This spring, HealthFinders Collaborative held a Health Coaching and Motivational Interview Training session. The training gives medical providers tools that support comprehensive, patient-centered care, and helps them identify both problems and solutions that may not be immediately apparent. The training is a part of HFC’s comprehensive effort to improve mental health, together with adding mental health providers and interpreter quality improvement.
The training, given to HealthFinders staff and volunteer doctors and nurse practitioners, presented different best practices for communicating with patients. The essential features of Health Coaching include:
- Setting the agenda–Asking the patient what they want to discuss at the appointment, confirming the patients items, asking what else they want to discuss, sharing what the provider would like to discuss, asking if it is ok to talk about the patients concerns first then the providers, and finally summarizing the agenda items.
- Ask-Tell-Ask is asking open-ended questions which encourage patients to communicate what they understand about the issue, and identifies where further clarification is needed. Only telling the information when the patient doesn’t know. Then asking the patient to restate what the provider/health professional said in their own words,
- Closing the Loop–to ensure the patient understands the information by repeating the “ask” and “tell” as needed until the patient restates the information correctly.
- Know your numbers is encouraging patients to know their blood pressure, blood sugar levels, etc.. what they mean, what causes them to change, etc…
- Medication reconciliation and adherence is asking questions to understand why patients are not taking medications as prescribed.
- Behavior-change action plans is encouraging patients to set goals which are SMART-Specific, Measurable, Action oriented, Realistic, and Timely.
One example of putting the skills learned in the training into practice is the case of a female Somali patient who came to our clinic to – as far as we knew – follow up on her diabetes and asthma. However, we quickly learned that the patient was far more concerned with pelvic pain than her asthma or diabetes. Using the principles of health coaching, we made sure to give equal time to all three issues and begin (and end!) with a discussion of the pelvic pain even though the provider was really concerned about this woman no longer taking her diabetes medications. By listening to and prioritizing the patient’s concerns, the provider was able to build trust with the patient and help her understand how her other chronic health conditions may be playing a role in her pelvic pain. This example demonstrates the value of taking the time to understand a patient’s perspective to improve patient communication and support them in choosing a healthier lifestyle on their terms.
Maritza Navarro, HealthFinders Care Coordinator, emphasized that, “The goal of health coaching is to center care around the needs of the patient instead of telling the patient what is best for them. Not only does taking the time to consider the overall well-being of people positively affect outcomes, but it also establishes mutual trust. It promotes a sense of personal agency. While we want to help anyone in their time of need, we also want them to feel confident enough to take control of their own health.”