanks for the tip.

Beth Sanders

August 29, 2013, 18:10PM
Congrats Christian! Let me know if you need some free http://LifeBio.com accounts for your Wellness Coaches to use...Building a quick biography in 30 minutes could be an excellent way to get to know the WHOLE person. Learning about their past...and their present/future goals while not just seeing this as a medical problem. Love to help!

OpenIDEO

July 30, 2013, 22:04PM
Congrats on making the Healthy Ageing Challenge Top 20! We're loving this intergenerational and peer-based model for enhanced patient care and that you're already making progress to bring this idea to reality. During Refinement, we're eager to see more of the empathy and interpersonal training you're envisioning come to life – how do you envision supporting the students and senior volunteers so that they can provide thoughtful and personal care to patients? Also, what are the milestones this program needs to hit in order to become real? For more tips on how to iterate and prototype your idea during the Refinement phase, read here http://bit.ly/agewell_refinetips and check this Lowdown: http://bit.ly/oi_refine

NAomi Woychick

July 22, 2013, 15:57PM
I love that this is a great service to seniors with the added benefit of developing great human interest skills for young volunteers
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Nick Dawson

July 22, 2013, 17:17PM
I wonder about integrating Nadine's idea http://www.openideo.com/open/mayo-clinic/ideas/ageing-empathy-exercise/#c-1c2ea292311368f01b514cc31116d7e1 about an empathy exercise.

What if these med students also experienced what it was like to be older and have a doctor's visit. Would that effect how they ended up treating patients?

We did an experiment, at one hospital I worked in, where we had doctors simulate being low income with no transportation.They had to get to an appointment and get prescriptions filled. It was extremely hard and time-consuming for them.

Empathy exercises, coupled with their experience of helping be navigators as students, might make for a whole new generation of physicians!

Meena Kadri

July 23, 2013, 01:31AM
Great insights and suggestion, Nick!
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Christian Burke

August 01, 2013, 17:47PM
Nick, I like this to build empathy and understand what their clients really go through.

Annie Lin

August 02, 2013, 00:40AM
Awesome idea Nick! I love that it encourages bringing together elements of different ideas in this challenge.

OpenIDEO

July 21, 2013, 20:13PM
Congrats on this post being today's onsite Featured Idea!
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Nick Dawson

July 20, 2013, 00:00AM
Christian - this is a quite refreshing take on graduate medical education!

I love this part:

The way this works is when a senior arrives at their doctor's visit, they are paired up with a health care student that serves as their wellness coach. Students are trained in empathy and interpersonal skills and start to build a relationship with their clients.

I wonder, does it have to be a healthcare student? What about training a whole new type of worker?
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Karen Brent

July 22, 2013, 23:49PM
I agree that this has the potential to be done with other types of workers - at UCSF, we have a Center for Innovation in Interprofessional Education, that we could engage as a partner to help bridge across our other schools (Nursing, Dentistry, Pharmacy).
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Cha Viloria

August 01, 2013, 16:19PM
I was thinking the same thing, Nick. Students of counseling/social work and other mental health workers could be utilized as well.. and they're already experts on empathy.
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Christian Burke

August 01, 2013, 17:46PM
yes, these are great ideas and questions.

Karen, great ideas about including Center for Innovation in Interprofessional Education and other health care schools (nursing, pharmacy, dentistry, physical therapy).

Cha, adding the social work students and mental health workers are a good idea.

Should we open this up further to the community?
include other students outside health care studies (technology, business, etc)? or maybe our students can train students who then work in other locations
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Christian Burke

August 01, 2013, 18:40PM
Nick, this is a great idea.
You talk about developing a whole new type of worker: can you share more about this?

Meena Kadri

August 01, 2013, 22:00PM
Trust is a strong theme emerging on our Refinement phase. Looking forward to folks considering this as they develop their ideas further.

Could be worthwhile talking to seniors to gauge their receptivity of receiving support from students from broader health-related domains vs those from beyond. You might also ask their opinions around the notion of certification for this kind of role. Certified volunteers may be more well received? And although they are volunteers – can the senior count on their support for a particular length of time? In what other ways might we help build seniors' trust in this initiative?
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Cha Viloria

August 01, 2013, 22:10PM
Funny, Meena. The UCSF team just had a meeting earlier today where I brought up the idea of a certificate. You're right, certified volunteers might be more well received by those receiving the service. And I was thinking about having the certificate in place because the training would include learning about communication and interpersonal skills that could be applied towards any field. So in that way we could open up the project to those beyond health care students, and participants would have a tangible certificate as an extra incentive.

Meena Kadri

August 01, 2013, 22:31PM
Don't you just love it when there's this kind of global resonance going on with OpenIDEO?! Excited that your team is revving on your idea together. Your suggestion seems like a great way to advance trust in those from beyond the realm of health care. During Refinement, it could also be good for your team to think more specifically about what might be included in the training (as communication and interpersonal skills is pretty broad ;^) Could there be ways of introducing innovative modules (like the Ageing Empathy Exercise: http://www.openideo.com/open/mayo-clinic/ideas/ageing-empathy-exercise/ amongst others) to equip the volunteers with the skills they'll need?
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Kathleen Land

August 08, 2013, 23:44PM
Hello Meena, and thank you for your suggestions. Modules like the Ageing Empathy Exercise can be very valuable tools and we are lucky to have such a trove to explore. In medical education, our focus is on the students, but we are developing these resource to serve the ageing members of our community and they will be among our best teachers as we refine our concept and bring it to fruition. Through interviews and real-life medcial visits with friends and family we will figure out exactly what needs to be included in the training and how the program needs to be desinged so that it truly serves those who will encounter it.
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Cha Viloria

August 09, 2013, 18:54PM
Thanks for the suggestion, Meena! We're definitely getting down to specifics on the training (as well as other pre-program, during, and post-program details), so we'll be sure to look at the Ageing Empathy Exercise.

Meena Kadri

August 11, 2013, 21:33PM
Great stuff, guys! Be sure to update your post with your latest ideas before we head into the Evaluation phase next week. Looking forward to what you come up with. We're super excited that you are joining us while actually being able prototype parts of this idea with real students and seniors.
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Christian Burke

August 12, 2013, 18:07PM
yes, from the group work, we plan to post more today / tomorrow and get feedback. thanks Meena!

Meena Kadri

July 16, 2013, 23:46PM
Fab idea, Christian! You mention successful models at UCSF – would be great to explain what that is to our OpenIDEO community and help them understand what has been learnt through these early prototypes. (Tip: you can update your post at any time by hitting the Update Entry button up there on the right) The partnerships aspect sounds particularly exciting – especially as they would broaden the touchpoints and spaces where these consultations could be carried out.
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Christian Burke

July 17, 2013, 00:57AM
Hi Meena, thanks for the feedback. Yes, I'll keep updating this, clarifying and enhancing (this is a group effort from a bunch of folks at UCSF medical school, I'll get others to contribute, post soon).

Meena Kadri

July 17, 2013, 21:17PM
Awesome updates – and we're so excited that people at UCSF are joining us for this challenge!

Meena Kadri

July 17, 2013, 21:45PM
Tip: during our OpenIDEO Ideas phase we hope that our community will collaborate to strengthen and build ideas, together. Do you have any challenges or areas of opportunity for this initiative that you'd like to share to help folks understand where they might join the conversation? Perhaps you'd like to add those in at the end of your post description. As an example of someone else who's leveraging our OpenIDEO community to further build their existing idea – check out conversations flourishing here: http://bit.ly/189B2VU
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Christian Burke

August 01, 2013, 17:49PM
Hi Meena, sorry about the response delay. good point, we're moving this forward, team is discussing this.

OpenIDEO

July 16, 2013, 23:31PM
Hi Christian, interesting post! Any chance you could find an image to go along with it? Images help grab attention and tell a story with higher impact. You should be able to use the Update Entry button on the right of your post and follow the instructions to add images from there. We know occasionally people have issues uploading images so let us know by hitting the Support tab on the left hand side of most pages of our site if you face any problems. Looking forward to seeing more of your inspiring insights on OpenIDEO.
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