Title : Maintaining use of the teach back protocol using a pilot program aimed at increasing patient understanding
Abstract:
The Institute for Healthcare Improvement (IHI) defines Always Events as aspects of the patient experience that are so important to patients and families that health care providers should reliably implement the events one hundred percent of the time. IHI lists the TeachBack method as one of these events. The TeachBack method is a way to check whether patients comprehend health information explained to them by their provider. This utilizes the “chunk and check” method, by giving patients one “chunk” of information and checking their understanding by having them explain it back before moving on to the next. While nurses and physicians may be educated on the method and have undergone training, there is not often systems in place to test adherence and determine if it is in fact being implemented one hundred percent of the time. The Neuromedicine Interdisciplinary Clinical and Academic Program (NICAP) at UF Health piloted a program in the Neurosurgery Clinic where trained undergraduate interns observe advanced registered nurse practitioners’interactions with their patients in their appointments. The interns complete a checklist that was created to assess different domains of the interactionand the degree of TeachBack that was being used. The checklist determines if key topics such as medication, pain management and expectations, activities after hospitalization, and assistance in reaching the Neurosurgery Clinic were discussed properly to ensure patient understanding. The data from these checklists are summarized and presented to the practitioners themselves. This continuous feedback allows clinicians to identify which part of the method they need to improve upon to better serve their patients. While this initiative is still in the pilot phase and its second Plan-Do-Study-Act (PDSA) cycle, it is currently being expanded to the neuro intensive care unit at the request of the medical director of the unit. In this unit, this method is not to be used uniquely at time of discharge, but whenever new information is being delivered to the patient. Nurses are often the members of the care team who interact most with the patient throughout their experience at the hospital and have the most opportunities to employ the TeachBack method. Educating nurses and other members of the care team on TeachBack is not sufficient in ensuring it is having the desired effect on patients. The program being piloted in neuromedicine at UF Health, is a way to promote a viable change in the quality of the interactions nurses are having with their patients.Ifgiven the chance to present on this topic, the audience will be educated on the TeachBack method and how to develop a program to monitor its use to ensure all patients are leaving their encounters feeling confident in their care team and in their own ability to positively influence their health. The audience will also see preliminary patient satisfaction data which shows patients report improvement with communication with their care teams since implementation of this pilot.
Audience Take Away:
• The audience will learn the importance of the TeachBack method in increasing patient understanding and positive health outcomes and how to create a program to determine if it is being utilized properly within the care team.
• Patients are often overburdened with information throughout their care experience and need more than written or verbal instruction to retain and understand the information. This presentation will allow audience members to rethink how they interact with patients and what the patients get from those interactions.
• Performing system checks is a method to increase adherence to important quality improvement initiatives such as TeachBack. This presentation will supply audience members with the tools to develop a program similar to UF Health’s neuro medicine pilot program to increase protocol adherence.
• Increasing TeachBack use in healthcare institutions across the globe is a practical solution to patient confusion and low compliance to medical adherence and post-discharge instructions.
