Center for Patient and Community Education
California Pacific Award for Excellence in Patient Education
2004 National Top Ten Winners
Wlatka Peric Knowlton, N.P., C.D.E.
Diabetes Jeopardy
Carl T. Hayden Veterans Affairs Medical Center - Phoenix
Phoenix, Arizona
Project Summary: Diabetes Jeopardy is an innovative diabetes education game for adults – primarily elderly patients and typically, with low literacy. The game is part of a broader, 2-day / 8-hour diabetes education program attended by VAMC patients and their families. The game follows the format of the TV game show Jeopardy; the game's enjoyable, interactive summary supports learning retention. The class is broken into teams that compete. Mugs and pens and other give-away promotional items are prizes awarded as prizes. VAMC's Podiatry, Nutrition, Kinesiotherapy, and Endocrinology departments all submitted questions for the game. The game presents questions under the categories "Diabetes Basics," "Nutrition," "Exercise," "Foot Care," and "Medications." The game reinforces information that has been presented verbally as well as in VAMC's Diabetes Management education manual, appealing to both auditory and visually oriented adult learners.
Heather Bernard, B.S., R.N.
Hand Hygiene Education Program
Community Memorial Hospital
Hamilton, New York
Project Summary: The purpose of this program is to improve general hand hygiene and thereby decrease infection rate. Research shows one out of three people do not wash their hands after using the restroom and most people do not know proper hand-washing technique. Patients are discharged from the hospital with the expectation that they will be managing their own wounds. The Hand Hygiene Education Program's user population is comprised of inpatients (medical, surgical, obstetrical, and newborn), outpatients, and patients' families and visitors. The program uses colorful handouts, posters, and pamphlets to educate about hand hygiene. These patient education tools are located throughout the Hospital in waiting rooms and bathrooms. Hand hygiene education is presented to patients on admission, reinforced during stay, repeated at discharge, and further reinforced by surveys.
Susan Allen
Coming to the Hospital for Surgery
Doernbecher Children's Hospital
Portland, Oregon
Project Summary: This patient education tool, a charming and engaging booklet, was developed for pediatric surgical patients and their families as an aide to alleviating fear of the otherwise unfamiliar hospital experience. The booklet provides an introduction to the hospital, a step-by-step depiction of the hospital stay, equipment familiarization, and a bibliography for further education. The booklet format incorporates several key learning issues: diversity and culture, reading level, visual representation, interactivity. Coming to the Hospital for Surgery is visually appealing and easy to understand.
Patient Education Teaching Packets
Greene Memorial Hospital
Xenia, Ohio
Project Summary: For this project, patient education needs were identified by studying frequencies of various diagnoses. The project's education units are structured around specific diagnoses; relevant patient education literature is physically contained in a convenient take-home envelope that is given to patients. During the patient's hospital stay, a teaching tracking form is attached to the envelope for hospital staff use. The teaching tracking form, completed by nursing staff, corresponds to written information provided to patients and their families. Packet materials include handouts and small posters – vendor-purchased, for the most part – that are easy to read and understand. Patient and family readiness to learn is continually monitored and re-evaluated. (If a patient is admitted with a primary or secondary diagnosis of CHF or pneumonia, a follow-up call letter is sent to the patient's place of discharge. The follow-up call is made, and if the patient and/or family require further information, additional education is provided by telephone. These follow-up calls have been found to reduce readmission rates of pneumonia and CHF patients.) While in the hospital, patients are surveyed to ascertain what they have learned – this enables assessment of teaching-method effectiveness. Upon discharge, patients sign the teaching packet form to verify completion of their patient education. A record of all education is both provided to patients and kept on file.
Stride for Health, Mall Walkers Program
Mercy Health System
Janesville, Wisconsin
Project Summary: This ongoing project addresses obesity – now epidemic in the United States. The Stride for Health Mall Walkers Program was created to respond to multiple patient desires: 1) a simple, effective way to control weight and stay physically fit; 2) a program that users can "stick with"; 3) support with motivation and consistency; 4) a location where walking is possible given climate issues; 5) assistance with setting reasonable goals and monitoring measurable results; 6) additional health information and support services; 7) fun, active social outlets; 8) easy access to free or low-cost health screenings to encourage preventative care. Any community member is eligible to join this program, at no cost. Already formed walking groups at the location are encouraged to join, and MD referrals are encouraged. The program includes a walking group, lectures by regular speakers, monthly health topics, free screenings, a computer kiosk, free member breakfasts. Each meeting has a short health presentation, a heart-healthy breakfast, and blood pressure screening. The program also includes structured walking, free screenings, regular guest speakers, and discussion of monthly health topics. The mall used – Janesville Mall – has a health education kiosk and is physically connected to Mercy Hospital. Patients use the kiosk to research health topics; they can email a Mercy Representative for additional information. Milestone goals are set to promote positive feelings and encourage participants to continue. A monthly door prize and other prizes for goal attainment are awarded.
Tom Hickey, P.A.
Patient Pathways: Post-Operative and Post-Discharge
New York-Presbyterian Hospital: Columbia University Medical Center
New York, New York
Project Summary: Patients and their family members vary in learning styles and therefore need a variety of visual, auditory, and other approaches to health education. Patients need to know what to expect in their hospital experiences and what to do when discharged. In addition, hospital lengths of stay have shortened, and patients for whom English is a second language may have difficulty understanding English-only communications. As a result, patients are sometimes discharged without materials necessary for understanding and caring for their illnesses. Patient Pathways: Post-Operative and Post-Discharge was designed for patients having open-heart surgery (non-transplant, LVAD patients), bypass, valve, and aneurysm procedures via sternotomy, thoracotomy or robotic approaches. For this project, two different posters were created. One poster, titled Post-Operative Pathway, is used for in-hospital display. The second poster, Post-Discharge Pathway, is provided to patients for home use. The purpose of these Pathway posters is to increase awareness of stages of recovery, warning signs, and expectations. The Post-Operative Pathway poster describes a typical path that a patient travels during open-heart surgery. It starts at day of surgery and goes through Day 5 of the patient's stay. Patients receive this Pathway poster during their pre-operative orientation; it is given to them by the Cardiac Outreach Coordinator. The poster is part of a larger patient education experience that includes discussion, a videotape, and a Patients' Guide to Surgery booklet. The Post-Discharge Pathway poster is given to patients in conjunction with a ½-hour "Discharge Education" group class for patients and family members. This innovative poster outlines what a patient can expect during hospitalization and following discharge. Both Pathway posters are easy to read and are available in English and Spanish.
Christine Vo, B.S.H.E.
Staying Free – A Santa Clara Valley Medical Center Inpatient Smoking Cessation Program
Santa Clara Valley Medical Center
San Jose, California
Project Summary: This project is addressed to patients who are active adult smokers and who are motivated by illnesses to change their smoking behavior. SCVMC is a county hospital that serves predominantly low-income and/or indigent, multi-ethnic, multicultural population. 20% of admitted patients are active smokers (compared with a 15% rate in Santa Clara County as a whole). The program is based on the observation that during hospitalization smokers are motivated to quit. Physically removed from the smoking "cues" normally encountered in their day-to-day lives, they go through withdrawal (48-72 hours) in hospital. Mechanisms of education include 1) identifying nearly all tobacco users hospitalized at SCVMV; 2) providing face-to-face intervention to patients who want to quit during hospitalization; 3) pharmacotherapy, and 4) outpatient follow-up. The program achieves a 6-month smoking cessation for 30% of participants. A simple referral-slip system identifies smokers who wish to quit. Intervention and counseling are provided. Patients receive 1) a strong bedside message from a physician; 2) 30-60 minute behavioral bedside counseling; 3) education materials (handouts, video, audio); 4) ongoing follow-up; 5) translations; and 6) referral to the Santa Clara County Outpatient Smoking Cessation Program. The one-on-one bedside interventions are effective. A variety of learning tools are offered, including videotapes, audiocassettes, and handouts. Patients can apply methods of education that work for them. Spanish and Vietnamese language versions are available (including audio, video and written materials). This project is a six-month program that includes ongoing telephone follow up by a hospital smoking cessation counselor (at 48 hours, 7 days, 21 days, and 90 days). Final follow up occurs after six months.
Adele Ducharme, M.S.N., C.C.R.N., C.N.A.
At Home with Heart Failure
Tri-City Medical Center
Oceanside, California
Project Summary: The population of patients with congestive heart failure (CHF) is large, and many of these are re-admitted to the hospital. Studies show readmission rates decline when patients receive education, support and referrals. The At Home with Heart Failure program addresses 1) CHF patients' need to know the meaning and causes of heart failure; 2) medication management; 3) when to report symptoms; 4) ongoing reinforcement of instructions; 5) emotional support and community support. In this program, staff nurses give verbal education and written instructions; patients then watch five vendor-purchased videotapes. For outpatients post-discharge, there is an At Home with Heart Failure telephonic case management program; information about this program is presented to patients while they are in the hospital. Patients seen in the Emergency Department are eligible for the At Home with Heart Failure program. Referrals are phoned or faxed to the case manager. Inpatients receive daily weight measurement, signs, symptoms reportable, diet activity monitoring, and medications. Outpatients receive free pillboxes, weight and medication charts, and a free scale. Post-discharge patients receive telephonic case management and educational materials that are mailed to their homes. The nurse case manager updates and verifies information with the primary-care physician. The program uses a variety of learning methods, including videotapes, handouts, and phone calls. Telephonic Case Management operates during daytime, workday hours. Patients are instructed to call their physician if they are symptomatic. Patients provided input in the project's creation via a controlled clinical trail. Hospital statisticians are collect data on readmission rates; patients are asked periodically if telephonic case management has helped them. This trial determined that patients who received the telephonic case management had a 45.7% lower rate of hospitalization.
Norma Blas
Inshirah Abdul Hadi
Amina Badmaax
A Multicultural Baby Shower: A Focus on Child Passenger Safety
Truman Medical Center
Trauma Services
Kansas City, Missouri
Project Summary: Providing injury prevention education to patients from different cultural backgrounds and who speak a variety of languages is a challenge. Ethnic populations are shown to have lower use of seat belts and passenger safety seats, and a higher incidence of motor vehicle crashes. In addition, these populations may not be receiving much-needed safety information. Recent immigrants need language and culture-specific educational tools. Cultural beliefs also affect passenger safety issues; accordingly, a culturally competent model is needed to educate this population on passenger safety. The specific population served by this program is that of pregnant women who deliver at TMC. This group includes women who speak English as a second language and non-English-speaking residents, among others. Demographically the group served by this program is 50% African American, 22% Hispanic, 21% Caucasian, 4% other, and 3% Asian. A growing number are refugees and immigrants, who speak a variety of languages (e.g., Arabic, Farsi, Kurdish, Somali and Spanish). TMC is a level I Trauma Center; as a safety-net hospital, TMC provides care regardless of ability to pay. In 2004, TMC Language Services (translation and interpretation) provided over 35,000 patient contacts (4470 Arabic/Farsi/Kurdish, 4560 Somali, 25,691 Spanish). During National Child Passenger Safety Week, car seats, baby blankets, and other gifts are given out. This is an interactive learning activity that addresses cultural concerns and offers demonstrations, presentations, and handouts. A pre-Shower survey is administered to assess baseline knowledge related to the topics. (The survey is provided in either written or oral form and in the patient's primary language.) In the patient-education component of the program, all written instructional materials are available in translations (Spanish, Somali and Arabic) as well as in English. An interpreter attends each session, and culture-specific behaviors are addressed. A follow-up survey is given after the Shower to assess learning. Safety topics include uses of car seats, smoke detectors, cabinet locks, bathtub nozzle covers, and electrical outlet plugs covers. Project development was a team effort on the part of Trauma Services, Language Services, Volunteer Services, Public Relations, OB/GYN Department, and Guest Relations.