Mary Emmett, PhD to Present Research at Two National Conferences
- Poster accepted for presentation at Concordium 2015, September 21-22, 2015 in Washington DC. Pain is the "fifth vital sign" for patients. Pain and symptom management is a quality indicator for palliative care. Thus, the methods used to assess pain are critical for its management. In 2012, the West Virginia Geriatric Education Center in collaboration with the West Virginia Palliative Care Network made a commitment to improve pain assessment and control for patients with a cognitive impairment. The network agreed to use PAIN-AD for pain assessment. Objectives: (1) To increase pain assessment for the cognitively impaired and (2) to improve pain control for the cognitively impaired. Participating sites changed practice. Prior to use of the PAIN-AD tool, assessment of cognitively impaired patients pain was performed using each practitioners subjective judgement. Sites are continuing to use PAIN-AD and have learned from data to use another tool CPOT for cognitively impaired ICU patients. Six months following implementation of PAIN-AD 63% of the patients were being assessed and after one year 88% were being assessed. Pain scores decreased for 84% of the patients, 9% showed no change and 8% experienced a higher score. Assessment continues to be high at 89% and pain control is being achieved for 81% of the patients.
- HEALTH LITERACY: A BARRIER TO PATIENT CARE AND SAFETY
Mary K. Emmett,CAMC Institute,Charlotte R. Nath,Professor Emeritus,Sara Jane Gainor,West Virginia University,Nancy Daugherty,West Virginia Geriatrics Education Center,Hanna Thurman,West Virginia Geriatrics Education Center
Another submission accepted for presentation at the Academy for Healthcare Improvement, October 29 – 30, 2015 in Alexandria VA.
HEALTH LITERACY: A BARRIER TO PATIENT CARE AND SAFETY
Mary K. Emmett,CAMC Institute,Charlotte R. Nath,Professor Emeritus,Sara Jane Gainor,West Virginia University,Nancy Daugherty,West Virginia Geriatrics Education Center,Hanna Thurman,West Virginia Geriatrics Education Center
Background: According to research from the U.S. Dept. of Education, only 12 percent of English-speaking adults in the U. S. have proficient health literacy skills. The overwhelming majority of adults have difficulty understanding and using everyday health information that comes from many sources, including the media, web sites, nutrition and medicine labels, as well as, from health professionals. “Health literacy is needed to make health reform a reality,” said HHS Secretary Kathleen Sebelius, “Without health information that makes sense to them, people can’t access cost effective, safe, and high quality health services.” Health literacy is a major public health priority. The Geriatric Education Center in WV created a health literacy training curriculum targeting health providers in rural West Virginia. The curriculum was implemented through symposia/workshops with intensive training in oral communication. Emphasis was on working with the elderly although strategies were not limited to that population. Providers included social workers, pharmacists, dentists, nurses, health educators, physicians, benefits officers and others. Training for the course participants began with an assessment of the environment, teaching practice, clinical practice, or community to identify opportunities for improving health literacy. The logic model was applied to these pre-training assessments during the training so that by the end of the training, each participant had developed an action plan for the targeted area of improvement. Change actions were identified and a method for improvement identified - PDSA (plan, do, study, act) cycles of change. Skill in teach-back and feed-back is built into the course with every participant having the opportunity to role play both. Training also included print material and health care environment literacy barriers.
Purpose of the Study: An action plan was developed by each attendee prior to leaving the training site. The plan design was based on the use of a logic model and incorporated the PDSA cycle of change to reach the terminal outcome. Real, tangible, distal outcomes were associated with those who translated learning into action (incorporated learning into educational curriculum; taught others the skills; developed awareness in others about health literacy; changed patient behaviors; changed clinic practice; or changed how employees relate to others.
Methods: An action plan was developed by each attendee prior to leaving the training site. The plan design was based on the use of a logic model and incorporated the PDSA cycle of change to reach the terminal outcome.
Results: Overall 158 individuals received education in health literacy from multiple disciplines. Using an action plan resulted in more individuals receiving knowledge but of equal importance building competency in health literacy. Communities, patients and clinical teams benefited from the changes which came from action plans. (See attached outcomes)
Conclusions and Implications: An action plan formed by using a logic model and incorporating the PDSA cycle of improvement results in change in practice, learning and patient care. Many factors influenced the outcomes associated with learning –motivation of the individual; organizational commitment; organizational resources; organizational priorities; personal priorities and probably more. However, the strategy of requiring an action plan with specific steps and formalized training in action planning appeared to be critical for completion of projects by participants. Consistent follow-up with participants also appeared to be critical for accomplishment of distal outcomes. The impact of any given project varied significantly based on the organization.
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