November 16, 2016
Patients who used to stay in the hospital for a month are now staying two weeks tops,” says Nicole Schechter, a rehabilitation psychologist. “There’s an emphasis on increasing the quality, rather than the quantity, of care across the field of medicine.”
Because of this trend, Schechter and Stephen Wegener, director of the Division of Rehabilitation Psychology and Neuropsychology, are sharing the traditions of patient engagement from their specialty of rehabilitation. They started patient engagement training three years ago to teach nurses, social workers, community health workers and physicians across Johns Hopkins Medicine to engage patients as partners in their health care and to teach new health behaviors—something that has long been part of the rehabilitation process.
Over the last three years, Wegener and Schechter have trained more than 350 health care providers to employ strategies from communication science and motivational interviewing to enhance patient engagement and achieve the goal of patient-centered care at Johns Hopkins Medicine.
For example, motivational interviewing, an evidenced-based set of principles and skills originally developed for work with individuals with addiction disorders, helps patients make decisions about taking an active role in their health. It gives practitioners a way of interacting and collaborating with patients to make changes that will improve overall health outcomes. This approach can also improve satisfaction with care.
“Patients who feel understood and listened to, and have their priorities, goals and values respected, are going to feel more satisfied with their care,” says Schechter, “They are also more likely to be engaged in their care.”
To help providers develop patient engagement skills, the training includes three stages: planning, initial training and maintenance. During the planning phase, the patient engagement team works with the leaders of the team it will be working with to understand who will be trained and what their goals are.
Nurse case manager Kay Concha, left, and patient experience concierge Tiffany Stokes, right, participate in patient engagement training with Nicole Schechter, middle.
The second phase, initial training, includes a 60- to 90-minute lecture to learn about the values, principles and skills of patient engagement. It then provides four to seven hours of basic training and one hour of additional education for patient engagement champions, who assist in ongoing maintenance activities for their teams.
The final maintenance phase lasts for one year and supports ongoing development and practice of participants’ acquired skills. The patient engagement champions create a maintenance plan for the group and have monthly training goals. Schechter provides materials and exercises that can take five to 15 minutes each to help maintain and refresh trainees’ skills.
“Our program is different from others across the country because it is in-person, skills-based training as opposed to passive online learning,” says Schechter, “and we have a maintenance program to ensure participants receive continuing development of their skills. Many other programs underestimate the importance of maintenance in provider skill development.”
Since starting the program, data from participants indicate they are very satisfied with their training and believe it is useful in practice. Now, Wegener and Schechter are conducting initial studies to determine the impact of the program on participant knowledge, attitudes and skills.