Using Care Guides Could Improve Patient Experience

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Healthcare reform is bringing about many new and potentially revolutionary concepts that are designed to improve the quality of the patient experience. One of these concepts is gradually capturing the attention of the nation’s healthcare leaders, Maura Lerner of the Star Tribune reports.

According to Lerner, care guides, an idea pioneered by Minnesota-based Allina Health, are people hired by Allina with no medical background. They are given two weeks of training, after which they are placed at one of Allina’s two dozen clinics to see patients.

Lerner explains, “The guides are part of a fast-growing, and hotly debated, trend in medicine: Putting people with minimal (if any) medical expertise on the front lines — with titles like patient navigator or coach — to help improve care, and rein in the costs, of patients with chronic illnesses.”

In the five years since the program was first established, these care guides have become “fixtures” within the Allina system.

The program is the brain child of Dr. Richard Adair who was looking for a way to provide more effective care for chronically ill patients. Hiring additional doctors and nurses wasn’t a possibility, given the expense, so he decided to experiment with care guides.

“With a $6 million grant from the Robina Foundation in Minneapolis, Allina hired a dozen of them, at the rate of $16 an hour, and set them up in cubicles in clinic waiting rooms,” Lerner writes. “Their job: Meet with struggling patients, go over their doctors’ instructions in detail, and see whether they could help them make progress.”

The typical care guide is young, in their early 20s, and fresh out of college. Adair feels this targeted guidance is more effective than the “bobblehead responses” doctors tend to get as they deliver quick, but wise advice for lifestyle changes during a visit. As one patient put it, “The doctor is always busy, the nurse is always busy.”

Care guides are able to take time with each patient. They’re rigidly taught not to overstep their boundaries by giving medical advice, but patients also tell them things that they won’t tell their physician, such as if they’re not taking their medications.

Early research indicates care guides also have a relatability with patients that enables them “to influence patients in ways that doctors alone could not — helping people to quit smoking, get their blood sugar under control, and make other small victories in the daily battle with chronic illness.”

Lerner reports, “One study, of 2,135 patients, found they were twice as successful as a control group at meeting their ‘patient-care goals’… Some 17 percent quit smoking, compared with less than 1 percent of the controls. They were even less likely to end up in the hospital.”

Critics of the program, however, believe care guides could end up doing “more harm than good” because of their lack of sophistication and medical expertise. One critic said, “…It’s like having a son, a parent, or good friend to speak with about your health…I don’t know anybody who would buy that service.”

As healthcare leaders, what are your thoughts on Allina’s program? Would you consider adopting care guides at your organization?

-by Pete Fernbaugh

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