September 2014 Newsletter

Motivational Interviewing: Help Your Patients Reach Their Goals

 

Most people are ambivalent about making changes - even those that can make them feel better and be healthier. Motivational Interviewing is used to strengthen a person's own motivation towards a commitment for change and is widely used in health care to help motivate a patient to accomplish goals. The acronym, OARS, is used to outline the process:

 

O: Open-ended questions

A: Affirmations

R: Reflective listening

S: Summaries

 

Below are some examples of provocative questions to help motivate your patients to increase their commitment to a goal:
  • How will your life be different once you make the change?
  • What have you realized about your health priorities at this time in your life?
  • What changes are you committed to doing?
  • How does this lifestyle change fit in with your overall health goals?
  • If I was the patient and you were the doctor, what would you suggest to me?
If you are struggling to obtain more information from a patient, try to have them take the lead by asking questions, such as:
  • Can you say more about that?
  • How is this significant?
  • What led you to that conclusion?
  • What option do you prefer?
  • Why is this a problem?

Listen for "change talk," or comments that might indicate your patient may have desires, abilities, wishes, or needs (DAWN) to change. Pick up on these verbal cues by asking more open-ended questions.

 

More information on Motivational Interviewing can be found here.

NCQA 2014 PCMH Standards - What's Different?   

 

NCQA recently released its 2014 PCMH standards that practices are beginning to use when applying for NCQA PCMH recognition. Overall, the 2014 standards require practices use their Electronic Medical Records (EMRs) to their fullest potential, engage patients, enhance community interactions, and integrate behavioral health into primary care.

 

As 35,000 clinicians at over 6,800 sites work to reapply for recognition under the 2014 standards, MedPage Today has released a few tips to keep in mind while applying:

  1. Team-based care is now a "must pass" element, including the patient in the care team.
  2. Further integration with behavior health can be established by referral agreements.
  3. Practices must show sustained transformation by demonstrating quality, access, and other processes that are not a snapshot in time and require constant monitoring.
  4. Meaningful Use Stage 2 requirements should be viewed as a prerequisite to NCQA 2014 PCMH recognition.
  5. Prices for the application have remained the same. 

More information can be found on NCQA's website.

Access PA SPREAD Resources!  

 

New resources continue to be added to our website at www.paspread.com to help you on your quality improvement journey! We are always looking to share best practices. If you would like to be featured or have resources to share, please contact us at paspread@hmc.psu.edu.

Best Practices Spotlight


Washington Heights Medical Group values input from the entire practice when testing PDSA cycles. Tests of change are presented at staff meetings, allowing all members of the practice to give input to that PDSA. After testing, the PDSA cycle is brought back to the meeting to discuss issues and changes that may need to occur. By involving the entire staff from the beginning, the practice has found it easier to develop effective processes.
In The Literature
 
Population Care Coordinators: A Key to Improved Care at Lower Cost? 

 

   Horizon Blue Cross Blue Shield has run a Patient-Centered Medical Home initiative for 5 years with over 200 practices. Participants and organizers credit care coordinators for their success. Here are 8 qualities a care coordinator needs:

Have a strong, well-rounded nursing background and general health care knowledge.

Be a kind, caring person.

Be a good listener, attuned to what patients are telling you.

Understand data and how to interpret it.

Be familiar with electronic medical records.

Be comfortable speaking in medical terms with providers and in lay language with patients.

Know the community, it's transportation system, services for the disabled, nursing homes, clinics, hospitals, and their departments such as emergency rooms, radiology facilities, etc.

Be intuitive, creative, and able to "think outside the box."
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