Partner Up! Development of Coaching and Motivational Interviewing Skills for Care Coordinators to Enhance Communication and Patient-Centered Care

Care coordination in clinical practice plays a significant role in the success of behavior change. Nurses in this unique role assist patients with complex medical needs across varied care settings to promote self-care. Communication, specifically the ability to elicit and guide patients through the change process, is an essential component to the success of this program. Results of a learning needs assessment at a multi-site healthcare organization demonstrated that RN care coordinators (RNCCs) lacked confidence in their coaching and motivational interviewing (MI) skills. A course was developed to respond to these learning needs and address two of the RN care coordination and transition management model competencies: provide patient-centered care planning by eliciting patient goals and priorities through MI and coach and counsel patients, families, and caregivers to promote self-care (AAACN, 2016).

Methods: The 14-week course is delivered through multiple modalities including videoconferencing, conference calls, and eLearning to provide content to learners across multiple sites. Didactic and experiential learning is facilitated through online modules, classroom sessions, simulated practice with peers, and partnering in practice with mentors. One-to-one mentoring is a required component to promote practical application of the skills into each learner’s unique practice. RNCCs dedicate up to 4 hours each week to completing the course.

Analysis: RNCCs must complete an online examination with a passing score of 90%. A self-reported Likert scale is sent to participants multiple times throughout and after the course to evaluate MI knowledge, attitude, and behavior (use of MI).

Results: Consistent data collection began in 2016, three years after the course initiation. From 2016 through 2018, 117 RNCCs completed the course with approximately one-fifth participating in the MI classes via videoconference. Reaction evaluations were positive with 91.46% rating the course as good or excellent. Examination results are used to determine mastery and guide future course improvements. The RNCCs’ MI knowledge, attitude, and behavior scores increased by 10.4%, 7.2%, and 7.8% respectively from the first class to two months after completion of the entire course. Learners found the most value in the demonstration of and discussion about interactions using MI, classroom simulated practice with peers, and partnering in practice with mentors. RNCCs shared that this new knowledge has allowed them to more confidently guide patients in developing and successfully achieving personal health goals.

Conclusions: The course enabled staff to improve coaching skills and MI knowledge, attitudes, and behavior while remaining within close proximity to their work locations. Course evaluations led to continuous improvement including diversifying content to reflect varied practices, increasing opportunities to view skills in use, and supporting mentor development to enhance partnering in practice sessions. Moving forward, the course will expand into other sub-specialty areas, including behavioral health. Education boosts will be sent to participants after course completion and resources will be developed for nurse managers to promote further integration of skills into nursing practice.