Are written materials easily accessible?

Intranet not always best for distribution

Making written handouts readily available to clinicians interacting with patients is an important element of patient education.

At Miami Valley Hospital in Dayton, OH, a patient education listing on the intranet gives staff the ability to print most items from a computer in their department, explains Janet L. Petty, MLIS, AHIP, associate librarian at Craig Memorial Library. The rest, such as commercial pamphlets, are ordered online, or via e-mail, fax, or a phone call to the patient education department. That department is operated by the medical library under the guidance of the medical staff-driven multidisciplinary Patient and Family Education Committee. When materials are ordered, the department is notified when items are ready. Staff members come to the library to pick up their order.

All materials are distributed free of charge, and there is one budget for written educational items. When departments are asked to pay for their materials, it is usually because they are specific to their discipline and not used elsewhere in the hospital, says Petty.

Within the patient education department at Mount Carmel East in Columbus, OH, a coordinator tracks supply levels with the help of two volunteers. Vendor items are ordered by an electronic purchasing system. When in-house materials need to be printed, a requisition is sent to the Creative Services Department, according to Karen Guthrie, RN, MS, manager of community and patient education. "While some of our staff advocate for only electronic access and printing, it can be an inconvenience for staff to print handouts that are given out frequently," says Guthrie.

She encourages departments to use the preprinted in-house materials only for topics that they frequently cover during patient education, she says. The versions that come from the print shop are more attractive, with a color header, and they are sturdier with a slightly heavier paper, Guthrie says.

The commercial and print materials are picked up by staff in the receiving departments or delivered by the education department. A courier delivers items to off-campus sites.

Most patient education materials at The Ohio State University Medical Center in Columbus are created in-house and distributed on the Intranet. This system not only makes materials accessible across the health system, but it also allows for consistent information to be distributed, says Diane Moyer, BSN, MS, RN, associate director of patient education at the center.

The purchased materials that are used are coordinated and distributed by other departments. For example, the cancer hospital purchases some brochures and materials and distributes them to the units. Also, the librarian at the consumer library coordinates ordering commercial materials distributed to the public at that location. To obtain copies of the pamphlets, people visit the library in person or the material is distributed by mail to people who call asking for information, explains Moyer.

Pep talk helps high-risk stroke patients

According to a recent study1 from the University of Michigan (U-M), high-risk stroke patients are twice as likely to get follow-up care from a primary care doctor if they receive a motivational talk over the telephone.

"It is unfortunate that these high-risk patients often have a lower rate of follow-up with their primary care physicians," says Rajesh Balkrishnan, PhD, associate professor in the College of Pharmacy and School of Public Health at the U-M, Ann Arbor. "They should not ignore their results and seek medical help."

The U-M study, published in the Journal of Stroke and Cerebrovascular Diseases, tested the effectiveness of telephone interventions with those who had two or more stroke risk factors.

More than 200 people participated in the study. All participants lived in North Carolina, a state in the "stroke belt," the southeastern region of the country with the nation's highest incidence of stroke. They received standard information on strokes, such as risk factors, or a telephone call, a brief intervention known as the Health Belief Model which offers specific health advice and discusses barriers to seeing a primary care physician. "Patients who had the telephone intervention were twice as likely to visit their primary care physician and discuss stroke screening results," says Balkrishnan. "Telephone interviewers worked with these patients and reinforced the need for stroke care with a primary care doctor." These patients also modified their diet and even talked about seeing stroke specialists, he adds.

Three months after the screening, 56% in the intervention group, compared to 38% who did not receive a call, had visited their primary care doctor specifically to discuss the stroke screening results.

Reference

  1. Anderson R, Camacho F, Iaconi A, et al. Enhancing the effectiveness of community stroke risk screening: A randomized controlled trial. J Stroke Cerebrovas Dis 2011; 20:330-335.

COPD readmits high among black patients

For patients age 40 and over with chronic obstructive pulmonary disease (COPD), hospital readmissions within 30 days of initial treatment were 30% higher among blacks than Hispanics or Asians and Pacific Islanders and about 9% higher than whites in 2008, according to News and Numbers from the Agency for Healthcare Research and Quality.

Based on data for patients who were hospitalized with COPD in 15 states during 2008:

  • About 7% of patients were readmitted within 30 days principally for COPD, but 21% were readmitted for any health condition (all-cause readmission).
  • There were 190,700 initial hospital admissions specifically to treat COPD, at an average cost of $7,100. The average readmission cost principally for COPD was 18% higher, at $8,400 per stay, but all-cause readmissions were 50% more expensive than the initial stay at $11,100.
  • Readmissions were 22% higher among patients from the poorest communities than among those from the highest income areas.
  • Readmissions were about 13% higher among male patients compared to females.