Suggestion from an old retired RN: Can health outcomes be captured & measured within a more progressive path ( similar to Prochaska's stages of change) to wellness rather than absolute resolution or cure? eg obese patient needs to loose 100 lbs. Agreed first goals for patient is to: 1) address sleep apnea by stating with sleep study 2) attend meeting with dietician to get nutrition education & 3) loose 5 lbs. Results upon follow up 3 weeks later with Dr at clinic: 1)patient does get diagnosed with sleep apnea & using a CPAP & sleeping better 2)patient has met with dietician with plans to follow up however, patient has not lost any weight. Steps 1 & 2 should be counted as a positive outcome. Even a movement from a pre-contemplative to contemplate stage is a good outcome on the path to a person's effective self management of their chronic disease. This results in an increase of the patient's agency and fewer visits to acute care. This would also then motivate a movement to more preventative care rather that reactionary acute care. Thanks for considering this suggestion.
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