Video-on-demand provides easy access to visual teaching tool, enhancing education
For best use determine purpose; selection process; ways to promote use
Technology can provide instant access to educational resources. Most institutions have catalogued written materials in a file on their Intranet system, so handouts can readily be given to patients as part of the teaching process. Also, many institutions are working to perfect video-on-demand systems, so a visual education format is available for teaching.
What is the best way to incorporate video-on-demand into patient education? It's important to first determine the purpose of the system.
The Ohio State University Medical Center in Columbus has assembled a team, chaired by Diane Moyer, BSN, MS, RN, program director of patient education, to look into implementing a video-on-demand system.
The goal is to have the videos accessible to both inpatients and outpatients. In this way patients and families can watch videos on tests or procedures in advance of coming to the medical center. Also, they can watch videos after discharge when they may be more rested and interested in learning about their disease process or treatment.
This will be accomplished by providing access through a patient portal on the Internet. It has not yet been determined if physicians will assign the videos or if patients will have access to all videos on the system. However, the team wants to track the titles of the videos the patient viewed so his or her health care team will know.
The committee helping with the system design determined that access to the video-on-demand system should not be available through the general web site at the medical center, because too much use could crash the server.
Rather than purchase a system from a commercial vendor, the information technology department at the medical center has obtained grant funds to design a system.
Having the capability to show a video to the patient or family when they are available and ready is certainly a benefit, says Moyer. "We have some fixed-channel programming, but staff seldom uses it, because often it is hard to coordinate the show time with the patient's schedule. Having a system that will be accessible for patients and families outside the hospital walls will certainly be useful, and that has been a request of patients and clinicians for some time. Patients are often too sick to want to watch a video while they are here. More care is done on the ambulatory side, so we need to give access to the patient at home," she adds.
At Wellspan Health in York, PA, the video-on-demand system replaced the TV on a cart. No longer did staff have to make arrangements to bring the video to a patient's room for viewing, because the patient could choose the best time for viewing the video.
Staff can view the list of videos which are categorized by diagnosis on the patient education portal on the Intranet. While some units have videos as part of their standard education plan, the video system is mainly an educational resource for clinicians teaching patients, says Christine Hess, MEd, patient and family education coordinator at Wellspan Health.
Patients need to be taught in the way they prefer to learn; therefore, the video-on-demand system is a good tool for teaching visual learners, says Hess. Also, clinicians are not limited to unit specific videos they have on hand. Many patients have multiple diagnoses, so even though they are admitted to a cardiac unit, they could require education on diabetes or asthma, as well.
"Nurses know they can pull from a different area to get the information and share it with the patient if needed," says Hess.
Easily included in teaching plan
The video-on-demand system at The Reading (PA) Hospital and Medical Center has made it easier to incorporate videos into teaching plans. Therefore, many titles on the system are mandatory for certain patients. Formerly, a closed circuit TV system was used, but patients were not always available to watch videos when they were scheduled to play.
Teaching plans for such diagnoses as heart failure and COPD have been implemented in support of certain core measures used to track a variety of evidence-based standards of care that have been shown to result in improved clinical outcomes.
While reviewing video content from a clinical perspective is important, it also is important to review the content from an educational perspective.
For example, the team for heart failure determined the educational components of the program. Debra Phillips, RN, MSN, patient education coordinator, acted as the consultant. Patients are taught with the aid of a 64-page workbook purchased from a commercial vendor that has a multidisciplinary approach to education of heart failure patients. Dietitians, physical therapists, nurses, and other disciplines all use components of the book to teach. Two mandatory videos are included in the program, one on basic concepts of heart failure and the other on how nutrition pertains to the disease.
A mandatory video also is part of the educational process for a Safety First Program initiated in September 2004 to meet The Joint Commission's National Patient Safety Goals 13 and 13A. An educational poster is hung in each patient room, and a handout is included in the admission packet. Nurses use these items to discuss the patient's role in hospital safety. Patients are then asked to watch a video. The video is shown to all patients, unless they have been admitted to the hospital frequently and have viewed the content before - or they refuse to watch.
Due to the fact that the videos generally are part of the curriculum developed by various departments, such as maternal child health, experts in these areas are used to select the videos.
"I am not the expert on all the standards. I am a one-person department for a 665-bed hospital, so I rely on those content experts to do the homework," says Phillips.
When choosing videos, those that are in both English and Spanish are a priority, as well as those that have closed captioning for the hearing impaired. While there is no formal policy for the selection process, the videos do come to Phillips before they are added to the system. She makes sure they do not promote commercial products and the quality is good. If there is time, she will have the multidisciplinary patient education advisory committee and the patient education resource nurse committee review the videos. Sometimes, a patient focus group will be asked to give feedback, as well.
At The Ohio State University Medical Center, the video-on-demand planning committee has a representative from each area that will show videos on the system such as cancer, heart disease, and diabetes. They work with staff from their areas researching what is available and previewing videos. The patient education department helps by providing names of vendors, catalogs, and information on online previewing of content.
Those doing the content review are asked to make sure the videos are not commercial endorsements, the information is based on current practice standards and guidelines, the quality is good, it isn't too long, and it was recently developed. Moyer says the reviewers also must determine if it is applicable to a general audience or if access should be limited to patients on a particular unit.
The cost of the equipment and the maintenance on a video-on-demand system can be costly. That's one reason the IT group at OSU Medical Center is developing a system. Purchasing the video and licensure to use the content on the system can be costly, as well.
That's one reason why it is important to make sure clinicians know about the resources and refer patients to the content, says Moyer. Presently, a group of physicians is waiting for video-on-demand. Yet Moyer suspects she will need to do the usual e-mails and newsletters to get the word out to others that are not aware of the development of the video-on-demand system.
Hess says she uses every chance she gets to educate staff about the video-on-demand system. Twice a month during orientation for new nurses at Wellspan Health, Hess provides information on educational resources - and that is one way word of the video-on-demand system is spread. She also promotes the system on an annual education in-service day, and this year it will be featured during Patient Education Week at a patient education fair.
"The video-on-demand system is well known within the hospital; I just need to make sure the new people coming on board know how to use it. What I do with many students is walk them through it physically," says Hess.
Phillips says she also provides information on the video-on-demand system during nursing orientation, giving details on how to access it and a listing of video titles.
"For the safety program, I tell them one of their tasks during orientation is to go to a room, dial video-on-demand, and watch the safety video," says Phillips.
SOURCES
For more information about effectively making use of video-on-demand for patient education, contact:
Christine Hess, MEd, Patient and Family Education Coordinator, Wellspan Health, 1001 South George St., York, PA 17405. Telephone: (717) 851-5859. E-mail: [email protected].
Diane Moyer, BSN, MS, RN, Program Director, Patient Education, The Ohio State University Medical Center, 660 Ackerman Rd., Room 667, Columbus, OH 43218. Telephone: (614) 293-3191. E-mail: [email protected].
Debra Phillips, RN, MSN, Patient Education Coordinator, The Reading Hospital and Medical Center, Reading, PA 19612. Telephone: (610) 988-8725. E-mail: [email protected].
Technology can provide instant access to educational resources. Most institutions have catalogued written materials in a file on their Intranet system, so handouts can readily be given to patients as part of the teaching process. Also, many institutions are working to perfect video-on-demand systems, so a visual education format is available for teaching.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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