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FEATURE Cutilli says the Hospital of the Uni-


versity of Pennsylvania developed an approach to patient education called “R.E.A.C.H. to Teach.” “It is essentially a marketing cam- paign for our staff as to what we want them to do when teaching patients,” she says. The R.E.A.C.H acronym stands for relate to patient and family; educate simply; ask and answer ques- tions; check understanding; and help promote health literacy. “Even with the quick turnaround in the ambulatory care environment, you can develop a relationship with the patient,” Cutilli says. “When you do so, patients are more likely to be receptive to information you share with them. Educating simply is about giving patients only the basic information they need to care for themselves when they go home. Focus on ‘need to know’ ver- sus ‘nice to know’ information.” The “ask and answer questions” component of R.E.A.C.H. can make a significant difference in giving patients the opportunity to fully understand how to care for themselves, she says. “We have a tendency to ask patients whether they have questions, which is not an open-ended question. The best practice is to say, ‘What questions do you have for me?’” Cutilli notes that providers also tend to ask patients whether they understand the information provided. “Very sel- dom do they say ‘no.’ We encourage our staff to ask patients to teach back the information in their own words. For example, our staff may say, ‘I cov- ered a lot of information and want to make sure I was clear. Can you tell me the three most important things to do once you get home to take care of your- self?’ Hopefully these interactions with patients promote health literacy.” Soliz is a firm believer in the value of repetition. “We focus on highlighting the key points that will keep patients safe once they are no longer under our care. We repeat these important messages, both verbally and in written materials.”


We encourage our staff to ask patients to teach back the information in their own words.”


— Carolyn Crane Cutilli, Hospital of the University of Pennsylvania


When repeating a message, Gris- som says patients must hear the same guidance. She recalls when patients undergoing laparoscopic carpal tun- nel surgery at one of her ASCs experi- enced high infection rates. “We investigated and learned that


the surgeons were essentially saying the procedure was not even like surgery,” she says. “They highlighted that the procedure only required a small inci- sion and that patients would be back to normal as soon as they returned home.” The ASC’s discharge instructions did not align with the surgeons’ mes- sages. Patients will usually listen to their physician over a nurse, Grissom says. “These patients were going home and performing their normal chores and getting infections. We spoke with the physicians and made sure we were all relaying the same message.” To help ensure guidance is more easily understood, Soliz says her ASC asks non-clinical personnel to review discharge and home care instructions. “They help us assess the readability and understandability of our docu-


mentation for people without a clin- ical background, which are typically our patients.”


Grissom says supplementing verbal education can help reinforce vital mes- saging. “We create packets for patients to take home and sometimes use tab- lets where we can show patients ani- mation of their surgery.” Soliz says her ASC is examin-


ing ways to better use its website as an educational resource. “We have recently discussed the possibility of creating videos or providing other forms of virtual education. We know there are additional avenues we can pursue to help ensure we are appropri- ately educating the patient.” Do not stop working to improve


your efforts, Grissom advises. “When we collect satisfaction information on the back end, we ask questions about the effectiveness of our educational processes. The information we learn is used to refine our approaches. ASCs should consistently strive to do a better job of educating their patients.”


ASC FOCUS FEBRUARY 2018 |www.ascfocus.org 19


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