Patient and Family Education Chapter

Haifa AlnaimiQuality Specialist IRN, MSc,CPHQ,CHCQM,PMP

The outlines:

• Patient Education Background.• Quality Model/paradigm.• JCI standards.

Remember 1:

• JCI is a tool organizations use to enhance the care.

• Just like clinical guideline that we adhere to.

A) Background about Patient Education

Patient education??

Patient Health Education (APP): Refers to any combination of activities planned to facilitate voluntary change in patient behavior for good health.

Why patient education is Important??

• Improved:– Understanding of medical condition.– Understanding of methods and means to manage

multiple aspects of medical condition.– Increased Compliance.– Patient Outcomes .– More effective utilization of medical services.– Satisfaction .

Who Provide Patient Education??

• Doctors.• Nurses.• Patient educators.• Dieticians.• Respiratory Therapist.• Physiotherapists.• Social workers.• Patient Relation Officers.

What competencies should educators have??

• Provide accurate, competent, and evidence-based care.

• Focus on relationship-centered care with individuals and their families.

• Be culturally sensitive and be open to a diverse society.

• Use technology appropriately and effectively.

B) Quality Model:• Structure……………Process…………..Outcome..

Example: Diabetic education.

• Structure: – Protocols, related Policies.– Diabetic Clinic.– Materials.– Staff (Diabetic educators).

• Process:– Referral process.– Length of education session.– How the education is given.

• Outcomes:– Controlled HA1C.– Controlled BP, LDL.

C) JCI

Standard VS Measurable elements??

• Standard is a level of quality.• The measurable elements simply list what is required to be in

full compliance with the standard.• In other words MEs are the specifications.

How Joint Commission will Evaluate it??

• Policies.• Data.• Staff & patient interviews.• Chart review: Documentation, referrals,…

PFE1. The hospital provides education that supports patient and family participation in care decisions and care processes.

• The hospital plans education consistent with its mission, services, and patient population.

• Participation in the care is a patient and family right.

PFE1. The hospital provides education that supports patient and family participation in care decisions and

care processes.

• There is an established structure or mechanism for education throughout the hospital.– How do you refer diabetic patient to health

educator??

• The education structure and resources are organized in an effective manner.

PFE2. Each patient’s educational needs are assessed and recorded in his or her record.

• The educational needs of the patient and family are assessed.

• Educational needs assessment findings are recorded in the patient’s record.

• There is uniform recording of patient education by all staff.– Remember assessing the patient in the Assessment chapter and

patient and family right.

PFE2.1The patient’s and family’s ability to learn and willingness to learn are assessed.

• The patient’s literacy, including health care literacy, educational level, and language, are assessed.

• The patient’s emotional barriers and motivations are assessed.

• The patient’s physical and cognitive limitations are assessed.• The assessment findings are used to plan the education.

• Literacy is defined as The ability to read and write. Oxford dictionary..

• What about Health literacy???

What about Health literacy الصحيه األميه ???((محو

• The Patient Protection and Affordable Care Act of 2010, Title V, defines health literacy as:

“ the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions”.

• Health Literacy is systemic problem in America Canada.

• 88% of Canadian population have low health literacy.

Peer-Reviewed Publications onHealth Literacy by Nation of First Author (2011)

United States 360Australia 48United Kingdom 37Canada 25Netherlands 14Germany 12Japan 7Spain 6South Africa 4Sweden 4Brazil 3China 3

• Majority of your patient leave the clinic without understanding what you have told them.

• HL is more than giving a patient a pamphlet.• It is two way communication • Patient satisfaction survey???• Signs of health literacy.• Use plain language

Case Study: Association of Health Literacy with Diabetes Outcome (Schillinger, et al. 2002)

– Method: Cross sectional observational study in US.

– Sample: 408 English and Spanish speaking patients, older than 30years and diagnosed as DMII.

– Tool: Health literacy assessment tool (s-TOFHLA)

– Outcome: HBA1C level & Self reported DM complications.

– Result: For each 1-point decrement in s-TOFHLA score, the HbA1c value increased by 0.02 (P = .02). Patients with inadequate health literacy were less likely than patients with adequate health literacy to achieve tight glycemic control (HbA1c ≤7.2%) and were more likely to have poor glycemic control (HbA1c ≥9.5%) and to report having retinopathy.

Video

• Health Literacy.

PFE.3 Education methods include the patient’s and family’s values and preferences and allow sufficient interaction among the patient, family, and staff for learning to occur.

• There is a process to verify that patients and families receive and understand the education provided.

• Those who provide education encourage patients and their families to ask questions and to speak up as active participants.

• Verbal information is reinforced with written material that is related to the patient’s needs and consistent with the patient’s and family’s learning preferences.

PFE.4. Health professionals caring for the patient collaborate to provide education.

• Patient and family education is provided collaboratively when indicated.

• Those who provide education have the subject knowledge to do so.

• Those who provide education have adequate time to do so.• Those who provide education have the communication skills

to do so.

• Any Question???

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