Neil Gulsvig

In my last article, I discussed the third driver to successful patient transitions, in-the-moment patient feedback. As we move to the forth driver, patient education, I want to start by exploring a hypothetical situation that demonstrates its importance.

Virginia, an 87-year-old widow, was admitted to your short-stay facility after hospitalization for angina related to coronary artery disease. Just before discharge, her doctor ordered transdermal nitroglycerin to prevent angina. The nurse at your organization explained to her she should apply a nitro patch every morning after she got home. Virginia transitioned to her apartment where she lived alone, and saw her personal physician for follow-up a week after discharge. Upon exam, six nitro patches were found at various sites on her body. No one had taught her how transdermal nitroglycerin worked, and that she should take off the patch every night before applying a new one the next morning. Virginia did not have enough information to manage this medication safely. How could this have been prevented?

Understanding the patient experience, as it relates to learning new information and skills to make sound health management decisions, is an important first step in developing learning plans with patients. Do we understand how their disease process has affected their lives, and how they are coping with the life changes that accompany it? Patients may feel overwhelmed with too much information to absorb. Perhaps they can’t understand the medical jargon, leaving them feeling confused and apprehensive. They may be wondering how they will be able to adapt to their new normal.

Engaging patients in their own healthcare challenges us, as healthcare professionals, to shift how we perceive patient education delivery. We need to move from viewing the people we teach as patients to recognizing them as persons and partners. We need to help patients move from being passive recipients of information, to persons who actively engage in dialogue with their health care providers about their health, treatments, expectations and goals.  We need to willingly allow our patients to share in the responsibility for their care, safety and well-being. We need to ensure our patient learning processes are truly person-centered.

Person-centered education can:

  • Strengthen the patient-healthcare team relationship
  • Promote communication about things that are meaningful to the patient
  • Help patients learn more about their health and health conditions
  • Empowers patients to monitor and manage their own healthcare and enhance their patient experience.

Ultimately, with patient-centered education, your organization is setting your patients up to be best prepared to self-manage after discharge and successfully care for themselves at home. 

Possible Challenges
There can be challenges in developing and delivering quality person-centered education. As providers consider employing this type of education in their organizations, it is important to consider these challenges:

  • Patients who are struggling to accept changes in health status and lifestyle may not be receptive to learning. Engaging them early in the stay allows more time to work through those feelings.
  • The ever-increasing complexity of medical care is challenging to convey in ways that patients can understand.
  • Patients may have limited basic literacy. They may not have good reading and comprehension skills, and they may not know how to find the information geared toward their capacity to learn.
  • Lengths of stay may be just a few days or weeks, making it difficult to help patients learn all they need to know in such a short time.
  • It takes time to gather appropriate learning materials designed for older adults and effectively deliver that content.

Take Action
As a provider dedicated to safe, sustainable patient transitions, patient-centered education is a critical component of each patient’s care plan. How can providers develop a person-centered education system that can meet these challenges and patient needs?  Consider these strategies to get started:

  • Develop an organizational mission, vision and philosophy that reflects commitment to quality patient and family education. Convey that message clearly and often to staff, patients and families.
  • Formalize your processes for quality patient and family education; develop policies and procedures.
  • Develop patient education content and aids designed for older adult learners.  Focus on key points, lay terminology, brief learning sessions and what to watch for post-discharge.
  • Identify patient and family learning needs and begin education early.
  • Establish processes to evaluate effectiveness of educators: teach-back, post-learning assessments, return demonstrations, and patient evaluations of learning sessions.
  • Identify and communicate clear and specific expectations for staff behaviors related to patient education.

Neil Gulsvig, CEO of Align, has more than 35 years of experience in the field of senior healthcare and extensive knowledge in human resources, communications and operations. Align is focused on developing integrated solutions that help providers reimagine patient experiences through engagement and successful discharge and transition planning.