Summer and Fall '19
Kyuntae Kim, Tanvi Ranka, Xuning Guo
COMET: COPD Medication Education Tool
Summer and Fall project at Institute of Healthcare Delivery Design and UI health with the Respiratory Health Association (RHA). This project is about creating an in-patient medication education and symptom recognition tool for COPD (Chronic Obstructive Pulmonary Disorder) patients for better hospital-to-home transition. The discussion guide empowers the patient to recognise and manage their symptom at home post discharge and take necessary steps to maintain a healthy lifestyle.
Special thanks to Kim Erwin and Jennifer Sculley
Currently leading a student team through research, synthesis and development of the discharge tool. Over the summer, I conducted;
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Secondary research, covering the current education material and understanding why it doesn't work.
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Primary research (interview, observation and shadowing) in both in-patient and out-patient setting. Direct contact with patient, caregiver and the medical staff.
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understanding the workflow and information flow to understand the best education delivery point.
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Review on the 'provotypes' with different possible touch points
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Co-conducting patient focus groups to review the prototype
Understanding the context: Current patient education
PHASE 1
THE CURRENT EDUCATION MATERIAL DOES NOT WORK...HERE'S WHY
There are few relevant visuals and the information is mostly general.
Resource materials are text heavy and written at 11-12 reading grade level.
Doctors often write or sketch on post-its to educate the patients about their condition. The current education material does not facilitate that.
Current material does not prepare for the change in medication due to patient's insurance coverage.
Current material doesn't call out important information regarding self management or the additional resources available for the patient.
Currently the education material serves the purpose of a handout rather than facilitating a conversation between the medical staff and the patient.
THE CURRENT EDUCATION MATERIAL DOES NOT SUPPORT THE REAL ENVIRONMENT...
The current education material is provided to the patient during discharge which is a high stress point for the patient to retain important information.
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Current education material used by the MoPhE (mobile pharmacy education) team at UI health.
Black and white print outs of the education material is then handed out to the patient after the MoPhE consult.
PHASE 1
Understanding the context: Current patient journey
UNDERSTANDING HEALTH SYSTEM + STAKEHOLDERS + WORKFLOW
Critical time of care;
COPD self-management interventions can reduce re-hospitalization.
No consistency in the education provided to the patient at different points of care
No variation in education given to a new COPD patient vs someone at a severe stage. Redundant information.
Medical staff works in silos. There are key members in COPD care who are not often part of the medical rounds which disrupts the patient education during the entire process
Activity map + different touchpoints | Prototype use opportunities
Reviews + prepares the patient for better hospital to home transition. Asks for any questions.
Introduces appropriate use of controller + reliever inhaler
Introduces appropriate use of controller + reliever inhaler, Inhaler education when possible
Fills in medication details, reviews 'what to take' and 'when to take' medications; set expectations for any medication change
Reviews + prepares the patient for better hospital to home transition. Asks for any questions.
Refers to tools to ask questions
Updates the medications based on insurance coverage.
Refers to action plan at home; refers to the back page to prepare for outpatient appointment
Refers to tools to ask questions
Quickly reviews the regimen patient left the hospital on + any preparation patient comes in with
Ideally provides consistent, updated education material for patients to use post follow up
Refers to the tools to support medication + symptom recognition conversations
PHASE 2
'Provotype' development
Design principles...
...support conversations in real-world conditions.
...serve as a reminder of self-management education back at home.
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...standardize plain-language explanations of medications across educators.
...optimize use of limited staff resources and time constraints.
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...equip patients with critical treatment plan information to promote continuity of care.
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...address the medication translation process from home to hospital to home.
...promote the benefits of using medication appropriately.
Three concepts...
Stepping up care
Decision tree concept
Patient engagement concept
'Provotype' review with the clinicians...
Different versions of the 'Provotype' with feedback from the medical staff at UI health.
'Provotype review with the clinical pharmacist. They round with the on-floor medical team and are a key member to deliver medicine education to the COPD patients.
'Provotype review with the respiratory therapist. They see the COPD patients on a daily basis. Possible delivery point for this education tool
PHASE 3
Prototype development
New team onboarding + Information breakdown
