Improving Access to Patient Education

Introduction and Problem Description: Spinal Cord Injury (SCI) is a difficult, life-changing event with great emotional impact on those who sustain the SCI and their families. Patient education has the potential to provide patients and their families with the knowledge and skills necessary to care for themselves post SCI and help minimise secondary complications over time (Shepherd et al., 2012). At the Spinal Cord System of Care (SCSC) Programme in the National Rehabilitation Hospital (NRH) in Ireland patient education has predominately been delivered through paper-based materials or face to face interactions with members of the interdisciplinary team (IDT). However, an audit of patient education folders in 2013 revealed that only 12% of patients used their folder routinely during their rehabilitation. Patients reported that information in the folders was overwhelming and daunting and that they were consulting the internet for information. One key difficulty in providing patient education is that there is a lot to learn and limited time during a rehabilitation admission to do so. Factors such as a person’s level of education, preferred learning style, their psychological adjustment to the injury (learning readiness) and emotional support can influence their ability to learn and problem solve (Van Wyk et al., 2015). Impairments in hand function as a result of a SCI means that physical access to paper-based educational materials is very challenging (Shepherd, 2012). Another barrier to acquisition of knowledge, skills and behaviours from SCI patient education in Ireland is that once a person is discharged from the neuro-rehabilitation setting there is limited access to credible, quality information sources. Practice Change Implemented: The National Standards for Safer Better Healthcare highlight the importance of using feedback from service users to improve the quality of the services provided (HIQA, 2012). The internet has been identified as a preferred means of accessing information for people with SCI (Letts et al., 2011; Goodman et al., 2008; Matter et al., 2009). In addition, the proliferation of smart devices being used on wards and integrated into therapy has been recognised in the literature (Fager and Burnfield, 2013; Folan et al., 2015). This change project aimed to tap into the virtual context to maximise educational opportunities for people with SCI. Chou et al. (2012) suggest that by bringing information to the patient at the place and time of their choosing, e-learning has the potential to broaden the reach of existing services. The addition of e-learning resources for SCI patient education at the NRH is an additional channel rather than a substitute for verbal or paper-based education materials. Aim: That the addition of e-learning resources reviewed and adapted by staff and patients in a SCI rehabilitation programme will improve access to meaningful and appropriate SCI patient education. Theory of Change: The Health Service Executive (HSE) change model (Figure 2) was chosen to guide the project because it recognises the cyclical nature of change, the key role of leadership and aims to improve patient experiences in healthcare. This model helped staff participate actively in the change process and work collaboratively in teams to improve delivery of patient education (HSE, 2008).