Transcript Livingston Community Health Presentation - CA-HWI

Livingston Community Health
HEALTH COACH PILOT PROJECT
Background:
Who is Livingston Community Health (LCH)?
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LCH is nestled in the heart of the San Joaquin Valley in northern Merced
County
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We have 2 sites, and serve over 14,000 patients and over 55,000
encounters per year
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Our patient population is very diverse ~ primarily of Mexican, Punjabi,
and Portuguese descent
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We have 15 providers – MDs, Mid-levels, BH, and Dental
23 Medical Assistants, and 6 Health Coaches
Background:
Why the Health Coach Model?
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Desire to educate and engage a difficult to manage patient population
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Growing frustration among Primary Care Providers and the lack of time
to educate patients
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Utilize and train non-billable staff to deliver team based care
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To connect an action plan and patient’s understanding
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To support patient’s wellness plan with support of coach
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Desire to develop a career ladder for entry level staff and opportunities
for upward mobility
Background: Funding the Pilot
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Golden Valley Health Centers & Livingston Community Health
partnered to apply for funding to create a career ladder and
pilot UC Davis’s Health Coach Program
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Training focus on DM and Hypertension Disease Pathology,
Motivational Interviewing Techniques, Agenda Setting w/
patient, identifying barriers, etc.
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Our coaches received 85 hours training total and certification
Success Stories
Case Study #1: Mariano
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1 week prior patient had A1C completed
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c/o: headaches, dizziness and blurry vision RBS: 420
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Provider requested MA Health Coach intervention
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Mariano expressed his stress in poor dietary habits
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After HC intervention, pt was motivated to change
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Mariano secured a glucose log completion BID
Saving a patient from insulin dependence
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Mariano came in to receive lab results: AIC @ 12.6
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Provider requested that HC provide insulin teaching
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MA Health Coach noted that this was her patient
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He had already begun to implement changes from our first session
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HC performed a random blood sugar – results were promising
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Provider decided insulin was not necessary
A HC Success Story: Mariano
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Changes Made:
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Eliminated soda intake completely
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Began drinking water
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Decreased flour & corn consumption
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Began exercising
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Glucose log completions/testing 82-
150
Case Study #2: Crisanto
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Came to the clinic not feeling well
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Was very resistive to changing his lifestyle
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Non-compliant with medications or testing
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Provider was frustrated and unable to assist
Health Coach Intervention…
At first glance, patient was resistant
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Provided time for Crisanto to talk and I listened
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He stated that he didn’t want help
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I didn’t push – I met him where he was at
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I gave him tools without the pressure of using them
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He took them…
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But said he’d never be back
The next day, who was at my door?
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Crisanto showed up at my office
the next day with expired strips
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He wanted help – but on his terms
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It’s important that a patient feels
like he is in control
A HC Success Story: Crisanto
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Changes Made:
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Takes meds and tests twice daily
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Keeps his appointments
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Monitors food and water intake
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Walks daily
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Reviews glucose log with Provider
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Blood Sugars: From 450-500 TO: 99-180
Thank You!