Teaching Patients How you doing? Marra Williams, CHES Patient Education
Health Care Consumers we call them patients Healthcare is a business. Caveat emptor People talk to each other. People will ask family and friends about health advice. People will talk to strangers about health conditions. People relate to one another through health sometimes. People aren t talking to their healthcare providers. We have to help change that (AHRQ Video - DVD) 2 Patient Education May 2014
Health Literacy Why don t patients learn? What does health literate and health illiterate look like? How is health literacy different from literacy? Health literacy is the ability to read, understand and act on health information given. Adults can learn anything needed for their health if it is taught in an appropriate way (for the learner). 9 out of 10 patients (not 90%) don t understand the health information given to them. People with poor health are 5 times more likely to have below basic health literacy skills than people with good health. 3 Patient Education May 2014
What do they know??? Patients and their families don t know about health situations until they are in it. It is our responsibility to teach our patients and their families This is a bad time for patients and their family to learn Patients and families are overwhelmed & in a foreign land where we speak another language Patients and caregivers need survival skills need to know information to start with, and only give more when they ask for it They do know if they are being respected and treated well. They do know if they are satisfied with the care they ve received. We will know what they thought about their care when they complete their satisfaction survey 4 Department Name Month X, 201X
How do we do what we do in patient education? We believe that all patients want to have an active role in their healthcare. We help adults learn about a specific health topic. We follow public health theory and models to design our interventions. We incorporate health education theories into programs and materials. We use evidence based educational methods and tools to help our patients have better outcomes. 5 Patient Education Overview, March 2014
Teach-back Is a skill Can be learned and improved with practice Is evidence based to show its effectiveness 1. Know the singular concept or skill you want to teach 2. Explain the concept by using plain language. Demonstrate the skill while explaining each individual step. More complex concepts/skills will need to be repeated or broken down to 6 smaller segments/tasks that are easier to remember correctly. 3. Ask your patient to repeat back what they just learned What are you going to tell your husband, friend, caregiver? What are you going to do when you get home? Never ask Do you understand? Or immediately follow-up with Have I confused you? until you change this behavior. (Find your trigger to make a change.)
We re still learning teach-back Watch this video. http://vimeo.com/49702573 Now, apply what you have learned. Video A: http://vimeo.com/49702983 Video B: http://vimeo.com/49786973 Which video best demonstrates what the nurse should do next? 7 Patient Education May 2014
We ve almost got it http://vimeo.com/49702572 Which key elements of effective teach-back do you observe the health care provider using? Use your 10 Elements handout to assess this interaction. http://vimeo.com/50438603 Last video provider talking about learning teach back. 8 Patient Education May 2014
Communication The problem with communication is the illusion that it has occurred. -- George Bernard Shaw 9 Patient Education May 2014
Things to consider when teaching Patients & Families Sit down. Make eye contact Slow down. Take a breath and relax Use a caring tone of voice and attitude. Patients will believe you want to help them Use plain language. Patients will stay engaged with the conversation if they understand it Break it down into short statements and/or concepts. Focus on the 2 or 3 most important concepts only. 10 Patient Education May 2014
Last considerations when teaching patients Most patients won t speak up because They are uncomfortable They don t want to say they don t understand you They don t feel good they are sick in the hospital They have language, literacy or cultural barriers Remember that less is more Limit the amount of information taught at each attempt Use a simple and direct message with frequent checks for patient understanding Use teach back or return demonstration methods to verify correct learning Time to check your skills for plain language translation. 11 Patient Education 2013
Resources to Teach Patients www.ucirvinehealth.org Intranet: SharePoint sites pathways, policies, etc Patient Education SharePoint site (https://intranet.ha.uci.edu/sites/patienteducation/default.aspx) QUEST Micromedex-CareNotes / ExitCare Inpatient referrals to patient education for free group classes in Quest Closed Circuit Television (CCTV) Emmi Videos stroke & heart failure batched; diabetes batch coming soon 12 Patient Education 2013
Final Thoughts on Teaching Patients Poor communication between patients and providers is a major factor 1. For poor patient satisfaction ($$$) 2. For malpractice lawsuits ($$$) 3. For possible readmission ($$$) Patients care about being able to: Get better Go home Stay home Live their lives their way 13 Patient Education 2013
Thank YOU for your time and attention! What questions do you have? Marra Williams, CHES O:714-456-8434 P: 714-506-1224 E: marraw@uci.edu 14 Patient Education February 7, 2014