Health Quality Innovation

Motivational Interviewing: Evoking Commitment to Change

Motivational Interviewing is a tool that can assist clinicians in their efforts to provide self-management support to patients with chronic illness.

This video,  produced by the Colorado Clinical Guidelines Collaborative (CCGC) provides a demonstration of motivational interviewing.  The provider in this demonstration does this by asking open-ended questions, providing affirmation, using reflective listening and summarizing for the patients (OARS). He also helps the patient to scale the importance of the issue and the patients confidence level for change behavior.  (CCGC, 5.5 min. [YouTube])

AAFP Offers Web-based Training Videos for Patient Centered Medical Home

The American Academy of Family Physicians has added three videos to its web-based resources for practices re-designing patient care using the model of the Patient Centered Medical Home.  In these videos family physicians discuss practice redesign and focus on three key components of PCMH:

• Improve Care with Patient Registries ( 13.0 min.)
• Improve Care with Self-Management Support (15.0 min.)
• Improve Care with a Team-Based Model (14.5 min.)

Click here to go to the AAFP website to view these videos

Video Series Describes Evidence-Based Health Coaching and Motivational Interviewing

Produced by Health Sciences Institute (HSI), this series of videos offers an introduction to Motivational Interviewing and evidence-based health coaching. In the videos Susan Butterworth, Ph.D. Associate Professor, Schools of Nursing & Medicine,Oregon Health Sciences University and HSI Advisory Board Member defines and describes Motivational Interviewing techniques and their application in the clinical setting.

This series may be of benefit to organizations considering using  'health coaches' on their PCMH, disease management, or chronic care improvement inter-disciplinary teams.

Video topics include:

• Applying Motivational Interviewing in Health Care (4.5 min)
• What is Motivational Interviewing (4.0 min)
• Patient Centered Care or 'Worst Case Scenario' (7.0 min)
• How can organizations Build  Evidence-Based Health Coaching Teams? (3.5 min)
• What are the Guiding Principle of Motivational Interviewing? (5.0 min)
• What is the 'Best Case Scenario' for Patient Centered Care? (5.0 min)

Click here to go to the HSI website to view these videos

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An Introduction to the Model for Improvement (IHI)

Available on the IHI Website, this 63-minute streaming video presentation features Dr. Robert Lloyd, introducing the Model for Improvement. The IHI Website offers the following description:

Dr. Lloyd’s presentation builds on a foundation of applied science, focusing on how three key questions can help drive your quality improvement work:

• What are we trying to accomplish?
• How will we know that a change is an improvement?
• What change can we make that will result in improvement?

You will also learn how to use the Plan-Do-Study-Act (PDSA) cycle to conduct rapid tests of change on a small scale, learn from these tests, and then apply that learning to the next cycle of testing. 

Finally, the sequence for improvement will be described and the steps to move from testing to implementing to spreading will be addressed. The presentation will also help participants set up a series of exercises to test their team’s knowledge and skills related to the Model for Improvement and PDSA cycles.

(IHI, free of charge registration required, 63 mins.)

Click here to go to the IHI website to register for this "on demand" video presentation.

Creating Opportunities for Group Medical Visits

This video was produced by British Columbia Ministry of Health and describes three common types of group visits:

1. The Cooperative Health Care Clinic (CHCC) which is a regularly scheduled group visit with the same group of patients with the same condition. It is typically scheduled for a specific number of visits.
2. The Drop-In Group Medical Appointment (DIGMA) which is a regularly scheduled appointment open to different patients with different conditions where individual patient issues are discussed within the group context.
3. The Shared Medical Appointment (SMA) which is a group visit for individual patients with the same condition. In the video they show a pre-natal group visit. 

(PrimaryCare DevCorp, 9min, [YouTube])

Transforming Safety Net Clinics into Patient-Centered Medical Homes

 The Safety Net Medical Home Initiative

In May 2008, The Commonwealth Fund, Qualis Health and the MacColl Institute for Healthcare Innovation initiated a demonstration project to help safety net primary care clinics become high-performing patient-centered medical homes (PCMHs) and achieve benchmark levels of quality, efficiency and patient experience.

• The goal of the Safety Net Medical Home Initiative (“the Initiative”) is to develop and demonstrate a replicable and sustainable implementation model for medical home transformation.
• The Initiative calls for partnerships between safety net providers and community stakeholders to work together towards a new model of primary care delivery that is recognized and rewarded for its holistic approach to patient care.
• Policy activation is critical in this transformation, and all partners in this Initiative are expected to participate in Medicaid and other policy reform efforts in their respective regions.
• Five Regional Coordinating Centers were selected to participate in the demonstration project, and each partnered with 12-15 safety net clinics in their state.
• These collaboratives will receive technical assistance on practice re-design topics such as enhanced access, care coordination, and patient experience. They will also receive funding to support a Medical Home Facilitator (who will lead clinic-based quality improvement projects) and other activities.
• The work of the Regional Coordinating Centers began in April 2009 and will continue through April 2013. 

The Safety Net Medical Home Website Resources:

The Initiative's website offers a wealth of information for those looking to learn more.  Newsletters, articles, papers, and webinars (audio and video).  Webinar titles include:

• Accommodating Part-Time Providers and Residents in the Medical Home (August 2010)
• Engaged Leadership (May 27, 2010)
  
• Optimizing Your Care Team in the Medical Home (April 30, 2010)
  
• Transforming Primary Care at Group Health Cooperative (April 16, 2010)
  
• HIT and Meaningful Use (March 31, 2010)
  
• Patient-Centered Interactions (February 17, 2010)
  
• Using EHR Tools to Support Medical Home Workflows
(January 26, 2010)
Speaker: Jeff Hummel, MD, MPH, Qualis Health (audio, and slides)
• Knowledge Building Session: How to Deploy Teams that Provide Continuous Team-Based Care (January 2010)
  Moderator: Ed Wagner, MD, MPH, MacColl Institute for Healthcare Innovation (1.5 hrs, audio, slides and related material)
• Structured Communication Methods to Enhance Team-Based Care (November 2009)
  Speaker: Sharon Eloranta, MD (37 mins, audio, video and slides)
• Knowledge Building Session: Empanelment (October 2009)
  Speaker: Amit Shah, MD, Multnomah County Health Department (1.5 hrs, audio and slides)
• Introduction to the Change Concepts (August 2009)
  Speaker: Ed Wagner, MD, MPH ( 15 mins, video)

Click here to learn more about The Safety-Net Medical Home Initiative

 

Click here view the web-based Publications and Resource Library for this project.

The Wisconsin Academy of Family Physicians Patient Centered Medical Home Project

This site is supported by the Wisconsin Academy of Family Physicians and is designed to help physicians, payers and public policy makers understand the components, viability and advantages of the Wisconsin Patient Centered Medical Home.

Click here for videos and more information on the Wisconsin Patient Centered Medical Home

Patient Education: Introduction to the Patient-Centered Medical Home

Emmi Solutions, the Patient-Centered Primary Care Collaborative, and TransforMED partnered to create this web-based patient education tool designed to play an integral role in the transformation of primary care practices to Patient-Centered Medical Homes.

Click here to view the full video

The AAFP Patient-Centered Medical Home Media Center

The American Academy of Family Physicians (AAFP) media center provides various resources such as articles and videos on the patient centered medical home model.

Click here to view the AAFP Patient-Centered Medical Home media center

Planned Care Visits: A Video from Improving Chronic Illness Care

Produced by Improving Cronic Illness Care (ICIC), the Planned Care Visit video was designed as a practical aid for clinicians, demonstrating how health care teams implement innovations in care for people who live with chronic illness.The presentation takes viewers on a planned care visit in a typical office setting. The first segment is seen through the eyes of a diabetic patient, with the subsequent two sections presented from a health provider's perspective. While a diabetes patient is featured, these elements of planned care can be applied to people who live with any chronic condition.  

Based directly on ICIC's work, the video assumes viewers have a basic understanding of the Chronic Care Model (CCM).  The video includes a facilitator discussion guide and diagram of the Model, and has inserted subtitles highlighting key concepts throughout.

Viewers have the option of reviewing entire series (34 mins.) or individual segments. 

• Planned Care Visit:  The Patient Experience (16 mins.)
• Planned Care Visit: The Provider Point of View (5 mins.)
• Planned Care Visit: The Self-Management Interview (12 mins.)

 

Click here to view ICIC videos.

   

Click here to go to the ICIC website to learn more about Planned Visits.