Last year, Holland Bloorview Kids Rehabilitation Hospital launched a brochure called "Understanding your role in safety: Clients and families." There are three versions, one for inpatients, one for clients in the outpatient child development program, and one for clients in the participation and inclusion program. An additional brochure called Managing Medications at Home was also created. Each brochure has a section outlining program specific tips on medication safety and how to work with the care team to prevent medication errors.
Health Quality Ontario had a chance to catch up with Laura Oxenham Murphy, Interim Director of Quality Safety and Performance, Ana DiMambro, Nursing Clinical Educator, and Nathan Ho, Director of Pharmacy, to learn more about how these resources are improving patients’ and families’ understanding of medication.
Why did you develop these brochures?
For three years now, we have been collecting data in our Quality Improvement Plan (QIP) on the indicator: “% of families rating that health care providers gave an understandable explanation of medicines.” We ask this question as part of our 72 hour post inpatient discharge follow up phone call led by our nursing team.
Our performance on this indicator has been very good, but we wanted to continue to do better, especially as it relates to inpatients being sent home with medication.
In 2017, a master’s student working Dr. Ross Baker conducted
a formal qualitative research study under the supervision of Caron Gan,
Clinical Team Investigator with the Bloorview Research Institute to gain
insights on what patients and families were struggling with post-discharge as
it relates to medication. The master’s student interviewed families after they
were discharged from inpatient programs at Holland Bloorview and gathered their
feedback.
We learned that patients and families wanted more direction on how to manage multiple medications and administer medications (e.g. measuring specific does, splitting doses, crushing medication, and making medication more palatable).
Patients and families also wanted direction on how to involve other family members in medication administration and integrate it into already busy daily routines and special events like trips. This was eye opening.
The brochures are meant to be a place to start these important conversations before patients and families go home.
Above: Inner flap of the Managing Medication at Home brochure
When are the brochures shared with patients and families?
The inpatient brochure is part of our “transition passport,” which is a binder provided to families on admission. It contains various education materials to help guide them through their patient journey. We have integrated the brochure into existing education processes.
The outpatient brochures are given to families in clinic areas prior to their appointments. They are provided by registration staff members.
Have you seen improvements since implementing the brochures?
Yes. We’ve seen improvements in the indicator: “% of families rating that health care providers gave an understandable explanation of medicines.”
Our target for this indicator last year was 90% and we exceeded it at 92.60%. We have since moved our target to 95% and are currently exceeding this target at 96.8%.
We have several initiatives associated with this indicator, but the brochures are a key driver of our improvements.
What are your next steps?
We continue to collect feedback from families on this indicator as part of our 72 hour post discharge phone call and report quarterly performance. We are in the process of translating our brochures into our top five languages other than English.
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Do you work on improving medication safety in your organization? Share your comments and lessons learned by clicking on “Add a Comment” below, or reach out to Laura Oxenham Murphy on Quorum.