CoxHealth, a six-hospital, community-based, not-for-profit health system, has developed a successful strategy to address opioid misuse through proactive patient education enabled, in part, by using their interactive patient television system from TeleHealth Services. Results from a pilot implementation showed increased patient engagement and improved patient satisfaction, demonstrating success in the strategy that is now being implemented system wide.
Over the past two decades, opioid misuse and abuse has become a national health crisis. For hospitals, increased readmissions and prolonged length of stays are among the many adverse and financially burdening ramifications. Hospital administrators must address outdated pain management policies and protocols to align with changing practices in pain management.
Proactive patient education about pain treatment from pre-admission to post-discharge at home can help reverse the crisis. Supporting this strategy is an interactive patient engagement and education system from TeleHealth Services to address patient and hospital needs. The system creates clinical workflow efficiencies and optimizes education at the patient point of care.
The goal for CoxHealth, an 860-bed system serving a 25-county region of Southwest Missouri and Northwest Arkansas, is to reduce adverse opioid events. The latest data from the Centers for Disease Control and Prevention paints an alarming picture for the state of Missouri, with the death rate from opioid overdoses increasing 31.8 percent from 2015 to 2016.
In late 2017, hospital leaders shared a sense of urgency in responding to this crisis and assembled a multidisciplinary task force to address opioid misuse. The task force included pharmacists, surgeons, patient educators, staff development nurses, public relations specialists and hospital administrators. The strategy included development of standardized patient communication, including pain management video education delivered at the point of care on patient in-room televisions.
TeleHealth Services’ interactive patient engagement system generates activity reports for staff to review, and measures learning and patient comprehension to assess when additional education is required. Clinical education is automatically documented in the patient’s electronic medical record (EMR) and can be accessed post-discharge to further reinforce adherence to medications and follow-up care plans. By streamlining the education process and identifying when teach-back strategies are needed to reinforce education, nurses can devote more time to patient-centered care.
Patient education videos were developed by Patient Education Coordinator Tina Tarter-Hamlet, MSN, RN, and the pharmacy team. Nurse training included flowcharts to guide them on ideal times for patient education. Joel Daniel, Pharm D, MS, CPPS, system medication safety pharmacist at CoxHealth, said, “Our pilot focused on level-setting patient expectations and increasing the cohesion of pain management communication across the system and between encounters. Thus a target metric was increased patient satisfaction scores centered on pain management.”
Increasing awareness of pain management and education before surgery was a catalyst for ongoing discussions. Staff were talking more with patients about pain management, and 20 percent of patients initiated discussions about pain management opioid use, including the safe disposal of opioids. In addition, patient satisfaction scores related to pain communication improved from 75% to 83.3%.
Kaylyn Lambert, director of patient experience for CoxHealth, said an eight percentage point increase in patient satisfaction scores is significant. She stated, “To see that much of an increase as a direct impact from a pain communication focus really shows the significance that this project has had on our patient population and will continue to have on our system.” Tarter-Hamlet added, "Our hope is this new way of teaching people about pain will make a difference for the entire community and help save lives."
“Patients are filled with fear and anxiety before surgery, and they want to be educated about their treatment and their care when they go home,” said Dan Nathan, president of TeleHealth Services. “Teaching patients and their family members about pain management improves their health and quality of life while also reducing challenges and rising costs burdening hospitals during this national opioid crisis. CoxHealth has designed and implemented a strategy using targeted education that improves outcomes and patient satisfaction.”
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