A strategy that is used in motivational interviewing is providing affirmations. Strategies used in motivational interviewing include:
‥ Avoiding yes/no questions: Ask informational, open-ended questions.
‥ Providing affirmations: Indicate areas of strength.
‥ Providing reflective listening: Respond to statements.
‥ Providing summaries: Recap important points of discussion.
‥ Encouraging change talk: Include desire, ability, reason, and need.
According to Rogers’ five-step diffusion of innovation theory of change, the steps are as follows:
1. Knowledge: the person gains information about innovation or change but needs more information
2. Persuasion: the person begins to seek out more information
3. Decision: The person weights the pros and cons when reaching a decision to implement
4. Implementation: The person implements the changes and assesses their value
5. Confirmation: The person decides to continue to use the changes.
The quantity of clients that received immunizations illustrates a process measurement while thinking about performance improvement. Process evaluations take place while a patient is receiving treatment. Structure metrics, such as the ratio of administrators to other staff and the caseload per case manager, are used to evaluate the structure of the care setting. Measurements of outcomes describe the results of interventions, such as the percentage of patients that pass away while receiving care.
Predictive modeling uses client information to anticipate which clients will most likely gain from extended case management services. When appropriately utilized, predictive modeling, which foresees future behavior and requirements, can help manage client care by concentrating care on those most needing it. Data mining methodologies are the foundation of predictive modeling.
Monitoring is the ongoing process the case manager employs to compile all necessary data and documentation regarding a client to assess the efficacy of care. Monitoring ensures that the treatment plan has been adhered to, the client is happy with the care received, and the outcomes support the effectiveness of the treatment plan or the need for plan modifications. Additionally, the case manager is responsible for overseeing the safe care delivery.
Interrater reliability is a test for instrument reliability that entails having two interviewers measure the same event when doing research to ascertain the efficacy of evidence-based improvements to a case management strategy. When two new instruments are utilized in parallel fashion, the means and variances produced by each version are the same. Two new instrument versions are utilized in alternate fashion, however they are not always parallel. When an instrument has test-retest dependability, it has been used twice under similar conditions.
The process improvement model that is used primarily to identify a problem rather than a solution is FOCUS:
‥ Find: Looking at the organization and attempting to determine what is not working well or what is wrong
‥ Organize: Identifying those people with an understanding of the problem or process and creating a team to work on improving performance
‥ Clarify: Determining what is involved in solving the problem by using brainstorming techniques
‥ Uncover: Analyzing the situation to determine the reason why the problem has arisen or why a process is unsuccessful
‥ Start: Determining where to begin in the change process
