Winter ’15
13
www.homecarefla.org
FEATURE
Shedding Our Traditional Approach
Today, the newest approach to achieve
greater patient and staff satisfaction with
our care delivery is to involve patients
very differently in their care than we have
in the past. How is this accomplished? By
using new skills of evidence-based health
coaching (EBHC)
®
that help us engage and
empower the patient as an equal partner in
the healthcare relationship. What does this
relationship look like? How does it work?
What makes it so successful?
Evidence-based health coaching is a
collective set of specialized clinical
conversational skills founded in
motivational interviewing (MI) that
empowers the patient, taps into his/her
own motivation to act, and recognizes
that the patient makes healthcare
decisions through the social context of his
life, such as personal values, beliefs, and
concerns. In a nutshell, our traditional
approach of “telling the patient what to
do” or “teaching him what to do” often
occurs without ever engaging the patient
to devise the treatment plan together. It
shouldn’t surprise us that the literature
suggests up to 60% of patients don’t
follow through with treatment plans
and as high as 50% don’t take their
medications as prescribed…
We have the expertise to assess, examine,
and teach the patient, but the patient has
the personal expertise about “himself”
that determines whether the treatment
plan is followed! Our expertise can enable
and engage the expertise of our patients,
allowing all of us to achieve greater results.
Health Coaching and MI have been
shown to decrease hospital re-admissions,
improve glucose levels, improve physical
activity, diet, and medication adherence,
just to name a few.
In summary, home care providers have
the perfect opportunity to lay aside
our traditional approach and adopt the
fresh, new skills of evidence-based health
coaching (EBHC)
®
, that is not only
meaningful to the patient and family, but
also fulfilling to healthcare professionals,
and important to our agencies as we strive
to achieve greater satisfaction and gain new
market share in an increasingly complex
business environment.
How to Access EBHC/MI Education
The concepts of EBHC with MI sound easy, but
it takes study and practice to become competent
in its implementation. HCAF and the NSHC have
aligned to offer its members this education at a
discount. For details, go to
To learn more about evidence-based health
coaching education and certification, visit
or contact the National
Society of Health Coaches:
Read more about this approach in Melinda
Huffman’s article published in Home Healthcare
Nurse, October 2014!
Melinda Huffman is a Cardiovascular Clinical
Nurse Specialist, Certified Health Coach,
nationally known speaker, and best selling author.
Co-Founder of the National Society of Health
Coaches, she is also a Principal of Miller &
Huffman Outcome Architects, LLC, Healthcare
and Health Coach Consulting. She can be
contacted a
References:
Huffman, M. (2014). Using motivational interviewing
through evidence-based health coaching. Home
Healthcare Nurse, 32(9), pp. 543-548.
Rollnick, S., Mason, P., and Butler, C. (1999). Health
behavior change: A guide for practitioners. London:
Churchill Livingston.
Rollnick, S. Miller, W.R., and Butler, C.C. (2008).
Motivational interviewing in healthcare: Helping patients
change behavior. New York: Guilford Press.
3.
EMPOWERING
THE PATIENT/FAMILY
Giving Information
Identifying what the patient already knows
and providing information accordingly is a
way to show respect of what is known and
more importantly to “empower” the patient in
the process. Rollnick, Mason & Butler call this
approach: Elicit-Provide-Elicit.
Example:
Clinician: “Tell me what you understand
about diabetes.”
Patient/Client: “You have to stick yourself a
lot to know your blood sugar, and you can’t
have sweets.”
Clinician: “Actually you won’t have to stick
yourself at this point. It looks like you’ll be
able to take a pill by mouth.”
Patient/Client: “Great. I was really worried
about that.”
Clinician: “There are several sugar-free foods
you can have in small amounts. There are
more choices today than in times past.”
Patient/Client: “Thank goodness. All I’ve
heard is that you can’t have any sweets. I
may be able to do this.”
Asking Permission
This strategy shows respect for the patient/
family and gives them the authority to accept
or reject what you have to offer.
Example:
Clinician: “What support do you have at
home to help you?”
Patient/Client: “I have a daughter who can
come by.”
Clinician: “Would you like for me to meet
with her?”
Patient/Client: “I’ll think about it and
let you know.”
