Posts Tagged ‘patient activation measure’

Patient Engagement Prerequisite: School Staff in Patient Activation, Health Literacy

October 19th, 2017 by Patricia Donovan

YNHHS embedded care coordinationEven after multiple years of patient engagement education, awareness training and related programming for its clinicians, PinnacleHealth Systems knew those efforts needed to continue if they were to move forward with new interventions. Here, Kathryn Shradley, director of population health, PinnacleHealth System, describes two key focus areas for clinician education.

We wanted to level-set on the definitions of patient activation and health literacy and what these terms meant to the organization and to the teams within. In full transparency, I want to be very clear: I believe initiatives for health literacy, patient engagement, patient education and population health will be on our task list for as long as I’m employed, and that’s okay.

We spent a lot of time educating front-line clinicians on health literacy, understanding who was using the Patient Activation Measure® (PAM®) and tools and attempting to broaden the language used around the health system. One of our initial goals was simply to have the words ‘health literacy’ be recognized and understood throughout the system. This is certainly still something we work on daily as a core piece of all of our engagement strategies. I’m happy to say that we have made progress.

One of the ways we obtained buy-in for our patient engagement strategy was to talk about the financial bottom line of low levels of patient activation and low levels of patient health literacy. We demonstrated to our executive teams, directors and managers that no matter where they were building an initiative and what they were building, if they didn’t include an engagement strategy in their product or service line, they were likely to experience difficulty—a difficulty that could otherwise be mitigated if we addressed some of these issues in their programs.

Source: Dual Approach to Patient Engagement: Activating High Utilizers and Coaching Clinicians

patient engagement

Dual Approach to Patient Engagement: Activating High Utilizers and Coaching Clinicians describes PinnacleHealth’s two-pronged strategy for prioritizing patient engagement among its clinicians and patient population, tactics that elevated key quality and clinical metrics in the process.

4 Behaviors of the Highly Activated Patient

May 7th, 2015 by Patricia Donovan

The success of a population health intervention depends upon participants’ level of self-engagement. The Patient Activation Measure™ (PAM) designed to assess an individual’s knowledge, skill and confidence in managing their health, consists of a 13-item scale that asks people about their beliefs, knowledge and confidence for engaging in a wide range of health behaviors. Here, PAM developer Dr. Judith Hibbard, MPH, Dr.PH, describes some of the traits associated with a highly activated, engaged patient.

It is important to understand exactly what is happening with individuals at different levels and what is going to help them. We did several studies to find out if activation predicts behaviors, and to determine which behaviors it predicts. We did a national probability study and then replicated that study in the United Kingdom. They found almost exactly the same results as we had in the United States. Since then, there have been many more studies.

We found that people who scored higher on this measure were more likely to:

  • Engage in preventive behaviors like screenings or immunizations.
  • Engage in healthy behaviors, such as regular exercise and having a healthy diet.
  • Engage in more disease-specific self-management behaviors, such as monitoring or adherence.
  • Engage in more health information-seeking behaviors.

Once we saw these results, we began to look at the data a bit differently. We realized from the data that some behaviors don’t start until people move further along that dimension of activation.

Source: Three Pillars of Health Coaching: Patient Activation, Motivational Interviewing and Positive Psychology
health coaching
Judith Hibbard, MPH, Dr.PH, is a professor of health policy at the University of Oregon. For more than 30 years, she has focused her research on consumer choices and behavior in healthcare. Dr. Hibbard is the lead author of the Patient Activation Measure™ (PAM) and advises many healthcare organizations, foundations and initiatives.

Technology Reshaping Behavior Change Business

February 25th, 2014 by Patricia Donovan

Technology, particularly mobile health, is reshaping the delivery of health coaching, as revealed by these select metrics from the 2013 Health Coaching survey conducted by the Healthcare Intelligence Network.

The prevalence of health coaching has climbed steadily in the last five years—from 60 percent five years ago to 75 percent today. Incentives to participate in health coaching are more plentiful, too, although participants have to do more than just sign up. Today’s trend is to hold the reward until the health goal is attained.

Technology, particularly mobile health, is reshaping coaching delivery. Telephonic coaching is still the most common coaching modality, but not as common as it was in 2008, when 86 percent of respondents reported the use of telephonic coaching. This year, that figure is 75 percent. Meanwhile, the use of smartphone coaching apps has nearly tripled in the last 12 months, from 4 percent in 2012 to 12 percent this year. Text messaging is up more than 50 percent, too, with 14 percent of respondents incorporating texting in their coaching programs.

health coaching technology
The effect of all of this technology? It remains to be seen. What we do know is that face-to-face coaching interactions are waning, down from 70 percent in 2010 to 59 percent in 2013, as are group coaching visits, which are now conducted by only 28 percent of respondents, versus 40 percent last year.

One constant: motivational interviewing remains the behavior change tool of choice. However, this year’s survey identified a near doubling in use of the Patient Activation Measure® to evaluate participants’ progress, from 10 to 18 percent. Interest in positive psychology has dropped steadily in the last five years, from 48 percent in 2008 to 26 percent this year.

Excerpted from: 57 Population Health Management Metrics: Assessing Risk to Maximize Reimbursement

5 Pillars of Stanford Coordinated Care Home Visits

December 31st, 2013 by Patricia Donovan

Connecting its high-risk patients to essential community resources is the fifth pillar of Stanford Coordinated Care’s post-discharge home visits program.

This community connection for complex patients rounds out the four elements of the CTI that take place during each home visit: medication reconciliation, red flag education, follow-up physician visits, and a personal health record (PHR).

“We think it’s important to get the patient hooked into whatever resources in the community can also help them to have good outcomes and not have to go back into the hospital,” explained Samantha Valcourt, clinical nurse specialist with Stanford Coordinated Care, during a recent webinar on Home Visits: Assessing Complex Patients Post-Discharge to Reduce Readmissions.

These local resources might include recruiting the patient’s church group to visit or assist with meals preparation, she said.

Stanford visits their just-discharged complex patients in the home environment because it offers a close look at the individual’s mobility, safety, nutrition status and support system. Of the five-point program, medication reconciliation is the most important task performed during the home visit, Ms. Valcourt noted.

Medication management problems immediately following the hospital discharge are a key factor driving hospital readmissions among high-risk Medicare beneficiaries, she said.

Just as it modified the CTI to suit its population, Stanford has added three questions to the HARMS-8 readmissions risk assessment tool developed by Care Oregon to identify patients who would benefit from a home visit. The post-discharge visits, which last about an hour on average, are conducted by Ms. Valcourt, an advanced practice nurse. Her preparation for the home visit begins when the patient is still in the hospital, she explains.

“About 20-25 percent of my time is spent on the pre-work and post-work around home visits, such as seeing the patient in the hospital, reviewing hospital notes and the discharge summary, coordinating with the PCP and care coordinator, and making follow-up phone calls.”

Among the process and outcome measures Stanford uses to evaluate the effectiveness of the home visits, which are separate from traditional home care, is the Patient Activation Measure®, which identifies a patient’s level of engagement in their own care.

Although program results are anecdotal at the one-year point, Stanford hopes the home visits will not only reduce rehospitalizations in the approximately 200 high-risk patients it serves, but also reduce lengths of stay, empower patients to partner in their care, improve patient satisfaction and bridge the hospitalist-primary care provider gap, Ms. Valcourt noted.

Ms. Valcourt provides more details on Stanford Coordinated Care’s home visits program in this interview.