Health Coach newsletter fall 2017

Hennepin County, Minnesota sent this bulletin at 10/13/2017 10:18 AM CDT

October 2017

This quarterly newsletter provides health coaching tips and resources to help you keep patients engaged in their care.

Setting the agenda

Patients’ concerns may not always be addressed in a clinic visit. You may be thinking, How can this be true? This is what we do all day — take care of patients’ health concerns. Yes, clinic staff routinely assess vital signs and blood chemistry, examine the patient, and prescribe medications to manage health conditions. However, what's often missing is addressing the patient’s concerns.

When the patient isn’t given the opportunity to voice concerns, he or she may leave the clinic feeling frustrated and confused about what to do. A potential result is that health outcomes fall short of the patient’s and provider’s expectations.

Setting the agenda at the start of the visit can help cover patient and care team concerns. Setting the agenda can be done during a pre-visit planning phone call or at the beginning of the visit and completed by the rooming staff or the provider.

Steps to setting the agenda

Ask the patient what he or she wants to discuss: “How are you doing and what brings you to the clinic today?”
Continue asking until all the patient’s concerns have been documented: “What else do you want to talk about?” “Do you have other concerns?” (Pause, allowing the patient time to think).
Retell what the patient wants to discuss. Confirm the discussion items.
Tell the patient what the clinic or provider wants to address.
Ask the patient if it is OK to first address the patient’s concerns and then your concerns.

An example of setting the agenda

Coach: Good morning Mrs. Johnson. How are you doing, and what brings you to the clinic today?

Mrs. Johnson: Well, I’ve been having stomach pains for about two weeks.

Coach: OK. Is there anything else that’s been bothering you or that you are concerned about?

Mrs. Johnson: I sometimes just feel my energy is low.

Coach: OK. Anything else? (Pause)

Mrs. Johnson: Hmm ... I think that is all right now.

Coach: OK. Just to confirm, you are concerned about stomach pains and low energy.

Correct?

Mrs. Johnson: Yes.

Coach: OK. In addition to addressing your concerns, we’d like to evaluate how your blood pressure and cholesterol level are responding to the medications you are taking, and the diet changes that you were going to try from your last visit. Would that be OK?

Mrs. Johnson: Yes, that’s fine.

Ask the health coach

Question

If the patient has a long list of concerns, how does the clinic handle this scenario in a 15–20 minute visit?

Answer

Some patients may have too many concerns to address in the limited time you have. When this happens, the provider will need to prioritize the list with the patient. Some items on the list may be suited for other clinic staff to handle, and other items may need to be deferred to a future visit.

Of note, compiling a list of a patient’s concerns or symptoms helps create a clinical picture, which assists the provider in making a diagnosis. Several concerns that seem unrelated to the patient may in fact be symptoms of the same problem. The provider puts the pieces of the puzzle together to make the diagnosis.

Check out the article below in Want to learn more?

Benefits of health coaching

You may know patients who would benefit from health coaching but have said they are not interested. We’ve developed a patient handout to promote health coaching. You can tailor it to your clinic or organization. Hope you find it helpful.

http://www.hennepin.us/~/media/hennepinus/residents/health-medical/public-health-promotion/health-coaching-handout-fall-2017.docx

Want to learn more?

Check out the article "Oh, by the Way ...": Agenda Setting in Office Visits in the American Academy of Family Physicians Family Practice Management journal.