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MA114 Chapter 22 patient coaching
- 2. 2 Patient Coaching 1. Describe the medical assistant’s role as a coach. 2. List and describe the stages of grief; also, discuss how the health belief model helps to explain what factors influence a person’s health beliefs and practices. 3. Describe the three domains of learning. 4. Explain how a medical assistant can adapt coaching to the patient. 5. Describe the teaching-learning process.
- 3. 3 Patient Coaching 6. Discuss how a medical assistant can coach on disease prevention. 7. Describe how a medical assistant can coach on health maintenance and wellness, including different types of self-exams and screenings. 8. Describe how a medical assistant can coach on diagnostic procedures and treatment plans. 9. Describe care coordination and patient navigation, develop a list of community resources, and facilitate referrals.
- 4. Coaching Disease prevention Health maintenance Diagnostic tests Treatment plans Specific needs Community resources 4
- 5. Stages of Grief Denial and isolation Anger Bargaining Depression Acceptance 5
- 6. Health Belief Model First part deals with person’s perception of his or her chance of developing a disease Second part deals with person’s perception of severity of disease Third part focuses on whether the person will take preventive issues 6
- 7. Domains of Learning Cognitive domain Mental processes of recall, application, and evaluation Psychomotor domain “Doing” domain Affective domain “Feeling” domain 7
- 8. Cognitive Domain Sensory stage Short-term memory Long-term memory Tips: Present information at an appropriate level for patient Build on patient’s prior knowledge about topic Present information in small chunks; well-organized Provide information in two different ways Have patient teach back information provided 8
- 9. Psychomotor Domain “Doing” domain Provide step-by-step directions to patient Give timely feedback on person’s performance Have patient “teach back” skill Repeated practice doing skill helps with recall and retention Make sure to use equipment and supplies patient will be using at home 9
- 10. Affective Domain “Feeling” domain Includes our feelings, emotions, values, and attitudes Make sure you address (as much as you can) any affective domain barriers prior to educating a patient Written home instructions should also be given 10
- 11. Developmental Levels Trust versus mistrust Autonomy versus shame and doubt Initiative versus guilt Industry versus inferiority Identity versus role confusion Intimacy versus isolation Generativity versus stagnation Ego integrity versus despair 11
- 12. Cultural Diversity Role of family and community Religion Views on health, wellness, death, and dying Views on complementary therapies Views on gender roles and relationships Beliefs related to food, diet, illness, and health Beliefs regarding sexuality, fertility, and childbirth 12
- 13. Communication Barriers Patients who have impaired vision Patients who have impaired hearing Patients who have language barriers 13
- 14. 14
- 15. Patients With Impaired Vision Alert patient that you are in the room and identify yourself Patient is unable to pick up your body language; use clear, concise language and a normal tone of voice Provide all written material in a large font or print size Consider the impact of color contrast and glare on materials Make eye contact 15
- 16. Patients With Impaired Hearing Face person when speaking Determine if person has better hearing in one ear over the other; position yourself accordingly If patient has hearing aid, encourage patient to use it Say person’s name before beginning conversation Keep hands away from your face when talking Limit extra noises in environment 16
- 17. Patients With Language Barriers Address patient by his or her last name Be respectful and courteous Use simple phrases Use an interpreter; focus on patient Use translated materials Pictures and models can be helpful during coaching session 17
- 18. Teaching-Learning Process Assessing the learning needs Determining teaching priorities Planning the teaching process Implementing the teaching process Evaluating the patient’s learning Documenting the teaching-learning process 18
- 19. Coaching on Disease Prevention By group: School-age children (handwashing and cough etiquette) Teens and adults (STIs, cigarettes, tobacco use) All age groups (vaccines; immunization schedules) 19
- 20. Coaching on Health Maintenance and Wellness Based on patient’s answers to screening questions, medical assistant may need to provide coaching on specific topics Medical assistant completes some screenings, but also educates on at-home self-exams 20
- 21. Self-Exams Breast self-exam Yearly mammograms start between 45-50 Testicular self-exam Also part of routine physical exam Skin self-exam ABCDE (Asymmetry, Border, Color, Diameter, and Evolving) Rule Oral cancer self-exam Also done routinely by dentist 21
- 22. Regular Screenings Blood pressure Bone density Cholesterol Colorectal cancer screening Dental exam 22 Dilated eye exam Lung cancer screening Mammograms Pap test Prostate cancer Type 2 diabetes mellitus
- 23. 23
- 24. One-Time Screenings Abdominal aortic aneurysm Males between 65-75 who have smoked at one time in their lives Human immunodeficiency virus (HIV) screen (blood test) People 15-65 years: at least once in their lifetime All pregnant women People with high risk should be tested annually Hepatitis C Person with risk factors should be tested 24
- 25. Additional Screenings Alcohol misuse screening Nicotine or tobacco screening Drug abuse screening Intimate partner violence screening Elderly safety screening Functional status screening Depression screening Peripheral neuropathy screening 25
- 26. Coaching on Diagnostic Tests Provide necessary information for diagnostic and laboratory tests ordered for patients Some tests require fasting; others do not Provide answers to the following: What is the test? Where does the patient need to go for the test? When is the test scheduled? Does the test require fasting? If so, for how long? If no food or beverages, does that include water? Should patients continue or stop taking their medications? 26
- 27. Coaching on Treatment Plans Medical assistants review treatment plans with patients Taking medications Caring for casts and splints Applying hot or cold therapy Using assistive devices 27
- 28. Care Coordination Provides personalized patient- and family-centered care in a team-based environment Advantages: Greater efficiency with providing patient care Reduced cost Greater patient care Individualized patient guidance and services Encourages patients to focus on goals and self-management Reduces hospital emergency department visits and readmissions Ensures patient’s needs and preferences for healthcare services are met 28
- 29. The Medical Assistant as a Patient Navigator A patient navigator is a person who helps patients and families with insurance problems, explains treatment and care, communicates with the healthcare team, assists caregivers, and manages medical paperwork Medical assistants are cross-trained in administrative and clinical skills, so they are in a unique position to serve as patient navigators in ambulatory care settings 29
- 30. Patient Coaching Patient education materials can be: On paper Apps YouTube links Other websites and videos Use only provider-approved sites 30
- 31. Legal and Ethical Issues All patients have the right to information before they agree to receive care Conduct adequate patient education and follow-up Document each patient education intervention completely and accurately Meet needs of all patients without evidence of prejudice 31
- 32. Patient-Centered Care Care coordination helps provide patients with individual assistance Patients who feel well cared for (and who feel comfortable talking with healthcare team) stay with their provider Care coordination will increase in popularity over the coming years 32