Health promotion is something we all learned in nursing school, but in the frenzied reality of today’s healthcare setting, the concept is an easy one to forget. How can you be proactive when you’re constantly being reactive?
The Health Promotion-Care Coordination Link
The Centers for Medicare and Medicaid Services defines one of the purposes for care management as providing support to patients with chronic diseases to achieve their health goals. The World Health Organization first defined health promotion in 1986 as the “process of enabling people to increase control over, and to improve, their health.” In other words, care management is health promotion.
“Too often in care coordination we view our jobs as fixing things,” says Faith Jones, MSN, RN, NEA-BC, director of care coordination and lean consulting for HealthTechS3. “But care coordination is not just about fixing a problem. Effective care coordination is sometimes about fixing things, but that shouldn’t be our long-term approach. Instead, we should be working with patients, not doing things to patients. We should be empowering them to understand their choices so they can make the best choices for themselves. That’s promoting health.”
Sound time consuming? It won’t when you consider the following scenario.
Take the ubiquitous prescription refill for high blood pressure medicine. The fix-it approach to care coordination is to wait until the patient calls, maybe on a Friday afternoon, to say they’re out of pills. A few rounds of phone tag later, and before you know it, the patient has missed a couple of doses. Now the doctor wants to do a follow-up visit, so you call in a 30-day refill, which might cost the patient and the payer more than a 90-day supply, not to mention requires an extra trip to the pharmacy.
Now consider the prescription refill through the lens of health promotion. A regular review of your patient records alerts you to the fact that in 30 days, your patient will be out of meds. Now is the time to check in with the patient. Find out how they’re responding to the medicine, ask about at-home blood pressure readings. If merited, schedule a follow-up visit. If things seem to be going well, provide the refill with plenty of time for there to be no disruption in doses.
“Once you organize your patients and your workflow to encourage health promotion, being proactive and not reactive in that refill scenario absolutely takes less time,” Jones says.
And when follow-up appointments are scheduled and not accommodated in between regularly scheduled appointments, this also ensures the patient is getting the time they need with the provider.
“Effective care is making sure we have the time to spend with patients, spending that time wisely, not duplicating services and not duplicating charges,” Jones says. “If you are proactive in your care coordination approach, it saves resources and it’s better for the patient and better for the healthcare system in general.”
Jones is helping to develop a forthcoming certificate course on incorporating health promotion in care coordination. In the meantime, she’ll be hosting a webinar on Feb. 20 that will serve as a health promotion refresher. In this webinar, “Health Promotion Is the Goal of an Effective Care Coordination Program—Are You Reaching Your Goal?” Jones will outline the links between care coordination and health promotion and, using common care coordination scenarios, provide practical ideas for refocusing your care coordination program on health promotion. Register now.