Patients' Health Goals in Montana, with Be Prepared to Be Engaged

Earlier this year, Vicki Thuesen, NP, learned about a simple new strategy to better patient outcomes during a Migrant Clinicians Network and the National Nurse-Led Care Consortium learning collaborative. The strategy, titled Be Prepared to Be Engaged, aims to help patients and their families prepare for and become more fully engaged in their medical appointments. “The presenter had said they had been using it, and studies were showing that this type of interaction increased patients’ engagement in care, which is something we’re always trying to improve,” Thuesen recalled. “I thought, well, let’s try it!”

Thuesen found that Be Prepared to Be Engaged, which was developed by the Agency for Healthcare Research and Quality, was deceptively simple. Patients fill out a one-page Patient Prep Card that has three prompts on it: “Today I want to talk about…”; “My questions are…”; and “My health goals are…”  Thuesen is the Clinical Director of the Montana Migrant and Seasonal Farmworkers Council, a community health center made up of five clinics in Montana. She’s also a member of MCN’s Board of Directors.  Directly after the webinar, she rolled out the strategy in one of the five clinics.

“We’ve had very positive response in our clinic, and we’re actually enjoying it!” she said. “We learn things about the patients that I don’t think they’d tell us, things that we wouldn’t have found out if we hadn’t given them the form.”

The clinic’s workflow easily provided the space and materials to integrate the one-pager. “We already give [patients] a clipboard when they walk in the clinic,” she said, to fill out the waiting room intake forms. Thuesen encouraged the nurses in the clinic to give the Be Prepared to Be Engaged form when the patient moves from the waiting room into the exam room.

“We already have a waiting room intake form, and at the top, it asks ‘what are you here for today?’ -- but it must be the way this form is written,” Thuesen surmised. “It’s hard to understand why we’re getting different results. But we are.”

In addition to the Patient Prep Card, the toolkit includes a simple Patient Note Sheet, where patients can write down important information about their health and next steps. The simple gesture -- providing a place to write down important information -- may make all the difference in getting results.

One patient, a worker on an H2A visa, has been a patient since the clinic’s opening five years ago. The patient has been learning English and was excited to try out the form in English. His form said: “My health goals are: stay physically active; not worry about the future; eat more vegetables and fruit; drink less alcohol; ride my bicycle whenever I can.”

“He’s an older man, and he doesn’t usually say much,” Thuesen explained. “We didn’t know that they would be goals of his until we started doing this. That’s what made it so fun! We talked a lot about it.”

Thuesen is excited to roll the strategy out in all five of her clinics, and encourages other clinical teams to talk with their quality management staff, as the strategy may be a way to improve UDS measures and scores. “We’re all looking for ways to engage patients and improve their care,” and this may be a relatively easy way forward that requires minimal additional staff time or training, she said.

“Sometimes you see a patient, and you think, ‘I just don’t know what to say,’ because they haven’t met any of the goals we’ve set,” Thuesen admitted. Be Prepared to Be Engaged, she says “seems to engage patients more than just discussion.”

Learn more about Be Prepared to Be Engaged, access the toolkit and materials, watch a webinar, and more at the Be Prepared to Be Engaged webpage.

Sign up for MCN’s webinars and learning collaboratives on our Upcoming Webinars page.