Simple Tool Improves Medication Adherence

Just how well do patients understand their medications? Not well enough, based on HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey results of patients discharged from the telemetry unit at a Cleveland Clinic regional hospital. Survey results in late 2014 showed:

• For “Communication about Medicines,” only 50 percent gave the unit a top score.
• Only about 60 percent understood why they were taking the medication.
• Less than 40 percent could describe a side effect of their medication.

“Communicating about medication is a challenge for hospitals everywhere,” says Kelly Brown, RN, in medical/surgical telemetry at Cleveland Clinic’s Fairview Hospital. “It’s especially important that telemetry nurses focus on medication education since patients are often discharged home.”

Understanding meds is hard for many reasons. Some barriers to educating hospitalized patients are that “they’re not feeling well and may be overwhelmed with new information,” Brown says. “Patients may not understand medical terms or long words, especially in complex medication regimens. Nurses need to overcome these barriers to improve medication adherence and post-discharge outcomes.”

Introducing: a patient-friendly teaching sheet

At the unit’s request in early 2015, a Cleveland Clinic pharmacy team developed a patient-friendly teaching sheet. It groups medications by function (e.g., antibiotics, pain, blood pressure/heart) and lists common side effects and special instructions.

The Telemetry team began using the sheet during shift-change huddles, and it gradually became the unit’s standard tool for medication discharge education. “Patients could see the most important details on one piece of paper,” says Brown. “We made it simple.”

Nearly 100 percent of patients understood

Three months later, the unit’s HCAHPS scores had improved substantially:

• Nearly 80 percent of patients gave the unit the top score for “Communication about Medicines”
• Nearly 100 percent understood why they were taking their meds
• 50 percent could name at least one side effect

“The sheets helped us increase patient understanding, adherence and satisfaction.” says Brown. Today, many telemetry units throughout Cleveland Clinic use the medication teaching sheet.