Headache

Calgary Headache Assessment & Management Program (CHAMP)

CHAMP is a multidisciplinary headache management program with 5 neurologists, 3 nursing, 1 occupational therapy, 1 psychologist, 1 kinesiologist, 3 clerical, and 1 research assistant / data analyst team members.

Mission Statement

Vision: Empowered patients and their families actively engaged in headache self-management.
Mission: To reduce the burden of headache related disability carried by patients and their families.
Objectives: Deliver care for patients with difficult headache disorders more efficiently and effectively through inter professional teams focused on both medical and behavioral therapies.
Contribute to headache care through clinical research and education of health care professionals.
Reduce utilization of expensive health care resources such as emergency rooms and inpatient beds through better outpatient management of patients with headache. 

CHAMP will:

• Provide patients with a caring and empathetic environment in which to monitor progress towards their functional goals.
• Encourage patient self reliance and active partnership in their headache care, with an emphasis on self management.
• Provide access to program services in a timely manner immediately following admission to the program.
• Serve the headache health care needs of the CHR in conjunction with the headache program of the CHR chronic pain center.
• Maintain a comprehensive quality management program with appropriate quality indicators and outcome measures.
• Deliver “best practice” care based on evidence available, with a commitment to develop new evidence where needed.
• Ensure all team members are committed to remain current in terms of best practices in headache care.
• Involve patients in the design of the program CHAMP offers and in the design of their individualized treatment.
• Carefully foster communication between patients and staff, and between the members of the inter-professional team to create a forum for the discussion of patient care plans.
• Work towards following every patient with outcome measures and team discussions so that all are accounted for.

 

Summary of activities

The clinical core of the CHAMP program consists of group workshops and one-on-one outpatient visits to physicians and other health care professionals.  The nursing component of CHAMP provides additional valuable patient service through telephone follow up and problem solving.  The educational session is the entry point for many patients to the CHAMP program, and during 2007, 362 patients and over 200 additional family / friends attended the education sessions which are offered 2 or 3 times a month.  There were over 2203 one-on-one patient visits to physicians and other health care professionals.  Many patients attended our self management, relaxation, sleep and body works workshops.

Education:  In addition to continuing medical education programs and teaching directed at University of Calgary residents and medical students, the CHAMP program provided elective rotations to 4 senior University of Alberta Neurology residents in 2007 (Drs. Jickling, Phan, Narasingh, and Jassal), and for one senior neurology resident from the University of Ottawa (Dr. F. Amoozegar). Ms. Khara Sauro, holder of the 2007 Canadian Headache Society National Headache Fellowship, completed her fellowship with CHAMP during 2007.

Research activities:  CHAMP continues to participate in industry-sponsored multi center clinical trials, and these have included in 2007 trials to evaluate the efficacy of botulinum toxin type A, occipital nerve stimulation, patent foramen ovale closure, and tonabersat in migraine and / or chronic daily headache prophylaxis. CHAMP has also analyzed the properties of two headache outcome measurements, the HIT-6 and the MIDAS, and an abstract has been submitted to the Canadian Neurological Sciences Federation annual meeting.  In conjunction with Dr Z. Kiss, outcomes on a CHAMP patient with implantation of a deep brain stimulator for the treatment of chronic cluster headache have been assessed, and an abstract submitted to the same meeting. 

Quality Improvement: CHAMP has studied program outcomes.  In addition, an abstract has been submitted to the Canadian Neurological Sciences Federation annual meeting on the CHAMP program and its outcomes.  Several patient focus groups have also been held to determine what improvements our patients think should be made in our program.  We are grateful to Jason Knox and Michael Suddes for their assistance with these focus groups.  

Moving forward

A number of action items to improve the program were developed and the program will work on these over the coming year. 

• Revising the education session to reduce the division between the medical and behavioral content, and to emphasize more our integrated comprehensive approach to headache care. 
• To review and possibly expand the role of the lifestyle assessment in the program.
• To initiate a formal quality management program for the CHAMP, complete with a small quality council.  This program would include quality improvement education for our staff, and the commitment of all staff to identify where processes could be improved, and to contribute to their improvement. 
• To focus more on “best practice” through the development of more standardized patient treatment processes.
• Ensure that all staff have access to the necessary continuing professional education in headache management.
• Facilitate inter-professional education regarding the care of individual patients through team rounds, etc.
• Improve our capacity to meet the needs of Alberta Health Services with regard to headache care and reduce our wait times by working to make our patient care processes more efficient.
• Develop further the kinesiology component of CHAMP as better posture, neck health, and physical conditioning contribute to headache management.

 

Conclusion

CHAMP continues to work towards meeting the headache care needs of our patients, together with the Alberta Health Services Chronic Pain Center Headache Program and to fulfill its educational and research objectives. 

 

 

 

Updated: 2009-04-29