Chronic Diabetes in Primary Care
Motivational interviewing is a collaborative conversation and decision-making process between a health practitioner and the patient receiving treatment (Butler et al, 2007). Although the process of motivational interviewing involves many stakeholders, only the patient can make the initiative in changing behavior and lifestyle to improve their health and avoid destructive behaviors (Miller &Arkowitz, 2007).
The key stakeholders that need to be involved in this motivational interviewing change improvement project at Ben Taub hospital include:
1) Diabetes Patient’s immediate families
2) Primary care staff and health providers including nurses and other health care practitioners
3) Chief of primary care
4) Hospital management
5) Patients
The policymaker and the health practioners should explore the contents and the recommendations of the motivational interviewing program. In the communication process, the policymaker may share information about the impact of the program on treatment of diabetes patients, the experiences of other health Practitioners with the program and the challenges associated with the implementation of the program. The policy maker must also inform the health practitioners about the necessary changes necessary in health care operations for the successful implementation of the program.
Another important communication point essential for health practitioners should be an explanation of the roles of each health practitioner in the implementation of the program. The policy maker should also seek the support of the primary care givers in the implementation of the program.
The main communication points between the primary care givers and the policymaker should include the role of the primary care provider in the implementation of the program like preparing patients for the motivational interviewing process, and the Communication of feedback and evaluation of the program.
The advantages of the motivational interviewing program to patients should also be thoroughly discussed with primary care givers. The challenges and the barrier associated with the program should also be thoroughly discussed with primary care givers so that they can have knowledge about the barriers to anticipate ion the implementation of the program.
Nurses and the health practitioners are the pillars of the change process in motivational interviewing (Burke et al, 2007). The communication points between nurses and the policymaker in this change project should entail communication about their roles in the change process. Other communication points that need to bee explored are the benefits of motivational interviewing in behavioral change process and the challenges associated with the implementation of the motivational interviewing project in the hospital.
The communication points between the policymaker and the immediate family members of diabetes patients should entail discussing the role of the immediate family members in the change program liker enhancing and encouraging the patients in the change process. This support can ensure that the patients remain within the set plans and goals of the change process.
The communication points between the policymaker and the head of primary care should entail an explanation of the role of the head of primary care in the implementation of the motivational interviewing project and the benefits of the motivational interviewing program.
The main communication points of the policy maker with the hospital management should entail communication about the role of the hospital management in the implementation of the motivational interviewing program. In the communication process, the policymaker may share information with the hospital management about the impact of the program on treatment of diabetes patients, the experiences of other health Practitioners with the program, the challenges associated with the implementation of the program and the necessary changes in health care operations for the successful implementation of the program.
It is also imperative for the policymaker to share information about the cost of the motivational interviewing project to the hospital with the hospital management. The policymaker should also share the benefits of the motivation interviewing in improving the health outcomes of the diabetes patients, the modalities of the implementation program and the challenges and barriers to proper implementation of the project.
Anticipating blockages of the implementation of the project and strategies of overcoming them
One of the main challenges that face the process of motivational interviewing is the lack of enough time by primary care givers to engage in motivational interviews with patients (Miller &Rollnick, 2002). According to Miller &Arkowitz, (2007), other challenges that motivational interviewing faces are:
Initiation of the discussion around lifestyle modification is always a challenge for many patients.
Lack of sufficient follow up plans for patients.
Lack of knowledge and counseling skills about motivational interviewing by the health practitioners
Lack of resources to support fully the process of motivational interviewing
The barrier of primary care givers having little time with patients for motivational interviews can be reduced through the overhaul of the process of primary care for diabetes patients. The process of primary care for diabetes patients should include the process of motivational interviewing in the continuum of diabetes care. The Enrollment of nurses in motivational interviewing programs can enhance their counseling skills and make them able to initiate meaningful conversations with patients.
References
Butler C., et al (2007). Motivational interviewing in health care helping patients change
Behavior.London: Guilford press.
Miller W. &Rollnick S. (2002) Motivational interviewing preparing people for change. London:
Guilford press.
Miller W., &Arkowitz H., (2007).Motivational interviewing in the treatment of psychological
Problems. London: Guilford press.
