Davee News and Events
September 2011: Congratulations to Barbara Buckley, who recieved the 2011 Annual ENA Conference Poster Award for Research while representing our department's Davee research team at this year's Emergency Nurses' Association conference in Tampla, Florida.
Literacy-based and Patient-guided Enhancement of Emergency Department Discharge Process
September 2009. Identified 5 sets of common ED diagnosis specific instructions.
5 diagnoses were chosen based on either the complexity of the diagnosis, multiple medications indicated for treatment, complicated homecare instructions and/or follow-up.
- Back pain
- Kidney Stone
- Head Injury
- Laceration repaired with sutures or staples
- Ankle sprain
September 2009 to May 2011. Development of the 5 diagnosis specific ED discharge instructions
This rigorous process began in September of 2009 and continued into 2011. A multidisciplinary team of healthcare professionals, literacy experts, medical illustrators and patients worked together to develop discharge instructions that not only were accurate in content, but would actually improve patient comprehension and there by improve patients out comes.
- November 2009. ED survey distribution with staff input to key concepts of each diagnosis
- January 2010. Expert panel review of survey results
- February 2010. Literature Review for content accuracy
- February 2010. Subspecialist review
- Sports medicine
- Literacy expert
- April 2010. Lexile analysis to ensure readability at 6th-8th grade level
- June 2010. Focus groups at FQHC to gather patient input to instructions
- 3 sessions, each session focusing on 1-2 of the diagnosis specific instructions
- June 2010. Illustrator utilized to develop drawings to assist patients in understanding diagnosis and key concepts
- December 2010. Graphic designer was brought in to enhance the visual appeal of the instructions
- May 2011. Final instructions launched in the ED
March 2010- Current. Nurse Liaison patient comprehension phone interviews
Nurses known for their excellent communication skills and expertise in emergency medicine were recruited to perform patient interviews by phone 24-36 hours post-discharge to evaluate patient understanding of diagnosis, homecare, medications, follow-up and reasons to return to the ED.
- 159 patients who received current standard of care
- Redeploy late spring/summer 2011 for additional 160 patients for evaluation of new instructions developed by research team
August 2010- May 2011. Patient preference pilot survey comparing existing instructions to newly developed instructions
The goal of this pilot was to determine patient preference of the discharge documents that currently exist compared to the newly developed model. In addition we asked the patients to identify words or statements that were difficult for them to understand. Finally, patients were asked to identify the things they needed to do to take care of their problem at home and reasons they should return to the ED.
- 100 patients in Feinberg Mezz Obs or ED Mezz
- Patients who evaluated our newly designed instructions were 3 times as likely to be able to correctly identify the things they needed to do to take care of their problem at home and reasons they should return to the ED.
May 2010 Ongoing. Manuscripts
- Several in Process
- Journal of Clinical Outcomes Management, October 2010: Communication Amidst Chaos: Challenges to Patient Communication in the Emergency Department
Review of Emergency Discharge Processes
January 2010. Survey distributed to ED’s nationally to obtain current patient specific discharge instructions, policies and procedures
The goal of this survey is to determine key elements found in patient specific ED discharge instructions and uncover policies and procedures to define best practices and paperwork to utilize at ED discharge.
- 40 respondents
- Research team identified key components found on review of patient specific instructions to assist in the development of enhanced patient specific instructions