Exam 2 - Pt Education and Empowerment Flashcards
Healthcare quality domains: safe
Avoiding harm to patients from the care that is supposed to be helping them
What are the 6 domains of healthcare quality?
Safe
Effective
Pt-centered
Timely
Efficient
Equitable
Healthcare quality domains: Effective
Providing evidence-based care to those who would benefit
Refraining from providing services to those not likely to benefit (misuse and underuse)
Healthcare quality domains: Patient-centered
Respectful and responsive care to individual patient preferences, needs, and values and using these to guide clinical decisions
Healthcare quality domains: Timely
Reducing waits and sometimes harmful delays in care both for those receiving and giving care
Healthcare quality domains: Efficient
Avoiding waste in:
- equipment
- supplies
- ideas
- energy
Healthcare quality domains: Equitable
Providing care that does not vary in quality due to personal characteristics like:
- gender
- ethnicity
- geographic location
- socioeconomic status
IOM strategies to improve med safety: patient’s rights regarding safety and equality in healthcare should be…
Formalized at state and/or federal levels
IOM strategies to improve med safety: Every patient should maintain…
An active med list that every provider involved in their care can access
IOM strategies to improve med safety: Providers should educate patients and/or caregivers about…
Safe and effective use of meds
IOM strategies to improve med safety: What should be available at all key points of the pt care process?
Consultations on meds
Communication strategies
Meet pts on their level
Roll w/ resistance
Support self-efficacy
Follow up
Communication strategies: Meet pts on their level
Use appropriate language
Show compassion
Listen (esp after open ended questions)
Be honest about disease and medications
Communication strategies: Roll w/ resistance
Typically avoiding direct confrontation…. But it is needed sometimes
Communication strategies: Support self-efficacy
Help patients develop and maintain autonomy
What are the AMA’s 6 steps for verbal pt communication?
- Use plain, non-medical language
- Create a shame free environment
- Use the teach back method
- Slow down
- Show them w/ pictures and simple diagrams
- Limit the amount of info given and repeat it
(Use CUSS Language)
What should you do if you give a patient instructions over the phone?
Make sure pt has pen and paper to document any dosage change
Write down info as you give it and date it
Read back the info and verify understanding
Have pt keep dated instructions w/ their med bottle for reference
What should be done if a prescriber is calling in a verbal?
Ask them to spell the name and what the purpose is
RPh/intern reads back entire rx
E-scripts preferred but faxing is also good to prevent errors
In WV who is legally allowed to take verbals?
Pharmacists and interns
Common errors involving communication
- Incomplete rx
- Misread rx
- Bad handwriting
- Use of previous drug/dose on pt profile
- Misheard rx
- Poor fax quality
- Intimidation/bad interaction w/ prescriber or agent
- Typing mistake
- Unable to clarify w/ prescriber
- Prescriber error
(I Might BUMP IT UP)
You can (and should) always ____ if you are questioning something about pt, care plans, rx, etc
Confirm
What is health literacy?
Degree to which individuals have the capacity to obtain, process, and understand basic health info and services needed to make appropriate decisions
(Basically do they have the ability to understand their care enough to make informed decisions)
What is health numeracy?
How a pt interprets numbers, values, or math that is associated with their healthcare
.
What are the individual factors of health literacy?
Communication skills of individuals
Accessibility to quality resources
Personal & professional knowledge
(CAP)
What are the systemic factors of health literacy?
Communication skills of healthcare workers
Culture
Demands of healthcare and public health systems
Accessibility to quality resources
What does a short assessment of health literacy (SAHL) evaluate?
Comprehension of medical terms and pronunciation
What is a rapid estimate of adult literacy in medicine?
7 item list focusing on recognition and pronunciation of medical terms
How is a rapid estimate of adult literacy in medicine administered?
Give pt a list of words and have them read them to you
If they don’t know the word, they can pass
If they pass or take more than 5 seconds, that one is wrong
What words are on the REALM-SF
Behavior
Exercise
Menopause
Rectal
Antibiotics
Anemia
Jaundice
How is a SAHL administered?
Show them 3 words — have them read the top one out loud, and say which of the other two are more similar to the top word
Ask them not to guess if they don’t know
What are red flags of low health literacy?
Saying they can’t read it because they forgot their glasses
Commonly brings family members to office visits
Incomplete/inaccurate intake forms
Identifying meds by visual cues rather than names on the bottle (color/size/shape)
Didn’t finish high school
Patients can still have LHL, even if they are:
Well spoken
College educated
Say they understand written info
Employed in healthcare
Assume all pts have ____
Difficulty understanding
What do pts with LHL or adequate health literacy prefer?
Medical info that is easy to read & understand
What % of people have health literacy TOO LOW to navigate the healthcare system & promote their well-being?
88%
___% have intermediate proficiency
55%
___% have basic proficiency
22%
___% are below basic proficiency
14
What % of adults are proficiently health literate?
12%
When using the teach back method, who is being tested?
The patient AND the provider
Make sure pt understands and that the provider was clear and included everything
How can we improve pt safety and aid LHL?
Consumer medication info
Rx labels
What is consumer medication info (CMI)?
Written info made for pts/caregivers about rx drugs
Who is CMI distributed to?
To consumers when rx is filled
What info does CMI include?
Info on general issues
Medication-specific recommendations
Examples of CMI
Med guide
Pt handout
Pt leaflet
What is the average reading level of CMI?
11-12th grade
Less than ___ of patients read CMI
1/3
CMI should be ____
Standardized
CMI should include ___ and ___
Drug fact boxes
Clinical pearls
A 2014 study evaluated and reconstructed CMI into 3 prototypes to improve comprehension. What are they?
Was it effective?
2 columns to organize info
Mimicked OTC drug facts labeling
Simple table format following health literacy best practices
*ALL THREE of these were better understood than the original format
Health literacy best practices prototype outperformed all others, but was ____ adopted by the entire profession
NOT adopted
