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;

  • Secondary research, covering the current education material and understanding why it doesn't work.

  • Primary research (interview, observation and shadowing) in both in-patient and out-patient setting. Direct contact with patient, caregiver and the medical staff.

  • understanding the workflow and information flow to understand the best education delivery point.

  • Review on the 'provotypes' with different possible touch points

  • 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.

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.

 

...standardize plain-language explanations of medications across educators.

 

...optimize use of limited staff resources and time constraints.

...equip patients with critical treatment plan information to promote continuity of care.

...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

We are currently working on the next stage, coming soon!