48 Population Health Management MotivationalInterviewing Motivational Interviewing (MI) is a goal-oriented style of communication where medical providers and patients collaborate on setting goals and finding ways to achieve them. It is designed to strengthen a patient’s personal motivation for and commitment to a specific goal by exploring the patient’s own reasons for change, in a nonjudgmental atmosphere of empathy, support and compassion. For example, instead of a healthcare provider telling patients what their goals should be for issues such as losing weight or quitting smoking, the provider and patient work together to set goals, then address any obstacles that might arise. In FiscalYear 2017, Concord Hospital’s Organizational Development staff coordinated piloting a‘Motivational Interviewing Learning Community’made up of MI experts to increase alignment and effectiveness of MI training throughout our system. Approximately 75 primarily clinical staff members were trained in basic MI skills through August 2017. HIGHLIGHTS § Nurse Navigation All CHMG nurse navigators have been trained in MI and are receiving ongoing coaching and support. In 2018, the goal is to have MI become a structured part of CHMG new clinical staff orientation with emphasis on nursing, medical assistants (MA) and the nurse navigation team. § Outpatient Rehabilitation Services Concord Hospital Rehabilitation Services has trained all of their clinicians in MI. Rehabilitation Services participated in the pilot group project and contributed meaningful feedback toward increasing effectiveness. Rehabilitation Services has MI champions and continues follow-up coaching sessions to allow for role playing and practical application of MI. Those who continue to apply MI skills with patients have shared positive feedback recognizing that conversations are helping patients become more engaged in their care, while empowering patients and developing trust. PalliativeCareandHospice Capital Region Palliative Care and Hospice* exists to help patients and their families cope with pain and anxiety associated with illness or end-of-life concerns. In 2017, we reached out to more patients, increasing palliative visits in patient homes, medical practices, Concord Hospital and nursing facilities. Hospice referrals also increased. As Capital Region Palliative Care and Hospice has continued to grow and evolve, CRVNA was able to increase the hours of spiritual care counselor support from the hospice teams to specifically increase palliative care in skilled nursing facilities already served by CRVNA hospice.This has also allowed the program to expand outpatient consultation at some primary care and specialty practices, and in the community setting as well. Palliative care provides relief from symptoms and stresses of serious illnesses to help improve a patient’s quality of life.This care can be provided along with medical treatment. Hospice care is for patients who have decided they do not want any more aggressive medical care. ACHIEVEMENTS § Community consults in conjunction with CHMG primary care practices and Payson Center for Cancer Care increased. § Palliative care consults also expanded in Concord Hospital, helping patients learn how to manage their illnesses at home so they could leave the Hospital sooner. Length of stay averaged 6.6 days if a palliative care consult was initiated within the first four days of admission, compared to an average length of stay of 15.9 days if a palliative care consult was requested after patients were hospitalized for at least four days. § Approximately 80 percent of our palliative care consults are related to goals of care, which often translate into referrals to hospice. Other specific requests include symptom management, pain management, depression and support for the patient and family in decision making. Those487patientsreceivedmorethan 4,220individual palliativecare ‘touches,’ definedasphoneconversations orface-to-facevisits. IN2017, 487 PATIENTS received PALLIATIVECARE. * Capital Region Palliative Care and Hospice is a collaborative effort of Concord Hospital and Concord RegionalVisiting Nurse Association.