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HMA Principal Designs Workshop to Enhance Delivery of Patient-Centered Care

This blog post was written by HMA Principal Jeffrey M. Ring, Ph.D.

There are many great things to do up in California’s majestic Sierras.  The air is fresh and crisp, the water runs clear and the trees stretch up to dizzying heights.

The health care practitioners of Avenal/Aria Community Health in Central California decided to head to the Sierras for a weekend retreat coordinated with Health Net, and an opportunity to learn together about enhancing the delivery of patient-centered care.  I designed an interactive, experiential workshop  that aimed to facilitate team-building, an exploration of the foundations of communication (including empathy, trust and non-verbal communication), and the skills of Motivational Interviewing which has been empirically demonstrated to be more successful in generating patient behavior change than giving advice.

Moreover, one of the aims of the workshop was practitioner vitality and wellness, and we explored mindful practice and self-care throughout the weekend.  As it turns out, the practice of Motivational Interviewing is in itself a practitioner wellness initiative, in that it reduces the burden practitioners feel from insisting on patient change or feeling frustrated with the lack thereof.  Patient and practitioner join as partners in exploring behavior change (such as smoking cessation or medication adherence) rather than arm-twisting for compliance.   The practitioner keeps an eye out for the patient’s readiness to increase or decrease new behavior, and aims to enhance that readiness through guided conversation and the sharing of pertinent health education.

Over the course of the weekend, we engaged in didactic learning, self-reflective writing and hands-on skills practice with the provision of direct feedback.  The group was exposed to the righting reflex, the Decision Balance, the Readiness Ruler, and other key Motivational Interviewing approaches.  The workshops were designed to be playful, engaging, and illuminating, and the results were stunning.  For every skill assessed, there was an increased level of knowledge gained after the training for the 30 participants.

Here are a few highlights from the data after completing the training:

  • A 122% increase in the number of participants who felt VERY CONFIDENT in their ability to express empathy and reflect a patient’s emotions during an interview
  • A 500 % increase in the number of participants who felt VERY CONFIDENT in their understanding of the key concepts of Motivational Interviewing
  • A 150% increase in the number of participants who felt VERY CONFIDENT in their ability to motivate an obese patient with diabetes to exercise
  • A 450% increase in the number of participants who felt VERY CONFIDENT in their ability to maintain equanimity in the face of discord in a clinical encounter

As a health psychologist and consultant working to improve health care delivery in underserved communities, it is clear that enhancing practitioner skills in empathic communication, Motivational Interviewing and Vitality/Wellbeing is a worthwhile endeavor, even when a team may not have the luxury to do so in precious natural settings!