The Quality - Cost Connection: Measuring the value of patient education
Measuring the value of patient education
Sort out impact of education verus other factors
By Patrice Spath, RHIT
Brown-Spath & Associates
Forest Grove, OR
Patients are being urged to assume more responsibility for the state and care of their health. Preventing illness and controlling its effects when it does occur requires optimum patient participation. Over the last few years, hospitals have developed and implemented a number of programs to educate and support patients and their families.
The goals of these programs range from providing specific information about postoperative recovery to improving long-term compliance with treatment regimens. A wide variety of media (e.g., print, video, web-based training, and personal communication) are used to achieve these goals. Because patient education programs require expenditure of human and financial resources, it is important to measure the effect of these programs on patient outcomes.
To determine the value of patient education programs, caregivers must measure the effect of education on patients’ knowledge, behaviors, attitudes, and skills required to maintain or improve their health. For patient education and intervention programs to be successful, they must demonstrate value.
Theoretically, education should improve patient compliance with their treatment regimen and self-management of their condition. However, these outcomes can be affected by several factors, many of which are unrelated to the amount and quality of education provided to patients. Carefully designed studies are needed to sort out the impact of education versus other factors.
Before measuring outcomes, it is important to determine what patients are expected to learn from the educational experience. More importantly, what change would you like to see in the patient as a result of training? Traditional education-related outcomes for a surgical admission are shown in Figure 1 (page 172).
These are immediate outcomes which can be measured during or promptly after the intervention. The nurse or caregiver responsible for providing the patient/family with the education is usually the one responsible for recording whether or not the outcomes were achieved prior to the patient’s discharge.
The need to evaluate the long-term effect of patient education is becoming more important. Issues to consider when designing an education-related long-term outcome study include choosing the appropriate endpoints to clearly measure the program’s clinical outcomes, health-related quality-of-life, patient satisfaction, and changes in health care costs.
The impact of patient education on clinical outcomes can be measured in a number of ways. Many interventions can improve patients’ compliance with their medication regimen and medical follow-up care.
Clinical outcomes also can be enhanced by improving the quality of the physician-patient interaction. When patients learn how to have a meaningful discussion with their physician, they are more likely to provide timely reports of their illness symptoms or adverse reactions. This minimizes the likelihood that patients will discontinue therapy without first contacting their physician.
Clinical outcomes also can improve significantly when the quality of patient self-care improves. Lifestyle management plays an important role in reducing risk in conditions such as cardiovascular disease and in improving treatment of conditions such as congestive heart failure.
Health-related quality of life measures generally address patients’ perceptions of their physical functioning, social functioning, role functioning, mental health, vitality, pain, and cognitive functioning. In many instances improvements in health-related quality of life are a natural result of improved clinical outcomes. However, patients’ perception of their quality of life also is improved when they are empowered by well-designed educational programs. Empowered patients tend to feel more personally capable of positively impacting their outcomes. For patients with chronic conditions, health-related quality of life can improve significantly when they are trained in self-management techniques and empowered with education.
Patients’ satisfaction with their health care depends, to a great extent, on their relationship with the health care provider. The foundation of this relationship is communication between parties. Past studies have shown that patients are more likely to be satisfied with their health care practitioner if the practitioner actively promotes health education. General patient satisfaction surveys used by most hospitals may not be sufficiently detailed to provide feedback about in-hospital educational interventions. A survey designed specifically for measuring patient’s satisfaction with the education provided by hospital caregivers is shown in Figure 2 (page 172).
Cost of health care has been shown to be reduced by patient education interventions by decreasing their demands on the health care system.
Two of the most frequently cited benefits of work-site health promotion programs are reduced absenteeism and lost work days.
According to some estimates, approximately 80% of all health problems could be treated at home. Effective education programs can prevent minor illness or injury from progressing to the point of needing professional intervention. Increased patient awareness through education can also result in earlier detection of problems and timelier outpatient intervention, thus decreasing hospitalizations. Lastly, chronic-disease patients who have been empowered through patient education programs generally have better coping skills and generally are less reliant on health caregivers.
Hospital caregivers have long been involved in educating patients and their families. With increased emphasis on managing the continuum of care, it’s time to measure the long-term effects of patient education programs. Properly designed and conducted patient education programs can demonstrate their value by improving patient compliance and comprehension. Appropriate measurement of the value of these programs is critical to their development and overall success.
Patients are being urged to assume more responsibility for the state and care of their health. Preventing illness and controlling its effects when it does occur requires optimum patient participation.Subscribe Now for Access
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