Q & A reinforces teaching JCAHO standards
Competition and fun help formal teaching
A question-and-answer game on the patient education standards of the Oakbrook Terrace, IL-based Joint Commission on Accreditation of Healthcare Organizations is helping staff at the Veterans Affairs (VA) Gulf Coast Veterans Health Care System in Biloxi, MS, prepare for an upcoming accreditation survey.
"I teach staff what the standards are in a classroom setting and then go back and reinforce the teaching with a fun way of learning," says Lynda Duhe, MSN, RN, patient and family health education coordinator at the health care system.
Education Jeopardy’
She rolled out the first version of "Patient Education Q & A" in 1999 and is in the process of revamping it to prepare for an upcoming survey. She visits clinics and hospitals within the VA Gulf Coast Veterans Health Care System during interdisciplinary treatment team meetings and assembles teams to play the game.
To play, participants are divided into two teams. Each team is given play money and a device to signal when they want to answer the question. The questions are worth $20, $40, $60, and $80 in four categories that include general, assessment, documentation, and required. There also are $200 bonus questions.
An impartial person starts the game by drawing a category from a box for the $20 question. Whichever team gets the answer right can pick the next category and price of the question. "It’s a good learning experience because if the team that rang in to answer the question doesn’t give a complete answer the opposing team will complete it so everyone is constantly learning," says Duhe.
A question on documentation might read: "Who is responsible for documenting patient teaching?" The team that rings in first might name all the disciplines that might be a part of the teaching reinforcing that documentation is an interdisciplinary collaborative process, she says. Once a question is answered, Duhe marks it, and it isn’t asked again.
Medical media department staff created the board with the questions on flaps that pull up to reveal the answers. Once all the questions have been answered, teams count their money to see who won. The team with the most money gets to pick from several prizes that might include mugs, pens, and pillboxes. After the first team makes their selections the second team gets to choose prizes. "I send everyone who has played a thank-you note," she says.
In the version for the preparation for the 1999 Joint Commission survey, questions were simple and straightforward. They included:
Assessment Category:
• How do you determine learning needs of patients and families?
Answer: Assessment
• What variables are considered in assessing patients learning needs, abilities, and readiness to learn?
Answer: Cultural and religious practices, emotional barriers, desire and motivation to learn, physical and cognitive limitations, and language
General Category:
• How do you know when patients and/or families have understood the teaching?
Answer: Feedback and/or return demonstration
• What do you do if the patient does not understand?
Answer: Repeat instructions and/or involve support person
Required Category:
• What instructions do you give the patient and/or family regarding discharge from the present level of care?
Answer: Information about community resources, how to obtain further treatment, and managing continuity of care
• How do you teach patients and families about food-drug interactions?
Answer: An interdisciplinary (provider, dietitian, nurse, and pharmacist) team approach is used.
Documentation Category:
• Who is responsible for documenting patient teaching?
Answer: All members of the health care team
• What is documented for patient education?
Answer: Advice or instructions, patient’s response, and whether the instructions were understood
The game Duhe is creating for the next survey will have questions that require participants to give the intent of the standard in their answer. She changed the way the game is played because Joint Commission surveyors no longer interview the patient education coordinator but go directly to staff on the floor. One of the new questions in the general category is:
• How do you know when patients and families have understood the teaching?
Answer: It is an interactive ongoing process that staff give the patients information, but they have to illicit feedback to make sure that the information is understood. If the patient can demonstrate or explain what they have learned then they know that they have learned. Staff then have to identify areas in which the patient needs further education or to reinforce previous teaching.
"Answers will require more detail. When we start to play the game, I will say What else, what else, what else,’ as they answer the question," says Duhe.
Source
For more information about using the "Patient Education Q & A" game to help staff prepare for a Joint Commission survey, contact:
• Lynda Duhe, MSN, RN, Patient and Family Health Education Coordinator, VA Gulf Coast Veterans Health Care System, 400 Veterans Ave., Biloxi, MS 39531. Telephone: (228) 563-2609.
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