Patient Education Nuts And Bolts

Patient education is a process that begins with the first encounter and continues throughout the physician-patient relationship.  This process provides the patient with enough information to make an informed decision to go forward with a treatment plan or to understand the consequences of refusing a physician’s recommendation.  Identifying patient education needs will depend on patient condition whether it be acute, chronic or at end of life.

Two types of patient education are necessary.  The first is general information about disease/disorder and the second is specific information such as medication, exercise, diet and equipment to promote wellness, maintenance, or comfort as appropriate.

Regarding medication, a patient needs to understand what the medication is for, how much and how many times per day to take it, by which route, the duration to take it, and why.

Patients have a tendency to remember only about 7% of what is said, but 24% of what is given to them in writing.  Diagrams of exercises and handouts for particular diets are helpful.  Instruction sheets explaining the reason and proper use of equipment and duration will reinforce verbal instructions.

Three learning barriers that may interfere with patient understanding are cultural differences, education levels and literacy/health literacy.

Cultural differences may impede an examination and limit a physician’s ability to assess.  For instance, if a patient’s belief system forbids undressing.

Educational levels vary.  One patient may lack formal education, which was not assessed and may lead to improper use of a medication and an adverse event. Another person may be highly educated, but does not understand medical concepts and misses the entire meaning of a physician-patient discussion.

It is important for staff to alert the physician to issues such as a patient who is unable to read.  Special care to educate this patient will be necessary.  Also, staff needs to reinforce what the doctor has told the patient and notify the physician whenever a patient needs clarification.

Patient educational materials should be written at a 6th grade level or less.  It is best to use short words, avoid using medical or technical terms or abbreviations such as “SOB” which may be misinterpreted for something other than, ”shortness of breath.”

Online and community resources directing the patient to pertinent information are found on many websites.  Provide patients with printed education materials as well as a list of websites for their particular condition such as www.diabetes.org .  A good general website is www.211.org.  This United Way resource that connects people to important community resources can also be reached by dialing 211 on a mobile phone. Directing patients to resources is a good way for the patient to become part of the decision making process.  Two programs to facilitate patient interaction are:

Speak Up Campaign by Naval Health Clinic Corpus Christi

Speak Up if you have questions or concerns.

Pay attention to the care you receive.  Make sure you get the right treatments and medications by the right health care professionals.

Educate yourself about your diagnosis and plan.

Ask a friend or family member to be an advocate.

Know what medications you take and why you take them.

Use hospitals, clinics or other organizations that have ongoing on-site evaluations.

Participate in all decisions about your treatment.

The Ask Me 3 by the National Patient Safety Foundation

What is my main problem?

What do I need to do?

Why is it important for me to do this?

Documentation is vital to capture patient perception of the need for a visit, the provider’s objective observations, assessment, and rationale for recommended treatment plan including patient buy-in.  When a patient refuses treatment plan, documentation must include a discussion took place and that the patient understands the consequences.

Dona Constantine is a risk management and patient safety specialist at the Cooperative of American Physicians in Los Angeles. This article is one of a series by CAP personnel.