Abstract
Several recent works have highlighted hospital discharge as a good opportunity to deliver patient education (PE). Despite its constraints (overcrowding and unpredictable workload, in particular), the emergency department (ED) should be viewed as an opportune place for improving patient satisfaction and adherence to recommendations, and thus for preventing complications and early readmission, suggesting that better PE and health information could be one way to enhance patient safety. Building evidence on how best to organise and deliver effective PE poses many challenges, however. This paper gives an overview of the main issues (what we already know and prospects for research/clinical approaches) concerning PE in the ED: improving provider skills, ensuring PE continuity, developing educational materials, interprofessional collaboration, identifying specific educational needs for certain subgroups of patients, evaluating PE delivery, and identifying the most effective interventions. Future research will be needed to develop evidence-based guidelines for a comprehensive approach to PE.
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References
Alberti, T. L., & Nannini, A. (2013). Patient comprehension of discharge instructions from the emergency department: A literature review. Journal of the American Association of Nurse Practitioner,25(4), 186–194.
Anderson, R. M., & Funnell, M. M. (2005). Patient empowerment: Reflections on the challenge of fostering the adoption of a new paradigm. Patient Education and Counseling,57(2), 153–157.
Braet, A., Weltens, C., & Sermeus, W. (2016). Effectiveness of discharge interventions from hospital to home on hospitalreadmissions: A systematic review. JBI Database of Systematic Reviews and Implementation Reports,14(2), 106–173.
Carman, K. L., Dardess, P., Maurer, M., Sofaer, S., Adams, K., Bechte, I. C., et al. (2013). Patient and family engagement: A framework for understanding the elements and developing interventions and policies. Health Affairs, Milwood,32(2), 223–231.
Castro, E. M., Van Regenmortel, T., Vanhaecht, K., Sermeus, W., & Van Hecke, A. (2016). Patient empowerment, patient participation and patient-centeredness in hospital care: A concept analysis based on a literature review. Patient Education and Counseling,99(12), 1923–1939. https://doi.org/10.1016/j.pec.2016.07.026.
Cienki, J. J., Guerrera, A. D., Rose Steed, N., Kubo, E. N., & Baumann, B. M. (2013). Impact of an electronic medical record system on emergency department discharge instructions for patients with hypertension. Postgraduate Medicine,125(5), 59–66.
Coster, S., & Norman, I. (2009). Cochrane reviews of educational and self-management interventions to guide nursing practice: A review. International Journal of Nursing Studies,46(4), 508–528.
Courtney, R., Ballard, E., Fauver, S., Gariota, M., & Holland, L. (1996). The partnership model: Working with individuals, families, and communities toward a new vision of health. Public Health Nursing,13(3), 177–186.
D’Ivernois, J. F., Gagnayre, R., & Morsa, M. (2017). L’ETP précédant la sortie du patient, une nouvelle frontière pour l’ETP. Éducation thérapeutique du Patient/Therapeutic Patient Education,9, 10001.
Eisenberg, E. M., Murphy, A. G., Sutcliffe, K., et al. (2005). Communication in emergency medicine: Implications for patient safety. Communication Monographs,72, 390–413.
Engel, K. G., Buckley, B. A., Forth, V. E., et al. (2012). Patient understanding of emergency department discharge instructions: Where are knowledge deficits greatest? Academic Emergency Medicine,19(9), e1035–e1044.
Engel, K. G., Heisler, M., Smith, D. M., Robinson, C. H., Forman, J. H., & Ubel, P. A. (2009). Patient comprehension of emergency department care and instructions: Are patients aware of when they do not understand? Annals of Emergency Medicine,53(4), 454.e15–461.e15.
Gagnayre, R., & Lombrail, P. (2015). De la pratique à la recherche en éducation thérapeutique du patient. Question de Santé Publique, 29, 1–4. Retrieved from http://www.iresp.net/wp-content/uploads/2018/10/QSP_n–29.pdf. Accessed April 15, 2019.
Gleason-Comstock, J., Streater, A., Ager, J., et al. (2015). Patient education and follow-up as an intervention for hypertensive patients discharged from an emergency department: A randomized control trial study protocol. BMC Emergency Medecine,15, 38.
Hassan, T. B., & Judkins, S. (2018). Winter all year round in the emergency department. British Medical Journal,363, k4438.
Hawes, E. M., Maxwell, W. D., White, S. F., Mangun, J., & Lin, F. C. (2014). Impact of an outpatient pharmacist intervention on medication discrepancies and healthcare resource utilization in posthospitalization care transitions. Journal of Primary Care Community Health,5(1), 14–18.
Hesselink, G., Zegers, M., Vernooij-Dassen, M., et al. (2014). European HANDOVER Research Collaborative. Improving patient discharge and reducing hospital readmissions by using intervention mapping. BMC Health Services Research,14, 389.
Hoff, T., Weller, W., & Depuccio, M. (2012). The patient-centered medical home: A review of recent research. Medical Care Research and Review,69(6), 619–644.
Ismail, S., McIntosh, M., Kalynych, C., et al. (2016). Impact of video discharge instructions for pediatric fever and closed head injury from the emergency department. The Journal of Emergency Medicine,50(3), e177–e183.
Karazivan, P., Dumez, V., Flora, L., et al. (2015). The patient-as-partner approach in healthcare: A conceptual framework for a necessary transition. Academic Medicine,90, 437–441.
Kelly, A. M., & Clooney, M. (2007). Improving asthma discharge management in relation to emergency departments: The ADMIRE project. Emergency Medicine Australasia,19(1), 59–62.
Lusk, J. M., Fater, K., & Care, P. (2013). A concept analysis of patient-centered care. Nursing Forum,48(2), 89–98.
Male, L., Noble, A., Atkinson, J., & Marson, T. (2017). Measuring patient experience: A systematic review to evaluate psychometric properties of patient reported experience measures (PREMs) for emergency care service provision. International Journal for Quality in Health Care,29(3), 314–326.
Marmot, M. (2010). Fair society, healthy lives: Strategic review of health inequalities in England post 2010. (London: The Marmot Review).
Mead, N., & Bower, P. (2000). Patient-centredness: A conceptual framework and review of the empirical literature. Social Science and Medicine,51(7), 1087–1110.
Moore, M., Winkelman, A., Kwong, S., Segal, S. P., Manley, G. T., & Shumway, M. (2014). The emergency department social work intervention for mild traumatic brain injury(SWIFT-Acute): A pilot study. Brain Injury,28(4), 448–455.
National Institutes of Health. (2009). The plain language initiative. Retrieved from http://execsec.od.nih.gov/plainlang/index.html. Accessed 24 April 2019.
Richards, T., Montori, V. M., Godlee, F., Lapsley, P., & Paul, D. (2013). Let the patient revolution begin. British Medical Journal,346(2), f2614.
Saidinejad, M., & Zorc, J. (2014). Mobile and web-based education: Delivering emergency department discharge and aftercare instructions. Pediatric Emergency Care,30(3), 211–216.
Snyder, H., & Engström, J. (2016). The antecedents, forms and consequences of patient involvement: A narrative review of the literature. International Journal of Nursing Studies,53, 351–378.
Szpiro, K. A., Harrison, M. B., Van Den Kerkhof, E. G., & Lougheed, M. D. (2008). Patient education in the emergency department: A systematic review of interventions and outcomes. Advanced Emergency Nursing Journal,30(1), 34–49.
Tabit, C. E., Coplan, M. J., Spencer, K. T., et al. (2017). Cardiology consultation in the emergency department reduces re-hospitalizations for low-socioeconomic patients with acute decompensated heart failure. The American Journal of Medicine,130(9), 1112.e17–1112.e31.
Uscher-Pines, L., Pines, J., Kellermann, A., Gillen, E., & Mehrotra, A. (2013). Emergency department visits for nonurgent conditions: Systematic literature review. The American Journal of Managed Care,19(1), 47–59.
Wight, D., Wimbush, E., Jepson, R., et al. (2016). Six steps in quality intervention development (6SQuID). Journal of Epidemiology and Community Health,70, 520–525.
World Health Organization. (1998). Europe report therapeutic patient education – continuing education programmes for health care providers in the field of chronic disease. Copenhagen, Denmark: WHO.
Zavala, S., & Shaffer, C. (2011). Do patients understand discharge instructions? Journal of Emergency Nursing,37(2), 138–140.
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The idea for this article came out of an annual meeting between the paper’s authors, aimed at defining future development for patient education and research. BP and MG are joint heads of a public health unit whose research focuses on different ways to improve/promote patients’ involvement in their own care and, more globally, in the health care system as a whole. AG is an academic emergency physician-researcher who tests the implementation of education experiences in his practice. AM and JCS are PhD students looking for innovative ways to address accessibility and effectiveness issues in care practices and PE delivery. RG is head of the Health Education and Practices Laboratory, which has been a pioneer in the development of PE in France and Europe. BP, AG and AM conceived the article. BP wrote the manuscript with help from MG, AG, JCS, AM, and RG. BP is guarantor of the article.
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Pétré, B., Margat, A., Servotte, JC. et al. Patient education in the emergency department: take advantage of the teachable moment. Adv in Health Sci Educ 25, 511–517 (2020). https://doi.org/10.1007/s10459-019-09893-6
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DOI: https://doi.org/10.1007/s10459-019-09893-6