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May 2019
This
quarterly newsletter will provide tips and resources about health coaching to
help you keep patients engaged in their care.
Incorporating health coaching into your work requires commitment from leadership and the care team. Health coaches need to be trained and workflows created to make health coaching a regular feature of patient care.
Benefits of having a health coach as part of the team
- Help the practice meet quality measures
- Improve patient satisfaction
- Promote behavior change
- Free up physician time
In the busy clinic setting, the health coach can assist the provider with patients who have chronic health conditions such as diabetes or obesity. The health coach can work with patients to create an action plan to achieve their health goals.
A key step of health coaching is following up with patients or clients to check on how they are doing, assess progress with their action plan, and offer support. Developing a clinic process that incorporates health coaching into the routine clinic workflow will make this more likely to happen. The workflow needs to suit your setting. Below is an example of a workflow that includes follow-up health coach sessions.
 The importance of coaching follow-up sessions
Often patient clinic visits are infrequent and a lot can happen in between visits. Strong evidence supports regular follow-up as necessary to achieve improved chronic disease outcomes. In a study conducted by the Department of Family and Community Medicine, University of California, San Francisco, it was found that the more coaching encounters patients had, the greater their reduction in blood pressure.
The health coach acts as a liaison between the patient and clinician. The coach can phone or e-mail patients between clinic visits to see how they are doing. This follow-up is an opportunity to identify misunderstandings and answer questions, review the action plan, build a trusting relationship, and schedule clinic visits.
Coaches can ask the patient how they are doing with their lifestyle action plan. And when things aren’t going as planned, the coach can help the patient get back on track or help revise the plan. Follow-up is also a time to acknowledge the patient’s success and progress and offer encouragement and support. It is a time to assess the patient’s motivation and confidence in making lifestyle behavior changes. The coach can provide health information and assist the patient with troubleshooting any barriers that get in the way of accomplishing their goals. For more complex questions, the health coach consults with the provider or asks the provider to contact the patient.
Some coaches do medication reconciliation, checking whether the patient is taking their medications as prescribed. As studies have shown that many patients take their medications incorrectly, follow-up with patients about new medication instructions can be of critical importance to compliance and outcomes. The coach reports to the provider any concerns that need to be addressed in a timely manner.
Coach: Hello Mr. Jones. This is Ms. Gomez from the clinic calling to see how things are going with your walking plan. You were planning on walking three days every week for 30 minutes each day.
Mr. Jones: Well, the first week was good, but then I didn’t do so well since then. The weather was bad the next week so I didn’t walk, and then I haven’t started back.
Coach: Yes, our winter weather can make it harder to get outside. Great job on your first week, though. How did you feel that week?
Mr. Jones: I felt pretty good. The days I walked, I had more energy in the evening, and I even slept better.
Coach: It sounds like walking made you feel better! Ok, so where would you like to go from here?
Mr. Jones: I really should be more active. I work at a desk all day and often just relax at home in the evenings. But it really is hard when the weather is bad!
Coach: So it sounds like you are really motivated to walk, but the weather is getting in the way.
Mr. Jones: Yes!
Coach: Ok. Let’s talk about where you could walk when walking outside is a problem for you. Do you have any ideas?
Mr. Jones: When I go shopping with my wife, I see people walking at the mall. I could do that.
Coach: That’s a great idea. What days of the week are best for you?
Mr. Jones: Hmmm... Saturday morning is a good time and Wednesday evening. I could ask my wife to walk with me too. If we plan to walk together, I think I’ll be more inclined to commit to this plan.
Coach: Perfect! So to confirm the new plan, you’re going to walk for 30 minutes on Saturday morning and 30 minutes on Wednesday evening. If you need to switch days for any reason that’s OK. The important thing is to find another day. On a scale of 1-10, how confident are you with this plan?
Mr. Jones: I’d say 8. I’ll start this week.
Coach: Great! Can I call you in two weeks to see how this plan is working for you?
Mr. Jones: Yes! I appreciate your support.
Implementing health coaching
Health coaching studies
If you are interested in learning more about the training curriculum or want to schedule a full day training or a one-hour refresher session, please contact Renee Gust at renee.gust@hennepin.us.
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Spring 2019:
Visualizing goals to achieve results
Fall 2018:
Part III -- Stages of Change -- Practicing new behavior
Summer 2018:
Part II -- Stages of Change -- Meeting the patient where they are
Spring 2018:
Stages of Change -- Meeting the patient where they are
Winter 2018:
Action plans -- patients active in their care
Fall 2017:
Setting the agenda — eliminating wasted clinic visits
Summer 2017:
Helping patients remember their care plan — closing the loop/teach back
Spring 2017:
MOTIVATING PATIENTS through participation
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