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January 26, 2016
4 Steps to Better Patient Education
Ongoing management of chronic healthcare conditions is becoming a trend, as evidenced by the Centers for Medicare and Medicaid Services’ (CMS) new separate payments for chronic care management (CCM). Since the beginning of 2015, CMS has encouraged regular contact with beneficiaries with two or more chronic conditions expected to last at least 12 months, or until the death of the patient, that place the patients at significant risk of death, acute exacerbation/decompensation, or functional decline, by offering payments for monthly visits that include a minimum of 20 minutes of qualifying care.
However, to make this focus on CCM successful within the new framework of patient satisfaction ratings and more efficient, effective care, patient education is critical. That means more than just handing a patient a pamphlet and sending them on their way. Well-thought-out patient education enhances patient satisfaction, patient involvement in care and patient safety — all of which can help you earn bonus payments from CMS.
Here are the four key tenets of a good patient-education program.
1. A consistent and informed staff
In order to do this, you must create a plan around patient education that clearly and concisely details the goals of your program, who is involved and their roles in educating patients, how you will deliver patient education (e.g. written materials, face-to-face teaching, follow-up phone calls), and how you will benchmark the current state of patient education in your practice, facility or hospital — and how you will measure progress going forward. Staff should have input into all the aspects of the plan, so that there is stakeholder buy-in, which will ensure the program can be updated or implemented fully. Having time frames for meeting goals (e.g. by six months, 90% of patients receive follow-up calls to ask how they are doing with managing new medications and answer questions) in place will give you a roadmap. Yet these deadlines should be realistic, recognizing that change takes time and will not necessarily be easy. Compile the patient education program in writing, to make it easy to train staff on its components.
2. Involved patients and family members
Find ways to involve both patients and their family members or carers in education about conditions that require ongoing care. Opportunities for reaching both groups include: clinical points of care, a patient portal, a public website, mobile applications and other programs, such as support groups. Patients, with the support of their families and/or carers, need to be fully informed to make decisions about care over both the short and long terms. Thus, it is important to provide them ample opportunity to not only ask questions at the point of care, but to be able to process that information, perform further research, and feel free to ask follow-up questions. A good patient education program should help ensure that patients and their families have opportunities, tailored to their needs (e.g. according to literacy level or preferred language), to become knowledgeable before a health crisis occurs. Keep in mind that, although these conversations can be uncomfortable, it’s important to both enhancing education levels and patient satisfaction levels that communication with patients and their families be honest and open.
3. Patient-specific education
Patient-specific doesn’t just mean condition-specific. Although patients should be provided education materials focused on their conditions in multiple media formats — such as written materials, videos, internet links and apps— it is of the utmost importance that each patient receive one-on-one education that is patient-centered. Using medical scribes to create documentation at the point of care frees healthcare providers to have open conversations with patients (and their families and/or carers), so that concepts and actions around their care can be fully explained — and, just as importantly, so that they feel they are being listened to and feel free to ask questions. Furthermore, with a medical scribe in the room, recording the encounter, the patient can be provided notes upon discharge or after the appointment that reinforces the education that has been done by the clinician. Going home with instructions that are specific to them helps the patient feel that they are important, and makes them more likely to actively engage and participate in managing their chronic condition.
4. Continual reinforcement of that education
Patients don’t have the same levels of knowledge that healthcare professionals do, and that means they sometimes forget the details, become confused or simply stop making what seems like an “extra effort.” Thus, it’s critical that your patient education program build in routes for follow-up, and not just at the point of care, at the monthly CCM care episode. Opportunities for reinforcement should be both patient-driven — such as apps that patients can download to their mobile phones, portals that they can access through their computers, or an easy way to get in touch with their provider or facility to ask questions — and provider-driven — that is, the provider, practice or facility should have routes for regular follow-up communication, including text reminders, phone calls and exchanges via apps or patient portals.
Patients who are paired with Care Navigators report feeling less anxiety, and an increased ability to self-manage their conditions between visits. And providers report increased job satisfaction from improved efficiency, and knowing their patients have access to care teams, and strategic support.
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