1 / 14

AACH ENRICH 2011

<?xml version="1.0"?><AllQuestions />. <?xml version="1.0"?><AllResponses />.

tarika
Download Presentation

AACH ENRICH 2011

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. <?xml version="1.0"?><AllQuestions /> <?xml version="1.0"?><AllResponses /> <?xml version="1.0"?><Settings><answerBulletFormat>Numeric</answerBulletFormat><answerNowAutoInsert>No</answerNowAutoInsert><answerNowStyle>Explosion</answerNowStyle><answerNowText>Answer Now</answerNowText><chartColors>Use PowerPoint Color Scheme</chartColors><chartType>Horizontal</chartType><correctAnswerIndicator>Checkmark</correctAnswerIndicator><countdownAutoInsert>No</countdownAutoInsert><countdownSeconds>10</countdownSeconds><countdownSound>TicToc.wav</countdownSound><countdownStyle>Box</countdownStyle><gridAutoInsert>No</gridAutoInsert><gridFillStyle>Answered</gridFillStyle><gridFillColor>255,255,0</gridFillColor><gridOpacity>50%</gridOpacity><gridTextStyle>Keypad #</gridTextStyle><inputSource>Response Devices</inputSource><multipleResponseDivisor># of Responses</multipleResponseDivisor><participantsLeaderBoard>5</participantsLeaderBoard><percentageDecimalPlaces>0</percentageDecimalPlaces><responseCounterAutoInsert>No</responseCounterAutoInsert><responseCounterStyle>Oval</responseCounterStyle><responseCounterDisplayValue># of Votes Received</responseCounterDisplayValue><insertObjectUsingColor>Red</insertObjectUsingColor><showResults>Yes</showResults><teamColors>Use PowerPoint Color Scheme</teamColors><teamIdentificationType>None</teamIdentificationType><teamScoringType>Voting pads only</teamScoringType><teamScoringDecimalPlaces>1</teamScoringDecimalPlaces><teamIdentificationItem></teamIdentificationItem><teamsLeaderBoard>5</teamsLeaderBoard><teamName1></teamName1><teamName2></teamName2><teamName3></teamName3><teamName4></teamName4><teamName5></teamName5><teamName6></teamName6><teamName7></teamName7><teamName8></teamName8><teamName9></teamName9><teamName10></teamName10><showControlBar>All Slides</showControlBar><defaultCorrectPointValue>0</defaultCorrectPointValue><defaultIncorrectPointValue>0</defaultIncorrectPointValue><chartColor1>187,224,227</chartColor1><chartColor2>51,51,153</chartColor2><chartColor3>0,153,153</chartColor3><chartColor4>153,204,0</chartColor4><chartColor5>128,128,128</chartColor5><chartColor6>0,0,0</chartColor6><chartColor7>0,102,204</chartColor7><chartColor8>204,204,255</chartColor8><chartColor9>255,0,0</chartColor9><chartColor10>255,255,0</chartColor10><teamColor1>187,224,227</teamColor1><teamColor2>51,51,153</teamColor2><teamColor3>0,153,153</teamColor3><teamColor4>153,204,0</teamColor4><teamColor5>128,128,128</teamColor5><teamColor6>0,0,0</teamColor6><teamColor7>0,102,204</teamColor7><teamColor8>204,204,255</teamColor8><teamColor9>255,0,0</teamColor9><teamColor10>255,255,0</teamColor10><displayAnswerImagesDuringVote>Yes</displayAnswerImagesDuringVote><displayAnswerImagesWithResponses>Yes</displayAnswerImagesWithResponses><displayAnswerTextDuringVote>Yes</displayAnswerTextDuringVote><displayAnswerTextWithResponses>Yes</displayAnswerTextWithResponses><questionSlideID></questionSlideID><controlBarState>Expanded</controlBarState><isGridColorKnownColor>True</isGridColorKnownColor><gridColorName>Yellow</gridColorName></Settings> <?xml version="1.0"?><AllAnswers /> AACH ENRICH 2011 Workshop Track One: Relationship-centered Communication to Improve Clinical Quality and Patients' Experience of CareSession Three: Education, Negotiationand Motivation

  2. Agenda for Session 3 • Review learning in Sessions 1 & 2 • Review objectives for this session • Didactic • Ask-Tell-Ask • Motivational Interviewing • Practice skills • Prepare to Re-enter

  3. Review • Evaluate the success and challenges of first two sessions • Understanding the 3 function model • Getting the patient-family’s story • Responding with empathy (NURS) • Using PEARLS • Practicing the skills

  4. Objectives For Session 3 • Acquire relationship-centered care skills which improve patient care • Ask-Tell-Ask • Motivational interviewing • Practice using these skills • Identify strategies for use of these skills in home institution • Objectives from participants

  5. Didactic • Last phase of interview • Educate patient about diagnosis • Negotiate plan of care • Counsel and motivate patient • Skills important for patient and family education and collaboration on a treatment plan • Ask, Tell, Ask • Motivational Interviewing

  6. ASK, TELL, ASK • Google search yielded 8,640 hits • Used in a variety of settings • Clinician-patient communication • Giving feedback in evaluation • Patient strategy for communicating with clinician • Used to communicate “bad news” • Has been called the “sandwich approach” • Bread-meat-bread

  7. ASK-TELL-ASK • 3 step approach • Step 1 • Can include asking permission to proceed • Ask for the perspective or understanding of other party • Step 2 • Tell your perspective, diagnosis, additional information which was lacking • Step 3 • Ask the other party to repeat, clarify, confirm

  8. ASK-TELL-ASK • Alternate “telling” and “asking” • Ask history or data gathering phase • Tell diagnosis, problem, recommendations • Ask about FIFE- feelings, ideas, fears, expectations • Assess readiness and commitment • Adjust and align action plan with science, FIFE and readiness

  9. Motivational Interviewing • Seek to understand the person's frame of reference, particularly via reflective listening  • Express acceptance and affirmation  • Elicit and selectively reinforce the person's own self motivational statements expressions of problem recognition, concern, desire and intention to change, and ability to change  • Monitor the person's degree of readiness to change, and ensuring that resistance is not generated by jumping ahead of the client.  • Affirm the person's freedom of choice and self-direction  [After Miller and Rollnick]

  10. Motivational Interviewing • Principles (Miller and Rollnick) • Understand the patient's view accurately • Support self-belief • Express empathy • Avoid or de-escalate resistance • Develop discrepancy

  11. Motivational Interviewing • Open-ended questions, gradually narrowing to more specific inquiry • Ask about patient’s beliefs, values, expectations, and perspectives • Use facilitative encouragers • Repeat / reflect (aspect(s) of prior statement or conversation) • Steer without dominating • Check and summarize

  12. Brief Action Plan (Cole) • Elicit patient’s desires for change • Get specific details • Offer suggestions if needed • Evaluate confidence • Use 1-10 scale • Probe about choice of number • Probe if <7 • Arrange for follow-up • Get details for check-in and review www.ComprehensiveMI.com

  13. Practice • Practice using the skills for educating the patient/family and collaborating on a treatment plan • Solicit anonymous cases from practice or use ready made cases • Work in groups of 3 to role play with 2 actors and 1 observer.

  14. Prepare to Re-enter • Identify skills you are willing to practice to improve patient/ family outcomes and experience of care • Identify strategies to use in your home institution to make a positive impact on care of patients • Identify allies who are willing to assist in changing the culture

More Related