Advancing the Patient Experience of Care

 

Practice Transformation Institute (PTI) will soon start an innovative Continuing Medical Education (CME) monthly series called Advancing the Patient Experience of Care. The six-part series is designed to identify and develop the skills essential for providing a positive patient experience of care within the clinical setting. A patient’s experience is enhanced through effective communication, obtaining patient feedback, interacting with diverse generations, using the spirit of motivational interviewing (MI) and MI tools, and exhibiting cultural competency and humility. Using measurement in determining areas for quality improvement in the patient experience of care will be explored.

Here is a quick look at the series schedule and what will be covered.

January 22, 2025, Part One: Impact of Effective Communication

• Describe the link between the Quintuple Aim, the Chronic Care Model, and the patient experience of care
• Explain the four essential parts of communication: sender, receiver, message, feedback
• Discuss active listening as essential to effective communication  
• Demonstrate the use of feedback to improve the patient experience of care

February 26, 2025, Part Two: Multi-Generational Approach

• Identify the five generational groups within the patient population
• Describe the traits and characteristics of five generational groups
• Create two communication strategies that reflect generational differences in the practice setting

March 26, 2025, Part Three: Spirit of Motivational Interviewing

• Define motivational interviewing
• Describe the four components of the spirit of MI (partnership, acceptance, compassion, empowerment)
• Discuss how using the spirit of MI will lead to increased patient engagement and self-management
• Create a plan to improve one’s use of one component of the spirit of MI

April 23, 2025, Part Four: Using Motivational Interviewing

• Describe three of the five basic tools of MI (open questions, affirmations, reflections)
• Identify situations in which one would use each of the tools described
• Discuss why the spirit of MI is necessary to effectively use the tools of MI
• Demonstrate use of the three basic tools discussed in this activity within a case study

May 28, 2025, Part Five: Cultural Understanding

• Define culture
• Differentiate between cultural competence and cultural humility
• Discuss why it is important to be both culturally competent and exhibit cultural humility in a health care setting
• Identify how effective communication and use of MI skills support cultural humility
• Develop a plan to enhance cultural humility impacting a significant culture within one’s practice

June 25, 2025, Part Six: Using Data

• Identify common surveys/questionnaires that measure patient experience of care
• Describe how to use information from patient experience of care surveys/questionnaires to improve processes within the clinical setting
• Identify methods to increase response rates to routine patient experience of care surveys/questionnaires
• Discuss the impact of patient experience of care on quality of care measures

These live virtual CME activities start January 2025 and will go through June 2025. Each activity will be on the 4th Wednesday of each month for 90 minutes with two choices for attendance, either from 7:30 AM – 9:00 AM or 12:00 PM – 1:30 PM. Each activity may be taken separately for 1.5 AMA PRA Category 1 Credits™. If all six activities are attended, 9 AMA PRA Category 1 Credits™ may be claimed. The greatest benefit will be realized by attending the entire series.

Michigan certified physician assistants (PAs) can use continuing medical education (CME) activities for physicians to meet their licensure requirements. The Michigan Board of Nursing accepts AMA PRA Category 1 credit(s) for nurses with one AMA PRA Category 1 credit being equal to one contact hour.

We invite you to join us for this great monthly series. Please see the link below for registration. If you have any questions or request further information, please contact yyang@transformcoach.org or hkinkle@transformcoach.org.

More information and registration: https://transformcoach.org/learning-solutions/advancing-the-patient-experience-of-care-series/

The Practice Transformation Institute is accredited by the Michigan State Medical Society to provide continuing medical education for physicians.

Practice Transformation Institute designates this live course for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. (Each live course is awarded CME)

Community Health Workers and COPD

 

Community Health Workers (CHWs) are a bridge to the communities they serve and the health services needed by their clients/patients. Assisting in managing chronic condition care is a role of the CHW and is a part of PTI’s Community Health Worker Program. 

One of the chronic conditions discussed in PTI’s Community Health Worker Program is chronic obstructive pulmonary disease (COPD.) COPD blocks airflow into the lungs and can cause long-term breathing problems due to inflammation inside the airways. Chronic bronchitis and emphysema are the two most common types of COPD. Over sixteen million people in American have been diagnosed with COPD. Unfortunately, there is no cure, but it can be controlled with good management. Tobacco smoke is the key factor causing COPD, but air pollutants in the home and/or workplace, genetic factors, and other respiratory factors are additional causes.

Symptoms of COPD include:

• Shortness of breath
• Excess mucous, phlegm, and/or sputum
• Coughing
• Wheezing
• Chest tightness
• Trouble taking a deep breath
• Fatigue 
• Dizziness or lightheadedness

There are many ways that COPD can affect the activities of daily living. These can include:

• Difficulty climbing stairs or walking
• Limiting the ability to engage in social activities due to symptoms
• Increase in confusion or memory loss
• Needing oxygen in and outside of the home
• Reducing the ability to work due to the disease process
• Increase in emergency room visits or hospitalizations

There are many things that a CHW can do to help their clients/patients with COPD. Eating healthy and getting physical activity are both important for all chronic conditions. A CHW can provide education and any needed lifestyle changes at home visits. As an example, quitting smoking is the most important thing someone can do to manage COPD. It would be important to discuss a client’s/patient’s readiness to quit, provide encouragement, education of the health risks associated with smoking, and help build self-efficacy in the ability to quit. A client/patient may need behavioral support, a support group, and/or medications and nicotine replacement therapy (NRT) for smoking cessation. Think about what referrals could help manage the cost of quitting smoking and check for any health insurance benefits. Possibly contact the local health department for resources, looking into coupons or co-pay cards through pharmacies, pharmaceutical companies’ patient assistance programs, and other websites or apps to find free or low cost NRTs and to help with the cost of inhalers. All of these things may be overwhelming and cause confusion and anxiety to the client/patient. A CHW’s help can be priceless!

Completing a social determinants of health (SDOH) screening and assessment can give more information on the big picture of the client’s/patient’s health. The CHW can address the findings by looking into community resources to investigate and recommend, and then follow up with the client/patient to see if the need was met. SMART goals and actions plans work together to provide a framework to achieve any goals. Motivational interviewing techniques are a client/patient-centered counseling style for addressing behavior change. CHWs can also raise awareness in the community regarding the risk factors for COPD. All of these items and more are discussed in PTI’s Community Health Worker Program.

Professional development is also an important part of being a CHW. Think about what learning opportunities would benefit the CHW and their client/patient interactions. There is valuable information on the links below on COPD management, managing COPD at home, questions for the healthcare visit, and recognizing and preparing for emergencies that may help clients/patients. 

The COPD Caregiver's Toolkit | NHLBI, NIH

During this COPD Awareness Month, take the time to learn more about COPD in order to support clients/patients, family members, and friends who are living with it.

https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/learn-about-copd/copd-awareness-month# 

https://www.nhlbi.nih.gov/health-topics/education-and-awareness/copd-learn-more-breathe-better/copd-awareness-month 

Practice Transformation Institute (PTI) is an approved provider of CHW training by the Michigan Department of Health and Human Services (MDHHS.) For more information on PTI’s Community Health Worker Program, please visit our website below. 

https://transformcoach.org/learning-solutions/community-health-worker-chw-program/ 

Health Literacy is a Long Game

 

As health care professionals, sometimes we forget that patients don’t understand what we may be telling them about their health. Even subjects like healthy eating when discussing carbohydrates, fats, and proteins can be difficult to comprehend for the lay person. Medical terms like unconscious or conscious, febrile or afebrile, and positive or negative are all examples that a patient may not understand. Think about a subject that you may know nothing about like physics, for example. If someone started rattling off terms such as binding energy, centripetal force, or escape velocity, you may not have a clue about this unfamiliar subject.

Health literacy is about people being able to find, understand, and use health care information. The more people understand the health information they are given, the more they can make informed decisions that can improve their health. Health literacy is a health equity issue, too, as race, ethnicity, education, socioeconomic status, and age can all factor in.

Attaining health literacy is a main focus of Healthy People 2030. The Healthy People initiative is written by the U.S. Department of Health and Human Services (HHS) and has been setting goals every decade since 1980. It serves as a guide to improve the health of our country at local, state, and national levels. The following information is from the U.S. Department of Health and Human Services.

5 Things to Know About Health Literacy

1. Organizations and professionals can improve their health literacy by using proven strategies, like answering questions in simple, non-medical language and developing and testing written materials with the audience they want to reach
2. Universal health literacy approaches benefit everyone. Vulnerable people like older adults, people who have difficulty reading and using numbers, or people who are not fluent in English face the biggest challenge. Anyone can have trouble understanding health information. If we act as though anyone is at risk of misunderstanding health information, everyone is better off.
3. Providers can use health literacy strategies to encourage people to take part in decisions about testing, treatment, and procedures. This lets people make healthcare decisions that fit their values, goals, preferences, and circumstances.
4. Clear communication between providers and patients improves health literacy, particularly if providers take the time to listen with respect and make information easy to understand. Checking to make sure patients understand the information is also important to ensure patients are informed.
5.  Being health literate will help people make informed decisions and take actions to improve their health. Being health literate can help people achieve their goals, whether this is trying to manage a chronic condition, engage in a healthy lifestyle, or take precautions to avoid getting sick.

With October being Health Literacy Month, let’s make it a priority to think about the information we are giving to patients and the words that we use. Look at what you’re saying from their point of view. Use patient-centered communication and the teach-back method for patients to state, in their own words, what health information was given.

New health care professionals come into the mix all of the time and will need training on the many key topics within health literacy. Seasoned health care professionals can always improve their health literacy skills with support and training. We have already been working many years on this subject. That is why health literacy is a long game. And as long as we continue to work at it, success will come.

https://www.cdc.gov/healthliteracy/learn/index.html

http://www.health.gov/health-literacy 

https://www.youtube.com/watch?v=BG-iY-em7mk

Fall Cleanup

 

It is that time again. Time to think about what needs to be done as we head into the fall season. Hmm. Let’s see. The kids are back in school and any after-school activities have been scheduled, the yard needs major upkeep with all the overgrowth and deteriorating flowers, the house insists on fall decorations inside and out, and, by the way, immunizations may be needed for someone in the family. Okay. Maybe that last one doesn’t automatically come to mind, but it is important. Let PTI help!

The Centers for Disease Control and Prevention (CDC) sets the adult and childhood immunization schedules based on recommendations from the Advisory Committee on Immunization Practices (ACIP). A few updated vaccinations were added to the schedules and, as always, it is best to check if something has been missed previously to make sure everyone in the family is up to date.

Getting vaccinations “on-time” with the childhood immunization schedule is important. Children who aren’t vaccinated on schedule are not only at risk of becoming ill themselves but can also spread illness to others who are not protected; this can include newborns who are too young for vaccines and people with weakened immune systems. Adults need to keep vaccinations up to date because immunity from childhood vaccination can wear off or wane over time.

Here are the latest updates for fall 2024:

COVID-19

The virus that causes COVID-19 is always changing and protection from COVID-19 vaccines declines over time. Receiving an updated vaccine can help protect an individual against the variants currently responsible for most infections and hospitalizations. It also reduces the chance of getting what is called “long Covid” which is an extension of health problems after having COVID-19.

• The CDC recommends the updated 2024-2025 COVID-19 vaccination for everyone 6 months of age and older
• For fall 2024, the CDC does not expect to initially recommend an additional dose of 2024-2025 COVID-19 vaccine for people 65 and older who are not moderately or severely immunocompromised

Flu

Most people only need one dose of the flu vaccine each fall. September and October remain the best times for most people to get vaccinated.

• The CDC recommends the updated 2024-2025 flu vaccine to everyone 6 months of age and older

Pneumococcal vaccine

There is a new vaccine called PCV21 that protects adults from pneumococcal disease. The vaccine has been updated from previous pneumococcal vaccines and contains eight new pneumococcal serotypes (classifications of the bacterium Streptococcus) that are not contained in currently available pneumococcal vaccines.

• The CDC recommends pneumococcal vaccination for many adults that is based on age, risk conditions, and pneumococcal vaccines that have already been received. It is recommended to talk to a health care provider about available options and what is best for a specific situation.
• PCV21 is an option for adults 19 years and older who currently have a recommendation to receive a dose of PCV

RSV (respiratory syncytial virus)

• The CDC recommends that adults 60 and older get an RSV vaccine if they are at increased risk of RSV disease. Talk to a health care provider about available options and what is appropriate based on the individual’s health condition.

Vaccine schedules can sometimes feel complicated to read and understand. Any questions can be directed to a health care provider. As we ease into fall, make sure all family members are up to date on their immunizations and check this off of your fall to-do list. Leaves are falling and autumn is calling!

https://www.cdc.gov/ncird/whats-new/cdc-updates-vaccine-recommendations-july-2024.html#:~:text=For%202024%2D25%2C%20ACIP%20recommended,RSV)%20vaccine%20for%20older%20adults.

https://www.cdc.gov/vaccines/hcp/imz-schedules/adult-age.html

https://www.cdc.gov/vaccines/hcp/imz-schedules/child-adolescent-age.html

Using Our Mind for Self-Care

August 2024
 

Relaxing on the beach in Cassville, MI. Photo by Yang Yang

Life can be rough. We all know that there are times that are rougher than others. We may be stressed, anxious, and have difficult emotions. What we may need to do is work on our wellness. But we also may feel guilty taking time for ourselves or practicing self-care when so much needs to be done elsewhere. STOP. It is vitally important for us to find ways to cope not only with the small day-to-day problems like grocery lines or slow traffic, but during those really difficult times in life. It is okay to think about ourselves. We can still do that while caring for and helping others. In fact, if we don’t take care of ourselves, we may be unable to help someone else.

Self-management is the use of many different skills or tools to manage behaviors, thoughts, and emotions. Some of these can be related to chronic health conditions and how to manage changes associated with them in order to carry out everyday activities. Other self-management skills can be used in other areas of life beyond chronic conditions. Some of these tools work better than others. It is important to try and see what works because everyone is different. This blog talks about relaxation techniques that use our mind to manage stress and negative emotions.

What does relaxation help?

• Reduces anxiety and stress

• Promotes emotional health

• Helps focus

• Enhances coping skills

• Gives us more energy

Mindfulness means paying close attention to our thoughts and feelings in that moment. Life is so busy that so many people aren’t really present. We may seem like we are running on autopilot to do our job, chauffeur the kids to their activities, make dinner, and get put on repeat for the next day. We jump around from thought to thought. We are impatient. Being mindful encourages us to pay attention to our thoughts, actions, and how our body reacts to them at the time they are happening. We don’t judge these moments as happy, sad, good, bad or react negatively to them. We realize they are there by observing them. Being mindful can help us realize how our mind races back and forth to the past or the future or a worry without being in the moment. Being in the moment helps us slow down and calm down.

Mindfulness can be practiced anywhere, like waiting in a grocery store line. Focus on becoming more aware of what is going on in that moment. We may hear people moving past with their shopping carts, voices conversing negatively or positively, children crying, cash registers beeping. We may see shoppers smiling or frowning, clerks packing groceries, people putting money into the lottery machine. We accept things just as they are. No judgment. This can be useful for something like healthy eating, too. Focus attention on each bite of food thinking about the taste and texture and flavor. Stop when our body lets us know it is full. This is mindful eating.

Guided imagery is imagining positive imaginary scenarios like a daydream we control to put our self into amore relaxed state of mind. It’s thinking about an image that is peaceful and soothing and pleasant. Close our eyes and breathe in a few slow and deep breaths. In through the nose and out through the mouth. Use as much detail as possible and all of our senses. If a favorite place to be on vacation is a beach, then what comes to mind when thinking about being there? Feel the smooths and on our feet as we walk along the beach. Listen to the incoming waves and watch them roll over our feet, cooling them. Feel the warm sun on our back as we walk. Hear the sounds of children laughing as they look for shells or play with toys. Look up to the sky and notice the seagulls flying and squawking, and the pelicans diving for fish. Do we smell salty air? Are there ships in the distance? Focus on as much detail as possible. Use all of the senses. If something comes to mind that we don’t like or causes distress, then throw it out to sea. Redirect the mind. Instead, think about the taste of the cold Margarita that will be waiting once we get back to the hotel pool. The mind drifts and the body relaxes.

There are scripts for using this technique or make up one as was done above. Whether we are actually at the beach practicing mindfulness or using guided imagery to imagine we are at the beach, we are in the moment and hopefully relaxing. Enjoy being in the moment and smile. Vacations, either real or imagined, don’t last!

Visualization is closely related to guided imagery to relieve problematic symptoms. It helps create a picture of us doing something we like or want to do. The mind creates images that we see. It helps build confidence. During the current Paris Olympics, television commentators discussed how some of the athletes use visualization to get their mind in control before an event as the athletes think about the exact way that they want to perform. Interesting stuff for sure!

Distraction can help train the  mind to focus on other things besides the stress or discomfort that we are experiencing. We are not ignoring symptoms but are choosing not to let them bein control. Since our mind can’t focus well on more than one thing at a time, we are able to turn off the other one that is causing us distress. There are aplenty of things that could be tried to help with short-term distraction such as counting backwards by twos, thinking of a kind of bird for each letter in the alphabet, trying to remember words to a favorite song as examples. This technique may also help with sleep problems. If we let a distressing thought creep in, then say “stop” either out loud or in our mind. Longer term distraction involves focusing on an activity such as cooking, gardening, painting, or going out to a movie, for example.

Positive self-talk helps us have control over a situation with helpful thinking. It can help us feel stronger. We are always talking to ourselves. Positive self-talk can help control how our mind thinks about events and how we feel. We can then explore what actions can be taken. Part of this can be taking negative thoughts and looking for something positive in those thoughts instead. This can be hard at first but gets easier the more it is done. Some people put positive affirmations inwriting and place them around their home to help.

Relaxation techniques can also include doing things we like to do. These are tools that can shift our mind and mood to a better place. It is important for our own well-being to add pleasurable activities to the week. Think about the activities that help with relaxation.

They might include:

• Connecting to something larger than ourselves: prayer, spirituality, meditation

• Creativity with cooking, crafting, drawing, gardening, painting

• Finding a stress reduction program

• Focusing on breathing techniques, yoga, meditation

• Getting a massage or facial

• Getting a good night’s sleep

• Going out to dinner to a favorite place

• Journaling

• Listening to music or making our own music

• Napping

• Playing with a child or pet

• Practicing gratitude or acts of kindness

• Reading books on subjects we enjoy or trying a self-care book

• Seeing or calling a friend

• Spending time outside in nature or in a park

• Taking a break from technology

• Walking, bike riding, working out

• Watching a movie

• Volunteering

Busy times and downright bad times. We all have our share. They are a part of life. Techniques that use our mind are away to relax. Our problems and worries may not actually go away, but we get a break from them. If we feel like more help is needed, it is okay to ask for support and treatment from a primary care provider or mental health professional. Be kind to ourselves just as we seek to be kind to others. We are worth it.

https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/positive-thinking/art-20043950

https://www.psychologytoday.com/us/basics/mindfulness

https://www.webmd.com/balance/what-to-know-about-guided-imagery

The Power of Parks

 

It seems like those of us in the health and wellness professions are always harping on the benefits of physical activity. But it is true! Physical activity has many benefits for all age groups. It is well-documented that being active is one of the most important things you can do for your health. With July being Park and Recreation Month, this is a good time to think about how important parks can be for us. With athletic fields, hiking trails, bike paths, playgrounds, and more, they can assist with the physical activity goals that we have set for ourselves and our families.

The CDC continues to recommend that children have 60 minutes or more of physical activity per day and adults 150 minutes a week. The activity can be broken up into various increments with whatever works for the individual. What does physical activity do? Physical activity helps us feel better, function better, and sleep better.

Children:

• Improves attention and memory
• Reduces depression risk
• Builds strong muscles and increases endurance
• Improves blood pressure and aerobic fitness
• Helps maintain normal blood sugar levels
• Reduces the risk of type 2 diabetes and obesity
• Strengthens bones
• Helps regulate body weight and reduce body fat

Adults, including those 65 and older:

• Immediate benefits: improves sleep quality, reduces anxiety and blood pressure
• Long-term benefits: brain health (reduces risk of dementia and depression), heart health (lowers risk of stroke, heart disease, type 2 diabetes), cancer prevention (lowers risk of cancer to bladder, breast, colon, endometrium, esophagus, kidney, lung, stomach), healthy weight (reduces risk of weight gain), independent living (helps people live independently longer), bone strength (improves our bone health), balance and coordination (reduces risks of falls)

This year’s Park and Recreation Month focuses on the recognition of more than 160,000 full-time park and recreation professionals, along with hundreds of part-time employees, seasonal workers, and volunteers who maintain our country’s parks. The theme for this year is “Where You Belong” which celebrates all of the ways that park and recreation professionals across our country promote a sense of belonging for all people. This includes welcoming and inclusive programs and fundamental services for all ages and abilities in the hope of making meaningful connections with others.

Let’s continue to support the importance of parks and recreation in keeping our families and communities healthy. If you need a little inspiration (along with a few laughs), watch an episode of Parks and Recreation again. Afterwards, go find a park and soak up the nature and beauty that surrounds you. Breathe deep, then get moving.

Discover the Forest
https://discovertheforest.org

 

Huron-Clinton Metroparks
https://metroparks.com

Michigan National Park Service
https://www.nps.gov/state/mi/index.htm

U.S. National Park Service – Find a Park

https://www.nps.gov/findapark/index.htm

https://www.nrpa.org/events/july/

https://www.cdc.gov/physical-activity-basics/benefits/index.html

June is Cataract Awareness Month

 

We may often think that only older people get cataracts. But did you know that if there is someone in your family with cataracts, you are at a higher risk for them yourself? June is a National Health Observance Month for cataracts so the public can be educated on this leading cause of vision loss, along with the symptoms, types, and surgery.

Did you know that cataracts are the world’s leading cause of blindness in approximately forty-two percent of all cases? That was surprising to hear. Here in the United States, there are more than twenty-five million people that are estimated to have cataracts.

What is a cataract?

It is a clouding of the lens of the eye. The lens blocks or changes as light passes through the eye and is normally transparent. It is located behind the pupil and the colored iris. Having a cataract stops light from passing to the retina so vision may be blurry or dim.

Symptoms:

• Light seems to be too dim to read or do close-up work
• Bright lights cause the loss of clear vision
• Hard to drive especially at night
• May see halos around lights
• Colors may not seem as bright
• Blurry vision, double, vision, feeling like a film is over the eyes
• Seeing a yellowish or milky spot in your pupil

Risk factors:

• Older age
• Hereditary
• Intense heat, radiation, exposure to UV sun rays
• Eye inflammation
• Diabetes, arthritis, metabolic disorders
• Eye injuries
• Eye infections
• Certain medicines such as long-term steroid use or cancer medication
• Infection during pregnancy with measles or rubella
• Smoking

If you have any of the symptoms along with the risk factors listed above, see your eye care professional who will be able to diagnose a cataract during a dilated eye exam. You and your doctor can discuss what treatment would work best for you at this time. Surgery doesn’t always have to be done early on. Sometimes brighter lights at home, anti-glare sunglasses, or new glasses or contacts can help. If cataracts progress, then surgery becomes the option.

Cataract surgery is an elective procedure done with lasers. Providers recommend to patients to have it done when the cataract causes enough vision loss to interfere with their daily lives. The clouded lens is removed and replaced with an artificial lens implant. It is an outpatient procedure. Oftentimes, patients can resume their normal activities in a few days with vision continuing to improve in the weeks and months ahead.

It is nice to know that cataracts are easily treatable. In this Cataract Awareness Month, it is important to stay informed about one of the leading causes of vision loss in our country.

http://preventblindness.org/cataract/

https://preventblindness.org/wp-content/uploads/2021/05/MK08-Cataract-Facts-1.pdf

https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/cataracts

Congrats to PTI!

Practice Transformation Institute (PTI) has received great news! We have been recognized as a Michigan Department of Health and Human Services (MDHHS) approved Community Health Worker (CHW) Program and have received Full Approval! This is wonderful news not only for PTI but for the practice teams, health care organizations, and communities who will benefit from the program that we have worked so hard to develop.

Our Community Health Worker Program teaches the core competency skills and health knowledge necessary to function as a CHW in a variety of community settings. We include information on healthy lifestyles, prevention and screening, and the most common chronic conditions. There is an emphasis on communication and motivational interviewing skills in order to enhance patient interactions. We also focus on the social determinants of health (SDOH) with attention given to health inequities, health literacy, and cultural humility and competency. Lots of great stuff for a potential CHW to learn!

Participants in our program will be eligible to bill for allowable services for Medicaid, Medicare, and BCBSM. Teaching excellence along with our leading-edge curriculum supports the participants in achieving the learning objectives of the program. The program also offers IACET CEUs that are recognized by a wide range of organizations, including professional organizations, regulatory boards, corporations, and universities.

According to the Bureau of Labor Statistics, the employment of CHWs is projected to grow 14 percent from 2022 to 2032 with about 8000 openings projected each year over the decade. If you are not yet familiar with CHWs, let us fill you in.

What is a CHW?

• A frontline public health worker who can be the bridge to a healthier community
• An advocate and liaison to connect individuals and families to health care and social services
• A person who has a strong connection to the community in which they serve
• Someone who may share the same ethnicity, race, language, socioeconomic characteristics, cultural, spiritual beliefs, and life experiences as found in the community
• A person who can work in urban or rural environments and with low-income, minority, immigrant, and underserved communities including those with limited English proficiency (LEP)
• A CHW can have diverse job descriptions as well as job titles depending on the organization in which they work

What are the roles of a CHW?

• Support and organize community outreach activities
• Work with state and local social services organizations
• Build trust within the community with access to culturally competent and language appropriate services
• Assist with health insurance enrollment and appropriate use of services
• Navigate the health care system and connect with community resources
• Link with health care providers that are culturally and linguistically competent
• Work as a liaison between health care providers and the community
• Support behavioral health by coaching and the use of motivational interviewing techniques
• Perform health screenings and disease prevention to improve health outcomes and reduce disparities
• Promote understanding and self-management of chronic conditions

Where do CHWs work?

• Assisted living facilities
• Behavioral health organizations
• Community focused organizations, including faith-based organizations
• Health insurance companies
• Legal clinics
• Nursing homes
• Primary care and specialist medical practices
• Public health departments, hospitals, clinics
• Schools
• Senior centers

See PTI’s website for more information on the Community Health Worker Program. We look forward to meeting you.

https://transformcoach.org/learning-solutions/community-health-worker-chw-program/ 

Rethink Your Drinking in Alcohol Awareness Month

Springtime is a fun time for a lot of us. Vacations may increase with the kids off for Spring Break and we are all ready to blow past the winter with the fun of the warmer temperatures. Party days are ahead. But there may be some of us who need to pay more attention to how we use those party days.

April is Alcohol Awareness Month and this is the time to increase not only public awareness about alcohol but education regarding the treatment and the prevention of alcohol abuse. Alcohol abuse is a preventable disease and treatments for it are good.

The 2020-2025 Dietary Guidelines for Americans continues to recommend one drink or less a day for women and two drinks or less a day for men. Alcohol misuse or heavy drinking is described as four or more drinks on any day or eight or more per week for women; for men it is five or more drinks on any day or fifteen or more per week.

Alcohol Use Disorder (AUD) is defined as an impaired ability to stop or control alcohol use despite social, health, or occupational consequences. It can cause lasting changes in the brain and can make patients vulnerable to a relapse. Most people who have AUD benefit from treatment such as behavioral therapies, medications, or a combination of both.

Signs of an Alcohol Use Disorder:

• Hearing comments from friends and family about how much you drink
• Spending more time drinking or thinking about drinking than you used to
• Drinking more or longer than you planned to
• Trying to cut down or stop drinking but being unable to
• Feeling depressed or anxious when drinking but continuing to drink
• Drinking interferes with work and social activities
• Having legal problems due to drinking
• Experiencing withdrawal symptoms when you don’t drink such as tremors, headaches, insomnia, anxiety, sweating

When someone drinks above the recommended limits their risk is increased for:

• Mental health conditions
• High blood pressure
• Stroke, heart disease, digestive problems
• Poor sleep
• Liver disease
• Cancer

“Rethinking Drinking” https://www.rethinkingdrinking.niaaa.nih.gov/ is a government website with lots of great information on alcohol and health. Items include learning about the guidelines for drinking, seeing signs of a problem, and using website tools to make a change. The website goes over what counts as a drink, how many drinks are in common containers, what’s your pattern, thinking about a change with pros and cons/readiness for change/a plan for change, strategies for cutting down, and support for quitting. Really good stuff here. Building new and healthy habits is the key to change whether this is done by increasing physical activity, eating healthily or cutting down on alcohol consumption when needed.

If more help is needed, SAMHSA (Substance Abuse and Mental Health Services Administration) has a national helpline in English and Spanish that is free and confidential, 24 hours a day, seven days a week for information and treatment referral for mental health and/or substance use disorders. 800-662-HELP (4357). People can also contact their primary care office or health insurance organization for resources.

https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm

Have You Been Screened for Colorectal Cancer?

 

Colorectal cancer is found in the colon or rectum. It is the second leading cancer killer in the United States when the numbers are combined for men and women. Screening can find precancerous polyps in the colon or rectum that can be removed before they have a chance to turn into cancer. Screening is also important to find existing colorectal cancer early when the treatment works the best.

Colorectal cancer screening recommendations from the American Cancer Society:

• Adults with an average risk start regular screening at age 45
• Done with either a sensitive stool-based test that looks for signs of cancer in a person’s stool or with an exam that visually looks at the colon or rectum
• People in good health with a life expectancy of more than 10 years should continue regular colorectal cancer screening through the age of 75
• Adults 76 to 85 years of age, the decision to be screened should be based on a person’s preferences, life expectancy, overall health and prior screening history

Colorectal cancer screening tests:

• Stool Tests
• There are 3 different stool tests to detect blood in the stool
• Guaic-based fecal occult blood test (gFOBT) – obtain a small amount of stool and return to the doctor or the laboratory. Stool samples are checked for blood. This can be done once a year.
• Fecal immunochemical test (FIT) – uses antibodies to detect blood in the stool. It can be done once a year and the same way as the gFOBT.
• FIT-DNA test (Colorgard®) – combines the FIT test with a test that detects altered DNA in the stool. Send the entire bowel movement to the lab where it is checked for blood. This is done every 3 years. Colorgard® may result in false positives for abnormal DNA markers that aren’t explained by subsequent colonoscopy findings.
• Flexible Sigmoidoscopy
• A short, thin, flexible lighted tube is put into your rectum. The doctors checks for polyps or cancer inside of the rectum and the lower third of the colon. It is done every 5 years or every 10 years with a FIT stool test every year.
• CT Colonography (virtual colonoscopy)
• Computed tomography uses x-rays and computers to produce images of the entire colon which are displayed on a computer screen for the physician to analyze. It is done every 5 years.
• Colonoscopy
• A colonoscopy is similar to the flexible sigmoidoscopy except the doctor uses a longer, thin, flexible lighted tube to check for polyps or cancer inside the rectum and the entire colon. During the test, the physician can remove most polyps and some cancers. The colonoscopy is also used as a follow-up test if anything unusual is found during one of the other screening tests. It is done every 10 years for people who do not have an increased risk of colorectal cancer.
• Colonoscopy is considered the gold standard!

There are many tests and it may be hard to decide which one works for you. Each test has advantages and disadvantages. Discuss this with your health care provider. There are many variables including your personal preference, medical conditions and problems that you may have, and a personal and/or family history of colorectal cancer and polyps.

Risk factors you cannot change include:

• Being older (more common after age 50)
• Racial or ethnic background
• Having an inflammatory bowel disease like Crohn’s disease or ulcerative colitis
• Inherited syndromes caused by gene changes

Risk factors you may be able to change:

• Having type 2 diabetes
• Lack of regular physical activity
• A lob-fiber and high-fat diet
• A diet high in processed meats
• A diet low in vegetables and fruit
• Being overweight or obese
• Alcohol consumption
• Tobacco use

Symptoms of colorectal cancer:

• There may NOT be symptoms early on
• A change in bowel habits, such as diarrhea, constipation or narrowing of the stool that lasts for more than a few days
• Feeling as though the bowel isn’t emptying
• Feeling like you needs to have a bowel movement but aren’t relieved by having one
• Blood in or on your stool
• Rectal bleeding
• Unintended weight loss

Talk to your health care professional if you have any of these symptoms. The symptoms may be related to something else, but it is better to make sure. As was mentioned earlier, the gold standard for colorectal cancer screening is the colonoscopy. Ultimately, though, the best screening method for colorectal cancer is the one that actually gets done.

The month of March is National Colorectal Cancer Awareness Month. Dress in blue on Friday, March 1 to show your support for colorectal cancer screening.

https://www.cancer.org/cancer/types/colon-rectal-cancer/detection-diagnosis-staging/acs-recommendations.html

Heart Healthy Living? Sign Me Up!

Getting woken up in the darkness of early morning by afamily member saying, “I’m having chest pain” is not the start of a good day for either party. The panic of that moment starts a rush of adrenaline and a call to action. Unfortunately, many people have been through that moment with somehaving good outcomes and others not so good. In this American Heart Month, there are plenty of ways to improve heart health inthe hopes that we never have to hear those words or say them to others.

Heart disease is the leading cause of death in the UnitedStates. The most common type of heart disease is coronary artery disease (CAD) which affects blood flow to the heart. CAD occurs when plaque, which is fatty, cholesterol-containing deposits, builds up in the coronary arteries and causesa narrowing of one or more of them. This plaque reduces blood flow to the heartand can cause partial or completely clogged arteries. Symptoms of a heart attack can vary, but many times there is chest pain which can feel like a tightness, pressure, or ache along with other symptoms such as fatigue,heartburn, dizziness, nausea and/or shortness of breath. Women may have symptoms to a lesser degree with jaw or neck pain, fatigue, and nausea. These can all be signs of an impending heart attack.

Healthy lifestyle choices can help prevent or treat some forms of heart disease. It is important to see your health care provider on a regular basis for physical examinations, lab studies, and medications when needed. Sometimes heart disease can be found early.

What do we have the power to control?

• High blood pressure (hypertension) – see your health care provider regularly as high blood pressure sometimes has no symptoms, take medication as prescribed, watch the amount of salt that is consumed in your diet

• High cholesterol (hypercholesterolemia) – take medication as prescribed, eat healthy with a diet high in fruits, vegetables, and whole grains, watch salt, cholesterol, and fat in foods

• Tobacco use – get help to quit smoking by using over-the-counter products or discuss with your health care provider for a prescription, avoid secondhand smoke in your home and car

• Stress – can be managed many different ways including talking to friends/family/therapist, finding solutions to current problems, getting plenty of sleep, meditate, deep breathing, eating healthy, and physical activity (can break the symptom of stress at that moment)

• Food choices – make dietary modifications for a healthy diet - reduced sodium, increased fruits, vegetables, whole grains, fat-free/low fat milk products, healthy oils, lean meats, fish, poultry, nuts, seeds, legumes, reduce sweets and other added sugars, DASH diet, Mediterranean diet

• Physical activity – current guidelines aim for 150 minutes of moderate intensity physical activity weekly and 2 days of muscle strengthening activity

• Weight – healthy eating and physical activity will help keep weight in the healthy range

What are risk factors that cannot be controlled?

• Age (the risk goes up as you age)

• Family history of heart attacks

• The risk for heart disease increases even more when heredity is combined with unhealthy lifestyle choices

Remember….

1. The most common type of heart disease is coronary artery disease (CAD).

2. Some of the risk factors that can be controlled are eating a healthy diet, increasing physical activity, reducing stress, not smoking, and taking prescribed medication for high blood pressure and highcholesterol.

3. Risk factors that cannot be controlled are age and family history.

4. See a health care provider on a regular basis to identify health issues early.

Disparities exist when race, ethnicity, and socio-economic factors are taken into account. Community Health Workers (CHWs) have a role inhelping to close that gap. CHWs are frontline, public health workers who connect individuals and families to health care and social services. They may work in urban or rural environments and with low-income, minority, immigrant, and underserved communities. By helping to educate patients and clients on the controllable items in the risk factors, they can help reduce the chance of heart disease. CHWs are becoming more prevalent in underserved communities and even on care teams. Some of the ways that CHWs could help specifically with heart disease are:

• Aid patients/clients obtain needed medications

• Assist in accessing healthy food

• Promote physical activity using resources in the patient/client’s community

• Support a smoke-free lifestyle and assist with tobacco cessation

• Educate the patient/client with self-management, care coordination, and stress management support

• Navigate the health care system, including health insurance enrollment and appropriate use of services

PTI has a Community Health Worker Program that teaches the core competency skills and health knowledge needed to function as a CHW to promote healthy lifestyles. See our website for more information. https://transformcoach.org/learning-solutions/community-health-worker-chw-program/

National Wear Red Day is February 2, 2024. Wear red to helpraise awareness of this number one killer. Motivate others to protect their hearts by learning their risks and making lifestyle changes. Make time forself-care. There is no one like you. Go Red!

https://www.cdc.gov/heartdisease/american_heart_month.htm

https://www.cdc.gov/physicalactivity/basics/adults/index.htm

https://www.goredforwomen.org

https://www.nhlbi.nih.gov/education/american-heart-month

https://www.mayoclinic.org/diseases-conditions/heart-attack/symptoms-causes/syc-20373106

Cervical Health Awareness Month

 

Happy 2024! As we enter a new year, we always hope for happiness, success, and good health. Talking about good health and how it can be achieved is one of the many things we do here at PTI. Keeping that in mind, let’s talk about gynecology and, specifically, cervical health.

Cervical cancer used to be one of the most common causes of cancer deaths in American women. The death rate dropped dramatically once the Pap test started being used. However, there are still more than 14,000 women in the United States diagnosed with invasive cervical cancer each year.  

HPV (human papillomavirus) is a common virus passed from one person to another during sex. There are more than 150 related viruses with only a few being high-risk. Most cervical cancers were found to be caused by the 14 high-risk types of HPV. For most people who have HPV, it will go away on its own. But for some people, it doesn’t go away and becomes chronic. It is these chronic infections that can lead to cervical cancer in women. The HPV test is a screening test used to detect the presence of HPV virus on the cervix.

The American Cancer Society cervical cancer screening recommendations are as follows:

• Start cervical cancer screening at age 25. People under age 25 should not be tested because cervical cancer is rare in this age group

• Women between the ages of 25 and 65 should get a primary HPV test done every 5 years. If a primary HPV test is not available, a co-test (an HPV test with a Pap test) every 5 years or a Pap test every 3 years.

• Women who are 65 years and older and have no history of cervical cancer within the past 25 years and who have documented adequate negative prior screening in the past 10 years, discontinue all cervical cancer screening

Note: There are some variations in cervical cancer screening recommendations between different organizations.

There are many types of cervical cancer and catching any of these early allows for more treatment options. Unfortunately, not all women get screened. Socioeconomic factors with low-income women not having easy access to health care services which includes cervical cancer screening, not being able to take time off from work, lack of or inadequate health insurance, and transportation issues are all reasons they may have not been screened. Cervical cancer may also be prevented by getting the HPV vaccine and learning ways to practice safe sex.

If one of your New Year’s resolutions was to schedule an annual checkup, make sure to include not only your primary doctor, but your gynecologist. Happy New Year!

https://www.cancer.org/cancer/types/cervical-cancer/detection-diagnosis-staging/cervical-cancer-screening-guidelines.html

https://www.nccc-online.org/cervical-health-awareness-month/

https://www.cdc.gov/hpv/parents/vaccine-for-hpv.html