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Lesson Plan for a Volunteer Peer Mentor Program at Hospital X Lisa SeldonN545-Technology and Curriculum DesignAugust 9, 20131

1BackgroundThe Affordable Care Act of 2010 was signed into law to help support the uninsured and underinsured as well as hold hospitals accountable for the care they deliver to patients.Healthcare organizations now have to focus of the quality of care they deliver and patient outcomes

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A year later, in April of 2011, the Department of Health and Human Services (HHS) implemented the Value-Based Purchasing Program (VBP). This program, which is administered by the Center for Medicare and Medicaid (CMS), will give hospitals incentives to improve their delivery of care (Coulter, 2012). Healthcare organizations will now be reimbursed based on their performance to key quality measures.

Many healthcare organizations struggle to understand these new rules and regulations set forth by CMS. Financially, SFMC has left money on the table to be absorbed by organizations that perform in the top decile according to CMS standards. Complicated calculations related to baseline, threshold and improvement scores have challenged economic analysts and financial officers to meet the quarterly budget and maintain a profit margin of >2%.

The aim of this project is to determine if there is a relationship between a volunteer peer mentor program and orthopaedic patient outcomes. More specifically, the goals/aims of this quality improvement project are to: (1) Maximize the patient experience and improve patient perception of care scores, (2) Prevent readmissions and (3) Leverage reimbursement from Medicare as evidenced by financial data that is aggregated and analyzed on a monthly basis.

2BackgroundA volunteer peer mentor program is a viable , innovative alternative to effectively engage patients and improve the patient care experience during the hospital stay.

This peer mentor role will augment, strengthen and support interactions between patients and the healthcare team; it will reinforce the motivational-behavioral aspect of managing disease processes;

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Enhancing the patient engagement process may be the key to meet the new standards set forth by the VBP program. Full patient engagement is evidenced by self-management, self-monitoring, adherence to healthcare regimens, involvement in infection control measures, etc.

According to Coulter & Ellins (2007), Policymakers believe that encouraging patients to play a more active role in their health care could improve quality, efficiency, and health outcomes. Certain interventions can improve patient knowledge and experience, access to health care, health behavior, and their overall health status (p. 25). Patient engagement empowers those with illnesses to understand every stage of their disease process from admission through their transition of care. 3Student Demographics/Contextual RealitiesVolunteer group, 18-65 years of age

These volunteers are educated individuals that are currently in nursing or medical school or retired healthcare professionals, administrators/directors, marketing executives, psychologist, etc.

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Student Demographics/Contextual RealitiesThis will be a two-day, face to face, peer mentor training program that will be offered during volunteer orientation.

A condensed two-hour Healthstream module will be developed to maintain yearly competency in this area.

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Program ObjectivesBy the end of this program:

Participants will be able to define the following terms: patient engagement, peer mentor, peer mentee and motivational-behavioral interactions. (Knowledge & Application-Cognitive) Lesson #1

Participants will role model effective communication skills including: active listening, constructive feedback and reflection, verbal, paraphrasing and nonverbal communication. (Cognitive) Lesson #2

The participant will acknowledge behaviors necessary for problem-solving and assist the mentee to develop this skill. (Receiving-Affective) Lesson #3

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Program Objectives (cont)By the end of this program:

Participants will acknowledge behaviors necessary for decision-making and support the mentee with developing this skill. (Receiving-Affective) Lesson #4

Participants will support the mentee to build confidence in his/her caregiving skills. (Human Dimension) Lesson #5

Participants will demonstrate behaviors to support motivational-behavioral interactions. (Cognitive) Lesson #5

Participants will be able to effectively collaborate with the patient care team to communicate the needs of the patient/mentee. (Human Dimension) Lesson #5

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Lesson #2-Effective CommunicationLearning ObjectivesGoal 2.1: Participants will examine scenarios that portray effective and ineffective communication techniques. (Analysis-Cognitive)

Goal 2.2: Participants will practice skills such as clear communication, active listening, constructive feedback and paraphrasing, in mentoring situations. (Application-Cognitive)8

Lesson #2-ActivitiesGoal 2.1

Will send participants pre-work via an e-Learning Powerpoint presentation regarding effective communication techniques. Pre-work will be reviewed as an ice-breaker to the conversation.

During the face-to face, will use the iMovie technology to show a total of four different scenarios that depict effective and ineffective communication techniques during a patient interaction. 9

Lesson #2-ActivitiesGoal 2.1

Will solicit participants input regarding what types of scenarios they witnessed and clarify correct and incorrect answers.

Will replay scenarios and help participants identify strengths and weaknesses of active listening, clear communication, feedback, verbal/nonverbal communications, etc.10

Lesson #2-Activities Goal 2.2Participants will be paired into groups of two. Each participant will receive a scenario that they must role play. Using a camera, the role play scenarios will be taped and replayed with MovieMaker software for group to give feedback on mentor/mentee interaction.

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AssessmentA short five question assessment will be attached to the eLearning pre-work. These questions will be used as an icebreaker to the effective communication module/lesson.

After the lesson, the participants will be verbally assessed on key components of effective communication. 12

AssessmentWill use the iMovie technology again to show more mentor/mentee scenarios and have patients to respond to questions using clicker technology. This will ensure participants understand key ideas and concepts of the mentor/mentee relationship.

Will shadow participants during their first day on the floor as mentors and spend an hour at the end of the day giving feedback regarding the interaction. 13

Technology SupportThe hospital conference rooms are wired with high-tech audio-visual equipment. A laptop will be used to present content using Powerpoint software. The scenarios from iMovie will be integrated into the presentation slides.A support person will be solicited to film/videotape participants during role play and will use Moviemaker which is downloaded on the laptop to play the scenariosThere is a school of nursing connected to our health system, so I will borrow their clicker technology to use for part of their assessment.

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ReferencesCoulter, A. (2012). Patient engagement-what works? Journal of Ambulatory Care Management, 35(2), 80-89.

Coulter, A & Ellins, J. (2007). Effectiveness of strategies for information, education and involving patients. BMJ, 335(7609), 24-27.

Ljungberg, I., Kroll, T., Libin, A., & Gordon, S. (2011). Using peer mentoring for people with spinal cord injury to enhance self-efficacy beliefs and prevent medical complications. Journal of Clinical Nursing, 20, 351-358.

Patterson, B., Kilpatrick, J., & Woekenberg, E. (2010). Evidence for teaching practice: The impact of clickers in a large classroom environments. Nurse Educator Today, 30, 603-607.

iMovie in teacher education http://edweb.sdsu.edu/sciencetg/ie/

Introduction to Windows MovieMaker2https://www.ischool.utexas.edu/technology/tutorials/graphics/moviemaker2/MM2handout.pdf

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