Embed Size (px)
Citation preview
The Power of PersuasionThe gentle art of influencing people to do something that you want them to do because they want to…
Ruth Medak, MD, FACPMedical Director of Hospice CareProvidence Hospice
Tuesday, March 25, 201412:00–12:45 p.m.
2
3
IIS Innovation Project Team
Kelleen BernardTeam Lead
Leigh Bohannon QI Specialist
Dawn PlanteProject Assistant
4
Norms
Please mute your phone during the presentation
Use the chat feature Tell us what organization you are with and
who is in the room with youThere will be questions and
discussion at the end of the presentation
5
About the IIS Innovation Project
CMS-funded demonstration projectGoals
Increase the number of medical practices electronically submitting adult immunization data to ALERT IIS
Engage providers in activities to improve immunization delivery and rates in Oregon
Improve quality of care for Oregon Medicare beneficiaries
6
Today’s purpose learn how to engage staff more actively in
preventive care delivery understand important barriers to providing
preventive health services and how to overcome them
learn strategies for persuading patients to follow through on recommended preventive screenings or vaccinations
hear how to incorporate decision tools that facilitate the provider-patient partnership
7
Ruth Medak, MD, FACPMedical Director, Providence Hospice
Dr. Medak is the former medical director for Acumentra Health. With more than 20 years as a practicing internist and 15 years in healthcare quality improvement, she represents QIO process improvement teams in the field, including in projects to improve primary care through EHR-assisted and population-based approaches.
Dr. Medak is ABIM certified in Internal Medicine and Hospice and Palliative medicine and is interim medical director for Providence Hospice and Home Services.
8
Persuasion
The gentle art of influencing people
to do something that you want them to do
because they want to…
9
What do you want to get out of today’s time
together?
10
Participants will be able to describe
important barriers to providing preventive care services
strategies for persuading people to follow through on recommended preventive screenings or vaccinations
11
How is persuading a patient to get CRC screening like getting a child to do homework?
12
Lessons about persuasion from daily
life
13
Appeal to what’s in it for themClear expectations (what, when,
where, how)Consistent messageConsequence for failure
14
Why don’t patients follow recommendations?
15
Common attitudes about patients
Noncompliant Or poor case
Procrastinator Or significant barriers
16
Reasons for failure to follow recommendations
Beliefs and culturePast experienceFearsLogistics
Listen to the patient to decide how to make your best “case”
17
Beliefs
Risk Low for everyone No family history of cancer Excellent personal health
Benefit Little or none for me
18
Beliefs and culture
Source of healthCultural and religious beliefsRole in the family and communityTrust or distrust of health care system
19
Fears
Fear of Pain Preparation Complications Finding cancer
20
Other issues
Logistics Time off work Transportation
CostLiteracy
21
Colorectal cancer screening factsLack of insurance
98% less likely to have a regular PCPget a CRC screening recommendationget screened
Low literacy Low CRC screening (even with insurance
coverage)
Source: American Cancer Society, 2008.
22
Colonoscopy instructions as seen by someone with low literacy
Your naicisyhp has dednemmocer that you have a ypocsonoloc. Ypocsonoloc is a test for noloc recnac. It sevlovni gnitresni a elbixelf gniweiv eocs into your mutcer. You must drink a laiceps diuqil the thgin erofeb the noitanimaxe to naelc out your noloc.
23
Old words in a new light
How would you respond to Would you like to have a pneumococcal
vaccination today? You’re 55 now, so you’ll need to get a
colonoscopy sometime before you’re 60. I’d like you to schedule a mammogram.
24
“So, Doc…How long do I have to ignore your advice?”
25
Critical discussion elements
WhatWhyWhenWhat if…
26
Other tactics
Be positiveSpeak for the PCP
Be prepared to cease and desist.Save your energy to try next time.
27
Operationalize advocacy
Identify patients due for tests and services Remind patients with prior
recommendation or order
Administer vaccinations Schedule mammograms Educate about CRC screening
28
You’ve identified a target…
Dr. “X” (or NP or PA) wants all of his/her patients to get a pneumococcal vaccination colorectal cancer screening biennial mammogram or any other service
29
A positive approach
“I’d like to give you your vaccination before your PCP sees you…”
“The referral coordinator will help you schedule a colonoscopy while you’re waiting.”
“Do you have any questions about the test?”
30
A positive approach
“The mammography center can usually schedule tests within 2 weeks. So, we’ll expect to receive your report by the 1st of next month.”
31
How do you respond?
“I’m healthy and I never get sick. Why do I need a pneumococcal vaccination/flu shot?”
“Nobody in my family has ever had breast cancer/colon cancer.”
“I’ve heard that the prep is awful!” “I’m afraid that they’ll find cancer.”
32
Conclusions
Persuasion is a skill that anyone can learn.
You have the power to save lives and improve health.
34
To join the IIS Innovation Project
Contact the IIS team Kelleen Bernard | Team Lead
[email protected] | 503-382-3953 Leigh Bohannon| QI Specialist
[email protected] | 503-382-3934
Go to www.acumentra.org/immunization
35
For additional information about the IIS webinar series
Contact Leigh Bohannon | QI Specialist
[email protected] | 503-382-3934
36
Your feedback is very important to us. Please complete the evaluation.
Our next webinar will be:Tuesday, May 27, 2014
“Running Reports in ALERT IIS”
This material was prepared by Acumentra Health, Oregon’s Medicare Quality Improvement Organization, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 10SOW-OR-IIS-14-06
