Does Training in Motivational Interviewing Techniques Increase Providers' Use of Patient Self-Management Goals?

One area of healthcare change is the impact of patient-centered strategies and accreditors, such as the Joint Commission, consider evidence of use of these strategies for awarding Primary Care/Patient-Centered Medical Home (PCMH) accreditation. This program evaluation will consider the unique characteristics of a local federally qualified health center (FQHC), its Joint Commission PCMH review and the identified gap in documentation of self-management goals (SMG). Based on a needs assessment, a professional development program was developed to increase primary care providers’ knowledge and skills in using Motivational Interviewing (MI) techniques to better construct and document SMGs. Review of documentation in the health record during a pre- and post-MI intervention period was used to assess the impact of the programming on primary care providers’ use of SMGs in patients with diabetes and/or hypertension. This study question was reinforced by a review of literature focusing on past research and program evaluation on methods of increasing patient-engagement, including the use of MI skills. Specifically with chronic care management and behavior change, MI theory has shown promise in identification of SMGs and corresponding patient activities and outcomes. This pilot study’s small sample of primary care providers of patients with diabetes and/or hypertension (n=5) and the larger group of participants in the MI professional development programming (n=30) will provide data toward the feasibility, sustainability and evidence for MI training. As a mixed method evaluation, both data specific to the impact on SMG goals (quantity and quality) and overall presentation content and format was assessed. The presentation impact was evaluated using a series of statements based on the objectives and format scored by the participants using a Likert-scale. The mean of each item was reported and identified satisfaction with the achievement of presentation objectives. One month after the program completion, no change was noted in the primary care providers’ documentation of SMGs in patients with diabetes and/or hypertension. Qualitative data did point to increased use of SMG and MI terminology and favorable attitudes toward attempts to increase patient engagement in action plans. Analysis of findings identified concerns as to the complexity of SMG documentation within the EHR system and exam time constraints. The findings will be shared with clinic administrators, providers and other stakeholders.