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Principle 1: Forming a Partnership
- Collaboratively develop a visit agenda with the patient and family.
- Engage entire team in supporting patients.
Principle 2: Problem Solving
- Ask about patient goals to improve their health.
- Help them make action plans that build confidence in their ability to reach goals.
Principle 3: Assessing Resources
- Ask if there are barriers to reaching their health goals.
Principle 4: Decision Making
- Use a “ask-tell-ask” conversational format to provide information.
- Ensure the patient accepts the plan and understands it.
Principle 5: Taking Action
- Prepare a written care plan or visit summary.
- Include goals and action plans.
- Using the care plan or visit summary, ensure the patient and/or family knows what to do when they leave.
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