About Threshold Behavior
The Issue
The Solution
The Solution
According to the World Health Organization, more than 80% of the World's population chooses not to follow their discharge or care plan.
We could describe the billions this cost and describe the countless lives lost or needless disabilities caused.
This has been done countless times and one more
The Solution
The Solution
The Solution
We offer a variety of evidence-based counseling services, including applied behavioral therapy, and the development of an Adherence Improvement Plan. We also offer specialized services for children and adolescents and support for early-onset nutrition habits.
How we do it
The Solution
How we do it
Our approach to implementing patient care plans is rooted in nutrition, nursing, and applied behavior analysis. We strive to create a safe and supportive environment where our clients feel comfortable exploring the function of their behaviors, setting events and antecedents that cue inappropriate nutrition behaviors. they can develop the skills and tools they need to thrive.
Transform Your Life with Threshold Behavior
We Wrote the Book
The basis of all human behavior is a single word: consequences. Applied behavior focuses on what people do. Four of the five consequence categories will assure us of non-adherence. Regarding following care plans, the medical team wants more of some behaviors (adherence) and less of others (non-adherence). On the other hand, patients look at a lifetime of habits and the punishing aspects of following their care plan. Let us show you how to identify your at-risk patients on admission so you can evaluate the consequences of your care plan on their behavior before they go home, and 8.5 out of 10 choose non-compliance. Let us teach you how to identify the punishers and penalties in your care plans. I believe we can improve the adherence ratio. Are you willing to try something else? It is evidence-based and a lot more effective than hope.
Threshold Behavior: Your Partner in Patient Education
Evidence Based Programs
Patients stop taking medications because of the consequences. We created a three-word mnemonic (ICE IF SAD) to understand why most patients quit taking their medications. Care plans are Inconvenient, Confusing, and Expensive (ICE). In addition, the Illness itself may have no symptoms. "If I don't feel bad, why must I take these pills?" Forgetful is the "get out of jail free" card. In the absence of organic brain disease, look at the other reasons. (IF). Side effects: What is the typical response if patients don't feel bad until they take their medications? Nonadherence. Acceptance: Many patients find peace in accepting the consequences of their disease process. They may need additional education to understand how the acceptance of their disease can be effectively managed. Distrust: Patients have unlimited access to the internet and a thousand contradicting articles about the best way to manage their condition. Nurses are best positioned to guide patients and work through their concerns (SAD).
Threshold Behavior: Your Partner in Patient Education
Medication Adherence is Lifesaving Behavior
Our programs on medication adherence training:
Who is at risk? Why do patients not follow their care plan, and continue life-saving or quality-of-life extensions? The picture of adherence is one of the most dismal in all areas of health care delivery. Every patient is adherent to your care plan on the day of discharge. Our consultants can assess your patients for known behavioral risk factors, evaluate their physical deficits that might contribute to non-adherence, and then we will conduct a Consequence Analysis with your patients and tell you where they ill fail down the road. Our Consequence Analysis evaluates your care plan from the patient's perspective. Then, we meet with providers to suggest where patients will fail in their follow-up care. We will never change your care plans. We will point out where your patients will choose to abandon them.
Hello
"TEACHBACK" has been around for forty years -
Our patient assessment and adherence Management Coaches can help you overcome patient education challenges and reach improved patient adherence.
Adherence Training starts at admission
Identify the At-Risk Patients
There is a 50/50 chance a patient will become non-adherent to their care plan within 30 days of discharge. The question is, which one? We have created a simple evidence-based matrix that can be administered on admission to help nurses identify patients needing additional attention with their patient education program. The Wright Patient Adherence Assessment Scale is a Green, Yellow, Orange, and Red format that provides nurses with a quick risk assessment tool.
Green Zone patients can generally be successful with their discharge plan and a "Teachback" session with their nurse.
Yellow and Orange zone patients, especially the higher Yellow and Orange scores, need to be further assessed and walked through the Adherence Management Coaching program.
About Threshold Behavior
Assessing Physical Ability
Once identified as at-risk, a further assessment can assist clinicians in targeting physical issues that contribute to non-adherence. Once again, this is an easily administered evidence-based scale resulting in a Green, Yellow, Orange, and Red assessment of physical risk factors the care team will need to address.
We are Ever-Mindful of Consequences
Our team consists of licensed clinicians who specialize in nutrition, nursing, behavior, and behavior-related health issues.
We are dedicated to providing personalized care and are ever-mindful of the 19th-century poet John Godfrey Saxe and his short poem "Six Blind Men of Indostan." "They went to see an elephant, though all of them were blind." Each touched a part of an elephant, and that touch determined their perception. Similarly, clinicians often touch one part of patients, and that establishes where we focus our attention.
The concluding sentence is, "While are were partly in the right, all were in the wrong."
Nutrition-focused disorders are more than simply an energy intake issue.
Our Approach
Nurses are Consequence Managers:
The importance of consequences can never be overstated. When it comes to providing direct care to another person for an hour, an eight-hour shift, or a twelve-hour shift, Nurses and their non-licensed support personnel are responsible for managing a lifetime of habits or genetic disorders that led to their seeking medical care (A). Their symptoms, acute or chronic, reached a threshold that led them to seek care.
That will likely lead to a diagnosis and perhaps an admission for inpatient care (B). With any admission, there will be orders, an assessment, and many tasks that are the consequences of the admission orders (C).
Throughout this admission will come countless ADPIEs and the behaviors, with their consequences up to and including the discharge (D).
Discharge planning will include patient education on medications, nutrition needs, and exercise. There will be a follow-up appointment or more. Patient education and the consequences of that education are often attributed to the discharge nurse. Then, patients return to the environment and habits that likely contributed to their illness, and they return to the habits that led to their hospital admission in the first place. As Dr. Ivar Lovaas reported in 1965, "Past performance is the best indicator of future performance.
Did you document your patient education in such a way as to protect your nursing license?
Adherence Management (AdM) Coaching Work Shop
Adhering to care plans has been a challenge for patients since the beginning of recorded history. We all follow the laws of behavior whether we want to or not. One of the basic laws is that "Behavior goes where reinforcement flows." There are only five consequences for every behavior. It does not matter what culture, gender, or belief system we live under; people avoid punishment and penalties. That is the problem. Care plans are filled with penalties and punishers from the patient's perspective. As hard as you try with patient education, if the consequences are punishing (receiving something you don't want) or filled with penalties (losing something you have and want), they will likely abandon your care plan.
At BEARS, we are happy to teach you the skills needed to identify at-risk patients, determine their physical boundaries, assess their risk-focused consequences, and then start on an AdM Coaching program that increases their adherent behavior.
From our first visit to discharge, BEARS' Adherence Management plan guides your patient through risk discovery, adversity, and the creation of better habits.
Mark Twain wrote, "Habit is habit and not to be tossed out the window by any man, but coaxed downstairs one step at a time."
Do we diagnose, write prescriptions, provide some patient education, and then "toss them out the window"? Perhaps there is a little prayer. Is it any wonder why more than 80% of our patients are non-adherent by the second month?
Let us teach your staff how to improve adherence.
For more information, please call 321-439-5949
Consequence Analysis
Every care plan has consequences for each of the orders written. Care plan adherence means that we need to evaluate the consequences from the patient's perspective. "Common sense" tells us that patients have their best interest
Adherence Management (AdM) Coaching Work Shop
Adhering to care plans has been a challenge for patients since the beginning of recorded history. We all follow the laws of behavior whether we want to or not. One of the basic laws is that "Behavior goes where reinforcement flows." There are only five consequences for every behavior. It does not matter what culture, gender, or belief system we live under; people avoid punishment and penalties. That is the problem. Care plans are filled with penalties and punishers from the patient's perspective. As hard as you try with patient education, if the consequences are punishing (receiving something you don't want) or filled with penalties (losing something you have and want), they will likely abandon your care plan.
At BEARS, we are happy to teach you the skills needed to identify at-risk patients, determine their physical boundaries, assess their risk-focused consequences, and then start on an AdM Coaching program that increases their adherent behavior.
From our first visit to discharge, BEARS' Adherence Management plan guides your patient through risk discovery, adversity, and the creation of better habits.
Mark Twain wrote, "Habit is habit and not to be tossed out the window by any man, but coaxed downstairs one step at a time."
Do we diagnose, write prescriptions, provide some patient education, and then "toss them out the window"? Perhaps there is a little prayer. Is it any wonder why more than 80% of our patients are non-adherent by the second month?
Let us teach your staff how to improve adherence.
For more information, please call 321-439-5949
