Improving Healthcare Outcomes, One Patient Call at a Time

February 11, 2020 Health Dialog

Beyond helping to treat rashes, colds, and migraines, a call with a nurse can mean the difference between a trip to the ER or a trip to the local pharmacy. Nurses can offer advice to scared parents in the middle of the night, to newly diagnosed diabetes patients who don’t know how to manage their new symptoms, or to those patients who need help navigating the complexities of the healthcare system.

In this series, we spotlight the hard-working nurses who educate, coach, inform, and reassure our client’s members when they need it most. With every patient engagement, our nurses connect patients to the appropriate level of care they need while helping our health plan, provider, and employer clients reduce unnecessary spending and ER visits.

Meet Gini Lea Quinn: From helping patients to guiding health coaches, Gini is proud to be a part of Health Dialog’s can-do culture. Starting as a nurse health coach over 13 years ago, she now leads her own team of nurses—providing them with the tools needed to deliver high-quality population health management and Nurse Line services to our payer clients and their members.

What work did you do before Health Dialog?

Before Health Dialog, I worked in a nursing home for 15 years. During 6 of those years, I was the wound care specialist, and I liked that very much. Give me a wound, and I could heal it—but I can’t grow a plant to save my life!

What has been your journey within Health Dialog?

When I first joined, I was a nurse health coach, and I did that for about a year and a half. At the time, there was a need for more community leaders—the people who guide teams of health coaches. I wasn’t sure I was qualified, so I wasn’t even going to apply, but my own community leader said “if you don’t apply, I’m going to apply for you!” So I turned in my resume, and I was chosen. I’ve really enjoyed it.

As a community leader, how would you describe your job?

A community leader is part supervisor, part guide. The health coaches are the ones speaking directly to patients, and I am here to help them become the best they can be. When I review my coaches’ calls, I look at the quality of their interactions with patients, how they are doing overall, and where they can make improvements. I meet with them to discuss what’s going well and offer suggestions on how to improve calls with patients. If they are frustrated about something, I listen and we collaborate on a solution. For example, if a health coach is working with a patient who is being very unclear about his or her symptoms, I help that coach develop investigative questions to help get to the root cause of the patient’s health issues. Delivering high-quality patient engagement and support is very important to us as a team and as an organization.

“We don’t tell patients what to do—we transfer knowledge and provide information on their best care options.”

What makes health coaching guidance so important?

At Health Dialog, quality in our coaching calls always comes first. Because of this, we give our new health coaches time to grow so they can master the process. This team of (predominately) nurses is on the frontlines of delivering what Health Dialog promises—evidence-based, fair, unbiased, and up-to-date information—so that members can make more informed health decisions. We don’t tell patients what to do—we transfer knowledge and provide information on their best care options. It takes particular skills for a health coach to do this well. That’s why I feel like the most important part of my job as a community leader is to help my coaches be successful.

What would you say makes someone a great health coach?

Health coaching requires a variety of patient engagement and communication skills that are developed through extensive, first-hand experience. And of course, a background in nursing and patient care is a must. Health coaches need to know what questions to ask patients to identify health issues as quickly as possible. That helps build trust and credibility with the patient.

What is different about telephonic coaching versus working in a clinical setting is that when you are on the phone, you can’t see someone. This makes it harder, because you can’t make visual observations, such as being able to see if someone is sweating or has a fever. To be successful, health coaches need to have sharp assessment skills and be able to recognize cues in the way patients speak and what they say. You also want someone who is eager to learn and doesn’t come into the process thinking they know everything, because you don’t. I learn something new every day.

Finally, compassion and a calming demeanor are both very important. Patients need to feel comfortable with our health coaches, or the interaction will not go well.

When patients call into the Nurse Line, what are their biggest barriers?

Our members’ biggest barrier is lack of knowledge—with respect to their health, their symptoms, what to do next, where to go, and what their insurance covers. The health coaches put their training into action in order to address each of these issues. As for questions related to health insurance, we refer them to customer service for assistance. When we help them break through these barriers, it’s gratifying to know that we are improving outcomes for them.

“It’s important for patients to understand that choosing one option over another could be the difference between life and death.”

Going back to your time as a health coach, what is one of your most memorable stories?

I remember I once got a Nurse Line call from a man in his 50s, and before he even gave me his name, he said his wife made him call. He insisted that his symptoms were just a sign of indigestion. I asked him some very specific questions about his symptoms and his answers suggested that he may be having a heart attack. I told him that according to how he answered the questions, his best option was to call 911, but he said that there was a hospital two blocks away and he could make it there on his own. I explained to him that when it comes to a potential heart attack or a stroke, you want treatment as fast as possible, and when you call 911, the paramedics can start treatment right away. Going to the hospital on your own means waiting in line for triage, and you don’t want to waste time here. You also have to think about things beyond just the medical treatment. For example, if his wife drove him, he could get worse in the car and she could panic and get into a car accident, and then you’ve got other problems. As a coach, when you’re helping a patient, it’s critical that you evaluate every possible scenario. It’s important for patients to understand that choosing one option over another could be the difference between life and death.

I called the member back a couple days later to check in on him. He confirmed that he called 911 and they determined he was indeed having a heart attack—he had a blockage and they had to insert three stents into his heart. He was very thankful and I felt so relieved that I was able to help him.  

Do you ever find that people call in thinking their concern is very severe, but after talking with you, they realize the severity is not as high as they thought?

We get a lot of that with pain. People call the Nurse Line panicked because they feel they’re experiencing the worst pain they ever had, and when we ask them to rate their pain level from 1-10, they’ll say 10. However, when we actually explain the different levels of pain to them, they may pick a different number. A pain level of 10 may mean the patient should seek emergency care now, but after hearing that, the patient may back away and say they don’t actually think it’s that serious. Helping them understand the different levels of pain helps to calm the patient down, and then we can re-ask the same symptom-check questions. Once they are feeling calmer and are more informed about their symptoms, they may provide different answers. If the patient decides that the ER is not the best option, we tell them which signs or symptoms to watch for and give them a timeframe for when they should call their doctor. If appropriate, we’ll also give them home treatment.

Thinking about your time here overall, what do you like most about working at Health Dialog?

I like the people I work with, and I’m passionate about Health Dialog’s mission and philosophy. We foster a culture where everyone wants to help each other out. Helping a coworker could not only save a life but also help one of our payer clients improve healthcare quality. I also love that I get to use my nursing knowledge every day and that I am helping people, even though I am not doing hands-on work anymore.

What do you enjoy doing when you’re not helping health coaches and patients?

In addition to working at Health Dialog, I am a stained-glass artist. I also work with the community theater and take care of my 82-year-old mother who has Alzheimer’s.

Thank you Gini for your dedication to the Health Dialog cause!

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