Sessions: Thursdays, May 8, May 15, May 29, June 12, June 26, July 10, 2008
1 p.m. - 5:15 p.m.
Des Moines University - Student Education Center
33300 Grand Avenue, Des Moines, IA
Classroom #115 (by Matthew's Bookstore)

Sponsored by Mercy Clinics, Inc., Des Moines University, Iowa Chronic Care Consortium, Mercy College of Health Sciences

Physician offices are challenged with managing an ever-increasing number of patients with chronic conditions in a healthcare environment that demands documentation of quality of care. By implementing the Chronic Care Model in the physician office setting, physicians can improve the support of their patients, improve office workflow, and improve clinic patient outcomes. The Physician Office Health Coach is an innovative staff position that focuses on implementing the Chronic Care Model, assisting individual patients to improve self-management skills, and evaluating the overall effectiveness of chronic care management in the physician office setting.

Purpose

To develop the skills of selected physician office staff to function as health coaches in support of improved patient self-management, to build leadership and facilitation skills in implementing the Chronic Care Model, and to lead quality improvement processes to increase overall effectiveness of the clinic practice.

By the completion of this program, participants will have experienced a combination of didactic learning, practical application, and competency assessments. A certificate of competency as a Health Coach will be awarded by Des Moines University for those passing the exam at 75% or above, and a passing score on the skill assessment.

Target Audience

Registered Nurses, Licensed Practical Nurses, and Certified Medical Assistants.

Fee

For employees of Mercy Clinics, Inc., fees will be paid by Mercy Clinics, Inc. $40.00 per session for all others.

Continuing Education credit

Nurses will be awarded CEUs by IBON Approved Provider #112 (Des Moines University) for each individual session:

• Session 1: 0.39
• Session 2: 0.45
• Session 3: 0.45
• Session 4: 0.48
• Session 5: 0.45
• Session 6 : 0.48

Program Objectives

Session 1 Objectives - May 8, 2008

Chronic Care Model

• Describe the 6 elements of the Chronic Care Model.
• Describe population based care.
• Relate the Chronic Care Model to the concept of the medical home.
• Describe the importance of creating a team to support chronic care model changes.
• Identify examples of changes that would support the Chronic Care Model in an office setting.

Role of the Health Coach

• Relate how health coaches must adapt to their own clinic needs and culture.
• Describe the five key functions of a health coach in the office setting.

Business case for the Health Coach

• Make a financial case for health coaches.

Model for Improvement

• Explain a PDSA cycle.

Medical Home

• Describe the concept of a medical home.
• List the benefits of a medical home.

Building a Registry

• Describe the key functions of a disease registry.

Session 2 Objectives - May 15, 2008

Myers-Briggs

• Describe the 16 types of personalities.
• Explain how knowledge of personality type can enhance your role as a health coach.

ADA Standards of Care

• List ADA recommended diabetes standards of care.
• Summarize the evidence base for diabetes interventions based on ADA standards of care.

Guidelines and Decision Support

• Identify decision support materials and tools that will assist a coach.
• Describe the role of decision support tools in the office setting.

Pre-Visit Chart Review

• List steps required for pre-visit chart review.
• Identify the role of each team member in the pre-visit chart review process.

Session 3 Objectives - May 29, 2008

Health Coaching for Self-Management Support

• Discuss the similarities and differences between health coaching, wellness coaching and lifestyle coaching.
• Describe the differences between the traditional model of health education and the health coaching model of behavior change.
• Identify and describe the four guiding principles of Motivational Interviewing.
• Utilize open-ended questioning in health coaching activity.

Session 4 Objectives - June 12, 2008

Health Coaching and Self-Management Support

• Describe the 5 stages of change and determine a patient/client's stage of readiness for behavior change.
• Determine when a patient/client is using change talk.
• Discuss how to ask a question utilizing appreciative inquiry.
• Define outcome and behavioral goals.

Health Literacy

• Demonstrate how to apply plain language concepts to written and oral patient communications.

Personality Type and Communication

• Discuss techniques that will increase effective communication with different personality types.
• Identify behavior cues that indicate particular personal interaction styles.
• Discuss how to adapt, when necessary, their own preferred approaches in order to better respond to a particular person.
• Recognize the role of type theory in understanding and managing stressful situations and also in delivering unwelcome news

Session 5 Objectives - June 26, 2008

Health Coaching for Self-Management Support

• Demonstrate how to guide the patient/client when setting behavioral rather than outcome goals.
• Write behavioral goals utilizing the SMART principle.

Community Resources

• Identify local community resources that can promote patient well-being and independence.

Coordination of Care

• Analyze current processes for care communication in the transition from patient hospitalization back to primary care service.
• Discuss how to strategically use available resources to optimize continuity of care.

Session 6 Objectives - July 10, 2008

Leadership and Team Building

• Identify techniques for conflict resolution.
• Discuss and formulate strategies for implementation to meet desired outcomes

Change Management Leadership

• Discuss how to reframe "pockets of resistance" into opportunities for change in the clinic setting.
• Discuss how to apply principles of leadership to organizational transformation.

Speakers

David Swieskowski, MD, MBA, Vice President Quality, Mercy Clinics, Inc.,
Kelly Taylor, RN, MSN, CCM, Director of Quality, Mercy Clinics, Inc.
Rebecca Lang, EdD, RDH, CHES, Certified Wellness Coach, Intrinsic Coach ®
Del Konopka, RN, MS, Clinics' Education Coordinator, Mercy Clinics, Inc.
Julie Weldon, RN, MSN Six Sigma Black Belt, Performance Improvement, Mercy Medical Center
Debra A. Curren, ARNP/CNS-ADM, CDE, CTN, Iowa Diabetes and Endocrinology Clinic, Mercy Medical Center
Monica Vail, RN, ADN, Nursing Supervisor, Health Coach, Mercy South Family Practice Clinic
Kelli Smith, RN, BSN, Health Coach, Mercy Beaverdale Clinic
Cathy Mielk, BN, BSN, Clinic Manager, Mercy Urbandale Clinic
Mary Ann Abrams, MD, MPH, Clinical Performance Improvement Iowa Health System
William Jagiello, DO, Mercy Beaverdale Medical Clinic
Carla Stebbins, Ph.D, Assistant Professor and Director, Healthcare Administration Program, Des Moines University
Fritz Nordengren, MPH, Education Technology Strategist, Healthcare Administration Program, Des Moines University
Tom Evans, MD, Iowa Health Care Collaborative

Disclosure Policy

Speakers will disclose to attendees the nature of any significant financial relationships they have with the commercial firms providing support, as well as the commercial manufacturers of products and/or the providers of services discussed in their presentations. They will also disclose if any pharmaceuticals or medical procedures and devices discussed are investigational or unapproved for use by the U.S. Food and Drug Administration (FDA).

Session Agendas

May 8, 2008 (Session 1)
Time	Topic	Speakers
1:00- 1:30 p.m.	Welcome and Introductions	David Swieskowski Bill Appelgate
1:30- 2:00 p.m.	The Chronic Care Model	David Swieskowski
2:00- 2:30 p.m.	The Role of the Health Coach	Kelly Taylor
2:30- 3:00 p.m.	The Business Case for Health Coaches	David Swieskowski
3:00- 3:15 p.m.	Break
3:15- 4:00 p.m.	Building a Health Registry	David Swieskowski
4:00- 4:30 p.m.	Model for Improvement	Julie Weldon
4:30- 5:00 p.m. 3.9 contact hours 0.39 CEUs	Practical Application for next session: Identify a change team within each clinic (including physician champion) Complete ACIC for clinic Develop a 5 patient diabetes registry using champion physician's patients Present business case to physician champion Apply a PDSA cycle to an improvement project in clinic Complete Myers-Briggs Inventory	Kelly Taylor
May 15, 2008 (Session 2)
Time	Topic	Speakers
1:00- 1:45 p.m.	Review Practical Application from Session 1 Bring action plan (PDSA) to address challenges or barriers noted in clinic setting	Kelly Taylor
1:45- 2:45 p.m.	Myers-Briggs Inventory: Identifying your Personality Style for Leadership	Carla Stebbins
2:45- 3:00 p.m.	Break
3:00- 3:30 p.m.	ADA Standards for Care Guidelines and Decision Support	Debra Curren
3:30- 4:00 p.m.	Guidelines and Decision Support Process for Pre-Visit Chart Review	Tom Evans
4:00- 4:50 p.m.	Office Processes for Pre-Visit Chart Review	Monica Vail Kelly Smith Cathy Mielk
4:50- 5:00 p.m. 4.5 contact hours 0.45 CEUs	Practical Application for next session: Bring clinic draft guidelines or standing orders to next meeting Develop pre-visit chart review form for diabetes patients Perform pre-visit chart review for five diabetes patients of the physician champion	Kelly Taylor
May 29, 2008 (Session 3)
Time	Topic	Speakers
1:00- 2:00 p.m.	Review Practical Application from Session 2 Bring action plan (PDSA) to address challenges or barriers noted in clinic setting	Del Konopka Kelly Taylor Rebecca Lang
2:00- 3:00 p.m.	Health Coaching for Self-Management Support Health coaching, wellness coaching, lifestyle coaching, health education: similarities and differences	Rebecca Lang
3:00-3:15 p.m.	Break
3:15-4:15 p.m.	Motivational Interviewing: Guiding Principles	Rebecca Lang
4:15-4:45 p.m.	Health Coaching Skills Development (listening, asking open-ended questions)	Rebecca Lang
4:45- 5:00 p.m. 4.5 contact hours 0.45 CEUs	Practical Application for next session Complete two coaching sessions with a partner from class, and complete practicum sheet	Rebecca Lang
June 12, 2008 (Session 4)
Time	Topic	Speakers
1:00- 1:45 p.m.	Review Practical Application from Session 3 Bring action plan (PDSA) to address challenges or barriers noted in clinic setting	Del Konopka Rebecca Lang Kelly Taylor
1:45- 2:30 p.m.	Health Coaching for Self-Management Support Transtheoretical Model: 5 stages of change Assessing for Change Readiness	Rebecca Lang
2:30- 2:45 p.m.	Break
2:45- 3:30 p.m.	Health Coaching Skills Development (establishing rapport, assessing readiness, determining next steps)	Rebecca Lang
3:30-4:15 p.m.	Health Literacy	MaryAnn Abrams
4:15- 5:00 p.m.	Personality Type and Patient Communication	Carla Stebbins
5:00- 5:15 p.m. 4.8 contact hours 0.48 CEUs	Practical Application Assignment for next class Bring examples of clinic education materials and review for appropriate reading levels Complete two coaching sessions with a partner from class, and complete practicum sheet	Rebecca Lang
June 26, 2008 (Session 5)
Time	Topic	Speakers
1:00- 1:45 p.m.	Review Practical Application from Session 4 Bring action plan (PDSA) to address challenges or barriers noted in clinic setting	Rebecca Lang Kelly Taylor Del Konopka
1:45- 2:30 p.m.	Health Coaching for Self-Management Support Setting behavioral versus outcome goals Utilizing the SMART goal setting guideline	Rebecca Lang
2:30-3:00 p.m.	Health Coaching Skills Development (setting behavioral goals)	Rebecca Lang
3:00-3:15 p.m.	Break
3:15-4:00 p.m.	Community Resources	Del Konopka
4:00-4:45 p.m.	Coordination of Care	William Jagiello
4:45-5:00 p.m. 4.5 contact hours 0.45 CEUs	Practical Application for next session Complete one coaching sessions with a partner from class, and complete practicum sheet Complete one coaching session with a clinic patient utilizing conversation flow guide sheet	Del Konopka
July 10, 2008 (Session 6)
Time	Topic	Speakers
1:00- 1:45 p.m.	Review Practical Application from Session 5 Bring action plan (PDSA) to address challenges or barriers noted in clinic setting	Rebecca Lang Kelly Taylor Del Konopka
1:45-2:45 p.m.	Leadership and Team Building for a successful office practice	Fritz Nordengren
2:45-3:00 p.m.	Break
3:00-4:00 p.m.	Change Management Leadership	Fritz Nordengren
4:00-5:15 p.m. 4.8 contact hours 0.48 CEUs	Health Coach Competency Assessments and Written Examination (SPAL Lab at Des Moines University)	Rebecca Lang