Frequently Asked Questions - California Quality Collaborative

Partnering with Patients: Using Motivational Interviewing
for Brief Action Planning and Shared Decision Making
Partnering with Patients (PwP) Program
A Motivational Interviewing Skill-Building Program | Oakland and Ontario, CA
Frequently Asked Questions
What is motivational interviewing (“MI”)?
Motivational interviewing (“MI”) is a goal-oriented, patient-centered counseling style used to elicit behavior
change by helping patients to explore and resolve ambivalence. It can be used to strengthen a patient’s
own motivation and commitment to change. It’s also described as a counseling approach and was
developed in part by clinical psychologists Professor William R Miller, Ph.D. and Professor Stephen
Rollnick, Ph.D.
The core skills of motivational interviewing (MI) can be learned by anyone interested in supporting others
to make change.
Who is MI training designed for?
CQC’s Partnering with Patients program is designed for patient-facing teams who work within medical
groups or clinics. Because having a culture to support motivational interviewing is extremely important
and greatly increases the chances for making the new training part of habit and culture, we require that
organizations send a minimum of three (3) patient-facing staff members to attend the training.
This level of training is applicable to a wide range of participants and often is most appropriate for those
who have the opportunity to work with patients or clients facing complex situations, ambivalence, or with
multiple concerns. MI workshops build on a clinician's own experiences in patient interactions to develop
further skills to enhance motivation.
Attendees may include but are not limited to:
o Physicians and their teams
o Nurse practitioners and registered nurses
o Front line staff (people who answer phones and schedule appointments)
o Medical support staff (Medical Assistants, Nurse Case Managers, Nurse Practitioners)
o Site Managers
o Social Workers
o Provider Champions / Physician Project Leads
o Physician leaders who are champions for Motivational Interviewing, Patient
Engagement, or Communications Development Programs
o Case Management /Utilization Management
Questions? Contact Jen Burstedt at California Quality Collaborative (CQC) at
[email protected] | 415-615-6306 | Date: Saturday, February 06, 2016
Partnering with Patients: Using Motivational Interviewing
for Brief Action Planning and Shared Decision Making
How is this different from other MI courses?
Brief Action Planning – Designed for a 15 Minute Office Visit (Or Longer)
This training will also include complementary skills related to MI that are commonly useful in clinical
settings such as Brief Action Planning and Shared Decision Making.
Brief Action Planning assists clinicians with the tools and guidance needed to increase the chance that
patients or clients will be able to act on advice or information. Many clinicians recognize this as a
"Teachable Moment." Using these skills can take little time (1-5 minutes) and are compatible with usual
practice. The workshop includes opportunity to practice skills using familiar scenarios.
Shared Decision Making (SDM) is a collaborative process that allows patients and providers to make
health care decisions together, taking into account the best scientific evidence available, as well as the
patient’s values and preferences.
Fundamentals Covered
The two days of training cover a wide variety of the fundamental concepts, including:
Brief Action Planning (BAP) * OARS (Open-ended questions, Affirmations, Reflections, Summaries) * MI
sandwich * Spirit of Motivational Interviewing – CAPE (Compassion, Acceptance, Partnership, Evocation)
* Ask – Tell – Ask * Teach Back * Shared Decision Making (SDM)
Adult Learning Principles
The complete workshop includes 2 in-person, hands-on training and role playing days plus 4 virtual
webinars. The format starts out by introducing 1 day of in-person training, followed by a period of 2
webinars during which time motivational skills and concepts are reviewed. This gives participants an
opportunity to practice their skills in their work environment, ask questions and receive feedback on their
progression. 2 – 3 months later, day 2 of the in-person workshop takes place. Given the time, participants
can practice skills and revisit coursework, achieving proficiency in the topics covered during day 1. Two
webinars follow the second in-person training session.
See the Partnering with Patients application for a more in-depth explanation and schedule, including
information about the organization-level coaching calls.
Trainers with a Diversity of Clinical Experience & Expertise
Offered in collaboration with the Centre for Collaboration, Innovation and Motivation (CCMI), instructors
include MDs, NPs and Health Coaches; staff with expertise in the specific area of interest is also included
(i.e. for participants who work with specific populations such as homeless, Native Americans, low-income,
pediatric, behavioral issues, etc.) CQC has collaborated with CCMI since 2013.
What types of outcomes do you tend to find in a practice that implements MI after our trainings?
This is a great question that is actually fairly complicated. The first nuance is what does "implement MI"
mean? We know that embracing and acting with the Spirit of Motivational Interviewing improves
engagement in care and that the other skills we teach improve engagement, understanding of
information, problem solving and creation of action plans and if followed up appropriately can improve
patient self-efficacy. But that won't happen if just a few people are trained and are not encouraged to use
Questions? Contact Jen Burstedt at California Quality Collaborative (CQC) at
[email protected] | 415-615-6306 | Date: Saturday, February 06, 2016
Partnering with Patients: Using Motivational Interviewing
for Brief Action Planning and Shared Decision Making
their skills. Nor will it happen if for example the organization is great at making action plans but don't do
follow up.
One of the comments we hear is that trainees are well-intended but system issues derail their efforts
or that competing priorities impede spread to get enough people trained to have impact at a practice
level. The second important nuance is "by when?" Outcomes are complicated and take into account the
disease itself, medical treatment as well as the life style issues of the patient. That is why we were
careful not to promise clinical outcomes within this short time frame at the practice level although many of
our trainees are excited by their success with their patients!
Publications on Motivational Interviewing
“Improving knowledge, attitudes and beliefs about acute coronary syndrome through an
individualized educational intervention: a randomized controlled trial.” O'Brien F, McKee
G, Mooney M, O'Donnell S, Moser D.
Conclusion: Ensuring patients retain information post education has always been difficult to
attain. This study demonstrated that patient education using motivational interviewing techniques
and an individualized approach has the potential to alter knowledge, attitudes and beliefs about
ACS among a high risk population.
“Motivational interviewing to increase physical activity in people with chronic health
conditions: a systematic review and meta-analysis.” O'Halloran PD, Blackstock F, Shields
N, Holland A, Iles R, Kingsley M, Bernhardt J, Lannin N, Morris ME, Taylor NF.
Conclusion: The addition of motivational interviewing to usual care may lead to modest
improvements in physical activity for people with chronic health conditions.
“Using motivational interviewing for smoking cessation in primary care.” Ridner
SL, Ostapchuk M, Cloud RN, Myers J, Jorayeva A, Ling J.
Conclusion: Resident physicians who use MI techniques have a tremendous effect on
patients' smoking behaviors. When the resident physician and the RN worked together,
participants achieved better outcomes.
“Motivational interviewing in medical care settings: a systematic review and meta-analysis
of randomized controlled trials.” Lundahl B, Moleni T, Burke BL, Butters R, Tollefson D, Butler
C, Rollnick S.
Conclusion: MI was robust across moderators such as delivery location and patient
characteristics, and appears efficacious when delivered in brief consultations.
Any organization should be thoughtful about implementation planning to really leverage the training and
to allow enough time for outcome changes to be measurable.
This document was created by CQC & the Centre for Collaboration, Motivation and Innovation (CCMI).
Questions? Contact Jen Burstedt at California Quality Collaborative (CQC) at
[email protected] | 415-615-6306 | Date: Saturday, February 06, 2016
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