Where Do I Get Accurate, Timely Information For My Patient Families?

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Employees at Cook Children’s can count on the accuracy and clarity of the up-to-date education materials available to share with patient families.

Who creates these resources? Where can you find them? And how can you be sure that the handouts use friendly formatting to emphasize key points in simple language? No medical jargon, in other words.

Suzanne Beckett, director of Library Services at Cook Children’s, explains that the materials include licensed content from four vendors as well as more than 950 custom handouts created by our own experts. The Patient Education and Health Literacy Council at Cook Children’s governs the development and implementation of these resources.

The Council’s goal: “With a focus on health literacy, teach-back and diversity, we help make sure our patients and families have access to current, accurate and clear patient education.” 

Suzanne wants to get the word out. First, she wants all employees to know what’s available so that the resources will be more widely used in every setting – from primary care offices, to urgent care and the medical center. Additionally, Suzanne wants employees to know the role of the Council behind the scenes in vetting the high standards of the materials.

There are two ways to find the materials (You must be on the Cook Children's Network): 

1.      Go to CookNet, to the gray Quick Links box on the right, to the Patient Education portal. There, you’ll see the search box for Cook Children’s custom resources as well links to all four vendors:  KidsHealth (Nemours), Lexicomp (Wolters Kluwer), Health Library (EBSCO), and the American Academy of Pediatrics.

2.      When wrapping up a visit or discharging a patient using Epic, you can access the Lexicomp content through the Clinical References hyperlink. These instructions are included on the patient's after-visit summary (AVS) and in the visit summary in MyCookChildren’s.

Topics include:

• Responsibilities of the primary caregiver
• Information about diagnosis and treatment
• Safe use of medications
• Pain management
• Diet modifications
• Rehabilitation
• Activity modification
• Signs and symptoms of worsening condition

These topics are only scratching the surface of information that’s available. To get an idea of the subject matter variety, consider these examples. A search for “migraines” on the link for Cook Children's custom handouts comes up with 11 results covering the management of chronic headaches, lifestyle reminders, sleep habits, occipital nerve block and other topics. A search for “ingrown toenail” within the KidsHealth resource yields information on at-home instructions and warnings about swelling and bleeding. A search of our custom handouts for “asthma” generates 55 results, including handouts on asthma triggers, inhaler use and a diagram of a child lungs, available in Spanish, Arabic, Chinese, Swahili and other languages. For instance:

http://intranet.cookchildrens.org/search/Pages/PatientDocs.aspx?k=asthma

Appearance matters too. The handouts are colorful, illustrated and arranged with frequent bullet points, bold type and subheadings that create an attractive page design. Some include checklists or lines for the patient caregiver to write notes.  

“Providing information to patients helps them become engaged, informed and better able to ask good questions,” Suzanne said. “Patient education helps reduce readmission rates. It helps reduce visits back to the Emergency Department. If we can help people learn what to look for when they get home and when to call their doctor, they’re going to catch things quicker. They’re going to be able to intervene sooner. And good information is going to reduce medication errors.”

Responsibility for the printing and consistent distribution of handouts belongs to each department at Cook Children’s. Suzanne recommends that the departments focus on the handouts they use most commonly. Copy no more than about one month’s quantity at a time; otherwise, a big stack of old handouts might linger in a drawer after newer versions are published.  

The four subscribed services continually update their materials. The custom handouts produced at Cook Children’s are reviewed every three years, or sooner if needed. That systematic approach helps to ensure the content is fresh and verified.

“Patients are going to accept as true the information they get from their doctor. You want to make sure that it's accurate, current and reliable,” Suzanne said.

Another important benefit, she said, is the health literacy component. The American Academy of Family Physicians (AAFP) recommends simple words, short sentences and visual aids. Written materials increase patient satisfaction and knowledge compared to verbal instructions alone, the AAFP points out.

According to the AAFP, more than one-third of U.S. adults have limitations in health literacy, such as following directions on a prescription drug label. Those literacy limitations -- in reading, writing, chart comprehension and use of electronic technology -- can affect health outcomes.

Suzanne said a patient’s or family’s abilities in health literacy are affected by stress, distractions, pain and sleep deprivation. “Probably most people who have a sixth-grade education can read a prescription label, but because of their limited health literacy, they may not be able to actually take action and comprehend the next steps of what to do with it.”

A standard of the Joint Commission requires patient education and training based on each patient’s needs and abilities. To comply with the Joint Commission, materials should be:

• Inclusive of the social, cultural and linguistic needs of patients.
• Written in “plain language” and at an average of at or below the sixth-grade reading level.
• Available in English and Spanish with additional languages available upon request.

“We do it because it’s the right thing to do. We need to help our patients have healthy outcomes, but it's also a standard that we need to adhere to for regulatory reasons,” Suzanne said.

The resources can complement the teach-back method practiced by Cook Children’s professionals, which aims to gauge the patient family’s comprehension of medical instructions.  Instead of the provider asking “Do you have any questions?” the teach-back technique says “I know I gave you a lot of information. Can you explain to me what we just talked about so I can make sure I explained it right?” Suzanne describes the teach-back style as less intimidating for patients who might not want to admit they don’t understand what the doctor said or what’s written on the handout.

Staff who get into the habit of using these patient education resources regularly will find them beneficial, Suzanne said. “A couple of the nurses who I shared it with were like, ‘I wish somebody had pointed this out to me sooner.’”

For information on rare diseases or any topic not covered in the materials available through CookNet or Lexicomp on Epic, employees may contact the Family Health Library at Cook Children’s.   

Related To This Topic:

• The Importance Of Providing Take-home Educational Resources For Our Patient Families
• A Library For Everyone: Three Libraries Provide Integrated Approach To Health Literacy