Clinical Health Coach Profile
Dan Schletty
Julie: | What is your role and how are you using Clinical Health Coaching? |
Dan: | Last fall I had the opportunity to take part in the Clinical Health Coach training program (on-site) through a partnership with the Minnesota Department of Health. We were selected as part of a grant process. I was able to attend an onsite training in Fort Worth, Texas. Before that, I didn’t know a lot about the Clinical Health Coach program. I have been a health coach for about 4-5 years and before that was working in the insurance realm of things where they had their own training in that area. It was good to get a feel for the clinical side of it. To have the coaching in a more realistic, relevant setting in the clinical field was very beneficial. |
Julie: | How are you using your Clinical Health Coaching skills now? |
Dan: | We’ve implemented a health and wellness coaching program within our model of care at our clinic. We started from scratch in March, 2013. We really didn’t have a vision before we got onboard with Clinical Health Coach training and now we have created care paths, work flows and I’m plugged right into the clinic. I’m another resource for the providers and the patients. When a patient comes to the provider, discussing lifestyle changes and he/she is willing to make change and is looking for support, the physician will make an electronic referral to me so upon checkout. The patient will have an appointment with me before they even leave the clinic. |
Julie: | How much time are you able to spend with that patient. |
Dan: | Initial appointments, I will have up to an hour. Follow up appointments we schedule up to 1/2 hour. With primary care, sometimes the patients don’t get as much time with the provider as they would like. I am able to build rapport with the patients. I get to know so much more about them on a personal level and on a behavioral level. Through that, they begin to open up and ask questions. That’s when the quality of our care goes up because then I can guide them to the right treatment they need. I can refer them back to the provider or inform the provider of results. |
Julie: | Have physicians been receptive? |
Dan: | Physicians have really been open to it. To date, we’ve had about 550 provider referrals since March, 2013. 150 self-referrals from the community. |
Julie: | With all of those, I’m sure you have had some great success stories. Do you have one you would like to share? |
Dan: | We have had quite a few great successes from individual patients. There are so many ways we try to measure success, like through biometrics, but a lot of the greatest successes are those that are done on more of a behavioral level. I receive a lot of a referrals from our mental health practitioner. A lot of these individuals are struggling greatly with depression along with other medical issues like diabetes and weight issues. You may never even see a smile on their face. After working with them for a month or two, you can see such a change in them visibly. Their confidence is increasing… so their quality of life is increasing. That’s one of the most rewarding things to see. The biometrics are showing a huge improvement across the board with coached patients vs. non-coached patients.We’ve had many situations where a patients’ LDL was 130 or 110 and after working on lifestyle changes it’s down less than 100. Now the providers quality measures are going up, outcomes are going up and patient’s health is improving. In many of the diabetes patients that I see, we have a 10% higher quality level for coach vs. non-coached patients. |
Julie: | How many coaches do you have? |
Dan: | Right now, it’s just me. I typically see between 6-10 patients a day. I handle our worksite wellness program too. We actually just opened an onsite fitness center. We’ve been implementing what we call active health coaching. We may meet in the clinic, but sometimes I will bring the patient down to the fitness center and bring them through a workout. Getting them familiar with exercising and building their confidence so they can go take advantage of other community resources. |
Julie: | What has been your greatest challenge? |
Dan: | It’s an ongoing process. The challenge in each individual is very different, so we need to adapt. One of the greatest challenges is being able to adapt to each patients’ needs. Being patient with a patients’ readiness to change or follow through with goals. No matter how bad you want them to change, it’s always up to them to make those changes. |
Julie: | What advice would you have for those people getting started with their training? |
Dan: | Take advantage of the role playing and coaching calls. Practice, practice, practice. It may feel uncomfortable, but it gets easier as time goes on. As you implement Clinical Health Coaching skills into the primary care or clinic side, getting the leadership support is vital, but even before going to leadership having a plan in place about what your thought process is and how you’re going to implement the coaching role. Create a vision and think about how that vision is going to support your organization’s mission and vision overall. Building rapport with the physicians is important… perhaps starting with one champion provider. Once the other physicians see the success, they may jump on board. Be visible for the providers and the patients. |
Julie: | What was the most valuable lesson you took away from the training? |
Dan: | Motivational Interviewing training in the clinical setting. I appreciated it is more specific and realistic for the clinical setting. |