Julie: | Christy, can you tell us about yourself and in what environment you are using your coaching skills? |
Christy: | I work for Guthrie County Hospitals and Clinics in Stuart, Iowa. I started there about a year and a half ago as the Care Coordinator. We are planning to start a Chronic Care Management program in the upcoming months. We just joined an ACO and I currently am working with the weight loss program. One of the Nurse Practitioners and I started that close to a year ago now. We have several patients that we see. The nurse practitioner primarily does the medication management and I do the health coaching, weight loss, and diet portions. |
Julie: | How often do you see your patients and how much time are you able to spend with them? |
Christy: | I see them every two weeks face to face. And, really… it depends on the patient. I allow an hour per patient. Some patients who are more self-motivated or educated may last 15 minutes. But, I definitely have some that are upwards of 60 minutes. Those may be people who need more affirmation and encouragement. |
Julie: | Are your patients referred to you by the nurse practitioner or the doctor or how do they come to you? |
Christy: | We have two different methods. We started the actual weight loss program and it is a separate entity from the hospital. So people can actually call themselves and schedule or we do have other physicians within the clinic who will refer to me, but they will remain under that physicians care. Our providers are very supportive and help to advocate the program. When patients come in through the weight loss clinic, they are under the care of the nurse practitioner. |
Julie: | How many patients are you currently working with and how have you marketed this program? |
Christy: | Currently, I have about 75 patients. We use several methods to market the program including: rack cards, business cards, newspaper ads and of course our providers’ recommendations. |
Julie: | How are you measuring outcomes? |
Christy: | We are using BMI for weight loss. As far as Chronic Care Management, we will definitely be reporting outcomes for CMS. That is something we are currently working on. |
Julie: | Have you seen a difference in how your patients relate to you? |
Christy: | Yes! We build a level of trust. They are more comfortable and they are able to open up more and are definitely more willing to receive the information. |
Julie: | Do you have a success story that you could share? |
Christy: | I have a male patient, who is morbidly obese and has had several failed attempts at weight loss…ups and downs and always regaining the weight. I have been working with him for approximately 6 months. In working with him, I found out he is really lacking in emotional support and just support in general from his family. Breaking through that barrier with him and providing that support that he is not getting from his family has made a significant difference for him. He had never had a cheerleader before to help him through challenges. He has actually successfully lost 67 lbs! |
Julie: | That’s great! How did you get him to that point? |
Christy: | He came in with a goal of committing to one year, which was big for him. He was the type who would, in the past, commit and then fall off the wagon. Often, he would set lower goals or lower expectations so he didn’t disappointment himself or fail. We really worked through those things. I will try and break that wall down by going through his past accomplishments and what has worked well for him. |
Julie: | How has the Clinical Health Coach training changed or altered the way you work with your weight loss patients? |
Christy: | I would say it really helped me find a new approach for patients who are struggling or I have difficulty reaching. |
Julie: | What skills have you found yourself using the most when helping your patients? |
Christy: | Probably the Motivational Interviewing. Especially with the sensitive topic of weight loss, I have found that both open-ended questions and reflections have been helpful in breaking down barriers with patients and promoting self-awareness and acceptance of behaviors. In many situations, it is often times hard for patients to have a positive outlook on the future or on what they are doing. Getting them to explore themselves more and tell me what they are looking for instead of me telling them. It definitely motivates them a lot more when it is THEIR idea and realization and not mine. |
Julie: | What was the biggest take-away from your Clinical Health Coach training and what advice might you have for others just beginning their training? |
Christy: | I would say letting patients set their own goals and have their own agenda. Let them lead the conversation. As far as advice for those starting the training… I would say make sure that you take the time to watch and videos and actually watch/pay attention! Going through the example coaching scenarios was also very helpful. |
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