Continuing its emphasis on education and collaborative learning, MHVC presented a half-day session for primary care teams in Suffern on January 13, 2017. The session, “Patient Engagement: Tips for Primary Care Teams,” was designed to teach participants practical  evidence-based communication skills and introduce helpful resources that can be immediately applied to improve patient engagement .

Motivational Interviewing: Communication skills to improve patient engagement and bring joy back to work

The agenda included an Introduction to Motivational Interviewing (MI) facilitated by Damara Gutnick, MD, MHVC Medical Director, who is also a trainer of Motivational Interviewing and a member of MINT (Motivational Interviewing Network of Trainers), and Maura Porricolo, DrNP, CPNP, MPH of the Montefiore Learning Network. Gutnick and Porricolo led interactive exercises that helped attendees gain insight into the impact their communication style could have on patient engagement.

The session introduced the spirit of MI (Compassion, Acceptance, Partnership and Evocation); core MI skills (Open Ended Questions, Affirmations, Reflections and Summaries); and the concept of “change talk,” and how it can be used to identify when a patient is ready for change. “If a patient is not ready to make a change, it is a waste of time to push for a plan. The key is meeting each patient where they are,” said Gutnick. Participants also learned how adapting a skill called “ask-tell-ask” while sharing information and advice with patients can help save time and increase efficiency during busy practice sessions and also ensure  patient understanding, which can improve adherence with treatment plans and medications.

Health Homes: The value of integrating HH referral processes into workflow

During the morning’s final program session, “Connecting Patients to Resources,” Katie Clay, Health Home Director, CommunityHealth Care Collaborative (CCC), and Amie Parikh, Executive Director, Hudson Valley Care Coalition, first challenged attendees to think about their “top ten” most difficult patients, and identify what makes them difficult to manage. Common themes emerged, including: lack of social supports, adherence challenges, Behavioral Health co-morbidities, and social determinants of health (SDH) needs. The Health Home Care Manager was then introduced as an effective resource to help coordinate care, facilitate connections to alternative SDH community resources, and support patient engagement.

Clay and Parikh then presented a PowerPoint of the “Nuts and Bolts,” including Health Home (HH) eligibility criteria and the process steps needed to make a health home referral. Porricolo led a lively discussion about the importance of being a “good partner,” including the need for bi-directional communication between the Health Home Care Manager and the PCP to support effective sharing of information between care team members. In an effort to get participants thinking about how they could apply what they learned to their clinical practice, an interactive exercise, designed as a board game, challenged participants to work in teams to think about how HH referral processes (including the identification of HH eligible patients and making the actual referral) could be incorporated into their PCMH practice workflows.

“I could apply what I learned in the morning to patients in the afternoon.”

Overall the program received stellar reviews, with 85% of participants sharing that they would apply something they learned during the workshop into their clinical practice in the next week or two, and if the workshop were to be repeated they would encourage colleagues/staff to attend.

Taylor Mrazek, Government Initiatives & Planning Strategist, Middletown Community Health Center, remarked, “I have attended multiple HH trainings in the past, but this was the best. This presentation was different because it was practical: We were given something that we could take back and implement right away with the process and workflow already mapped out for us; it was extremely useful and transparent, and that is what health care organizations need right now.”

Dr. Shelly Carolan of Crystal Run Healthcare summarized the views of many attendees. “As physicians, we were traditionally trained to speak to patients in a paternalistic manner. Unfortunately, this approach has not improved patient outcomes. This dynamic presentation forced me out of my comfort zone and revolutionized my approach as a physician. I now have this tool of ‘motivational interviewing’ to empower my patients and partner with them to improve their own health. The realization that I can refer eligible patients to health homes lifted a weight off my shoulders and will allow me to better care for my patients; I referred my first patient to a health home yesterday.”