Developing an Implementation Plan for the Health Behaviour Change Framework - Making Every Contact Count

Introduction: Ireland, in common with other developed countries, is reforming its health services to meet the challenge of tackling the cost of chronic diseases.   An essential element in addressing this is engaging health professionals in preventative activities as part of their routine clinical consultations.

Description of practice change implemented: The Making Every Contact Count Framework is a National Framework for health behaviour change in the health service, which sets out how interventions to support lifestyle behaviour change need to be integrated into our health service.  The adoption of this approach by clinicians, frontline staff and leadership teams will result in the people who access the health service on a daily basis being supported in their efforts to make lifestyle behaviour changes in order to reduce their risk of developing chronic disease.

Aim and theory of change: The aim of Making Every Contact Count is to improve the health of each person accessing the health service on a daily basis. Successful implementation will result in patients, expecting their health professional to ask them about their lifestyle behaviour and feeling genuinely supported by him/her to make changes that will improve their health.

Targeted population and stakeholders: Health Professionals working in the health service in Hospitals and Primary Care. Higher Education Institutions involved in the training of Health Professionals.

Timeline: Five years

Highlights: (innovation, Impact and outcomes) The implementation plan actions focus on four key areas: organisational systems and structures, partnerships, health service staff and patients.

Organisational level: Strong clinical and professional leadership and commitment will be a key requirement.

Structures and systems need to be in place to monitor and track the implementation.

Partnerships: Strengthening existing partnerships

Development of new partnerships including collaboration with the Higher Educational Institutions, Professional Associations, Training Bodies and Health Professionals employed external to the HSE.

Staff: Engagement with staff regarding the concept of Making Every Contact Count is crucial

Provision of innovative training for staff that is appropriate and accessible for them is a key part of engaging with staff.

Patients: Development of clear referral pathways and community supports in the area of health behaviour change.

Comments on sustainability: Long term commitment to implementation and training is necessary. 

Comments on transferability: The escalating cost of chronic diseases both for individuals and their families along with the costs to the health and social care systems is an issue for all developed countries.

Conclusions: Implementation of this plan will involve a culture change within our health system and a move from solely a focus on training of staff in behaviour change techniques to a more integrated approach

Discussion: Organisational commitment and clinical leadership will be essential to the implementation; otherwise the impact will be limited and short term.

Lessons learned: Developing the implementation plan highlights the complexity of leading and managing change.