# Presentation: 026008

## IHS National Patient Education Initiative:  A Process for Developing a Multi-disciplinary Patient Education Program for Hospitals and Clinics

**This Initiative was started in 1995 **
**at IHS Headquarters**
**        **

**Red Lake Hospital****: National Demonstration Site**

**Red Lake Project Coordinators****:  ****Jeanine McDermott,RN **
**	****	****	****	****   ****Bonnie Smerud,MSN**

## National IHS Patient Education Initiative 

**Goal:**
**To establish a uniform method for all health providers, both clinical and non-clinical, in the provision of Clinic/Hospital and Community-based patient and family education**

## Support & Resources Made Available from IHS Headquarters

**   ****Process Manual for Developing a  **
**      ****Site-Specific Patient Education**
**      ****Policy and Procedure Manual for**
**      ****Hospitals and Clinics throughout**
**      ****IHS**

**   ****Funding Opportunities for **
**     ****Improving/ Enhancing **
**     ****Demonstration Sites’ Programs**

## Support & Resources Made Available from IHS Headquarters (continued)

**Training Dollars and Opportunities**
**Technical Support**
**Standardized/Computerized Patient Education Documentation system utilizing the IHS Patient Education Codes & Protocols**

## Standardized/Computerized Pt. Ed. Documentation System utilizing the IHS Patient Education Codes & Protocols

**4-part mnemonics that are a short-cut for documenting patient/family education encounters.**
**They are entered in the Patient Education Section of the PCC.**
**They result in an entry on the health summary for future reference.**

***What are the Patient Education Codes & Protocols?***

##  A Typical Patient Education Encounter

**I discussed with Ms. Jones that her obesity puts her at increased risk for diabetes, heart disease, gallstones, back and knee problems, and infertility.  I discussed the relationship among obesity, caloric intake and exercise.  I explained that she likely has a genetic predisposition to obesity and that she will have to work harder to lose weight.  I explained that she could lose weight through a plan including regular exercise and dietary  modification/restriction.  I advised her to talk to a physician before she began any diet especially fad diets.  I emphasized the importance of good hygiene.  We discussed some components of a healthy eating plan including regular meal times, eliminating  or limiting snack foods and fatty foods, reducing sodium consumption and adding more fresh fruits and vegetables and fiber to the diet.  We discussed that the most healthy fluid for the body is water and that colas and alcohol contain many hidden calories.  We discussed that healthy eating plans begin at the grocery store and discussed techniques for shopping for a healthier body.**

## Can be documented succinctly on the PCC as . . .

**OBS-C,LA,EX,N-G-JM**

## OBS - Obesity

**DP - Disease Process**
**C - Complications**
**LA - Lifestyle adaptations**
**N - Nutrition**
**EX - Exercise**
**FU - Follow up**
**P - Prevention**
**L - Patient information Literature**

## How were these codes developed?

**A multidisciplinary team consisting of 2 doctors, 6 nurses, a pharmacist, a dietician, a certified diabetic educator, and a certified medical records technician from across I.H.S. met and revised and added to existing codes that were initially developed out of the Tucson Area under Liz Dickey’s direction.**

## Support & Resources Made Available from IHS Headquarters (continued)

**Development of low-literacy, culturally-specific patient education literature**
**Development of ORRYX:  a software program designed to measure specified performance indicators (including documentation of patient education) throughout IHS)**

## IHS Health Education Web Site
(to be launched September, 1999)
Pt. Ed.Codes
Health Education Newsletter
Pt. Ed. Process Manual
Culturally-specific Pt. Ed. Materials designed by the different sites 

**IHS Health Education Web Site**
**(to be launched September, 1999)**
**Pt. Ed.Codes**
**Health Education Newsletter**
**Pt. Ed. Process Manual**
**Culturally-specific Pt. Ed. Materials designed by the different sites **

## Commitment and Resources at the Service Unit Level

**Establishment of a permanent Multi-disciplinary Patient Education Committee **
**Collaboration with CHS (tribal) programs and IHS**
**Authority granted to the committee to coordinate Pt. Ed. curriculum and purchases of Pt. Ed. materials **

**The drafting of collaborative hospital-wide Pt. Ed. Policies**
**Consistent and coordinated information to our customers**

**Is resulting in . .**** .**

## Our Implementation Process

**1995****	**

**Obtained commitment from our Administration**
**Formed and oriented hospital-wide, multi-disciplinary Pt. Ed. Task force  to project**
**Developed Mission Statement, Philosophy Statement and purpose/goals and objectives of task force**

## Implementation Process (continued)

**1996**

**Assessment of current patient education practices**
**Survey of Staff, charts, PD’s, Performance Appraisals**
**Current curriculum and documentation practices in each department and discipline**

## Implementation Process (continued)

**1997**

**Receive $10,000 ‘grant’ from Headquarters**
**Hospital-wide Pt. Ed. Policy **
**Develop consistent method to assess learning of our customers**
**Revise PDs and PAS to reflect and create built in method to measure Pt. Ed. Documentation**
**Establish permanent Pt. Ed. Committee **
**Budget control for Pt. Ed. Resources**
**All Departments coordinating curriculum and forms**

## Implementation Process (continued)

**1998**

**Develop Site-specific patient education literature**
**Integrate diagnosis-specific patient education documentation into the Inpatient care plan from admission through discharge and home-care**
**Establish Pt. Ed. Section in MR with Social and Patient Education Assessment**
**Initiate Use of Patient Education Codes throughout system**
**Provide Staff Orientation  **

## Current Status in 1999

**Distribution of Pt. Ed. Materials to departments and disciplines &/or specialties**
**Provide support to Health providers to use of Pt. Ed. Codes**
**Demonstration site for Orryx**
**Sharing of Indian-specific Pt. Ed. Literature- IHS Web site.**

**Current Focus is on. . .**

**Monitoring/ measuring Pt. Ed. Documentation and Learning Assessment utilizing our PI process **

## Plans for the future. . .

**More educationally-oriented, Indian-specific artwork for our walls**
**Health Information Display Cases in the Main Lobby, in the Urgent Care Lobby and in the Inpatient Waiting Area**
**Media Center for patients and health-care providers**
**Disease-specific education modules using the Diabetic system as a model**