What should be on a PODS - Part 6

Design considerations for PODS:

-          PODS should be in plain language 

-          PODS should have short and simple instructions

-          PODS should have large fonts 

-          Should PODS be written in the patient voice? (e.g. my concerns, my plan, what does it mean to me)

-          How can PODS be culturally sensitive? (e.g., diet instructions, recipes,  community resources)

o   Also, in which areas and when is this needed?

-          How can PODS be language sensitive?

o    dual column - a chosen language and English side by side with same information

o   double sided - English on one side and a chosen language on another

o   patient education materials in multiple languages

o   in which areas and when is this needed?

-          What is the best use of visual communication 

o   Calendar

o   Timeline

o   Chart

o   Images of symptoms

o   Images of medications and related info

o   Images of food

o   Images of resources 

o   Images of contact people

o   Pictures of providers 

-          What is the ideal format? 

o   Paper 

o   App 

o   Patient portal  

o   Ideally this should exist in multiple formats

What should be on a PODS - Part 5

Other things to consider:

-          - Should we consider alternative medicine as a provider if its important to patient and have a section on the PODS for follow up with them?

-          - Should we consider family support as a provider and have a section on the PODS for follow up for them?

-          - Should we have sections on PODS for each “provider”?

-          - Should we have a section for patients to write notes?

-  

What should be on a PODS - Part 4

How should we tell patients about danger signals to watch out for?

-        -   Guidelines in a timeline if the patient feels a certain way on a certain day, they should do x 

-         -  Include visuals of possible symptoms and what to do if have them which may include multiple steps such as first take meds and if that doesn’t work go to hospital

-         -  Traffic light symptoms - green are normal, yellow are minor, red go straight to the ER

-          - How feel now correlated to how the symptom may change and get worse and what to do if it does

-          

      

What about reporting on symptoms in general? 

-          Should we include a self-care log for patients to record symptoms

o   With names and pics of possible symptoms

o   With a visual rating scale

What should be on a PODS - Part 3

What resources do patients want? What from this list would you include?

-          - Websites 

-          - standard patient education information 

-         -  phone number for medical records 

-         -  Community resources such as community centres

-         -  Social network support

-         -  Helpline

-         - recipes, exercise videos 

-           - legal assistance

       - kid friendly activities

        - child care

        - pet care

What should be on a PODS - Part 2

Here is a look at how we can include medication information on a PODS. 

-         Most of the groups at our event agreed that the medications should be presented in some sort of chart with potentially any or all of the following details

o   name of medication

o   picture of time of day to take the medication

o   picture of what the medication looks like

o   picture of dose (e.g., number of pills to take)

o   with check box of am, pm, hs

o   picture of whether the medication should be taken with or without food

o   side effects

o   a reason why to take each medication

o   contraindications and drug interactions 

-          

       Here are some other things to think about:

           - Should the medications be colour coded?

-                    - Should we include a sticker sheet to match the chart to the actual medication bottles?

-                  - Should we include other follow up activities with the medications in a daily chart of time, med/activity, dose/amount?

What should be on a PODS and how should it look - Part 1

Over the next week, I will be posting daily thoughts on different items that we think should be on a PODS and some options for how to include them. 

We would love your input!

Here is the first one - 

What to expect the first week home and beyond - patients want to know how they can expect to feel.A lot of patients are surprised at how long it takes them to fell somewhat normal again and they want to know what is normal. If it is normal for them to feel like garbage for 2 weeks, that is fine. They just want to know.

At our design event, the groups came up with various ways to include this in a PODS.

-         -  On a calendar with maybe an icon to show how you an expect to feel or a note of when you may begin to feel less tired, etc

-          - On a timeline (with pictures?) of how you can expect to feel at discharge, at one week, and at 2 weeks

-          - A picture and description of what success looks like and when it is expected to happen

-          - A list of how do the patient feels now (at discharge) with arrows corresponding  to how the symptom may change into a danger signal (e.g. now have less energy à go to H if can’t get out of bed)

-       -   A list of normal symptoms with icons

The Beyond Words PODS Design Event

This past Thursday, groups of patients, providers, designers, patient relations representatives, and patient education representatives came together to design patient oriented discharge summaries. The day was a big success and the groups worked together amazingly well. After a brief introduction to the project, we got right to work.

The groups rotated through 4 stations, each with a case study of patient's stay in hospital. The groups were faced with the task to be creative and think of the ideal PODS for that patient in 20 minutes. Meet our 4 case studies:

1. Wen-Yang, the 10-year old refugee, new to Toronto with his mom and younger brother who is diagnosed with pneumonia and spend the night in the hospital. Due to mis-communication, Wen-yang end up returning to the ER unnecessarily 2 days later.

2. Lisa, an 87 year-old Italian woman who loses her independence after an unexpected bypass surgery due to chronic heart failure. She cannot keep on top of all the guidelines surrounding her many new medications.

3. George, a 22 year-old international university student from Greece, who is in a car accident and suffers many injuries. He suffers memory loss and has trouble getting back into the swing of things.

4. Jose, a middle-aged taxi driver suffering from kidney failure, diabetes, and obesity among other things. He is in the hospital for something minor and ends up with a hospital-contracted infection.

The solutions that resulted were amazing. They were more traditional discharge summaries that were enhanced with multiple languages and images to make things more clear to patients. They all included key information patients wanted such as phone numbers of who to call with questions and expectations of what to expect in the first week home form the hospital. Almost all of the solutions contained some sort of calendar view. There were solutions that developed apps to connect patients to their care plan, their families, resources int he community, and their doctors. There were solutions that included interactive patient portals with educational videos. There were solutions that came with stickers to color-code your medications,areas for patients to write notes, and checklists for them to keep track of all their follow up plans. There was even one solution that included a weighted placemat that looked like a calendar and held all the patient's pills. If the patient missed a few pills, the next of kn would receive an automatic message.

The Beyond Words project team is going to systematically review all the solutions and designs. I can't wait to see what comes out of this amazing event. Here are some pictures from the event.