Using Medication Flashcards to Help Improve HCAHPS Scores
Darian Williams, Grace Topham, Macy Martin, Riley Hantin, Trevor Curran
Abstract
Purpose: To find a way to give information in a
comprehensive way by using medical flashcards.
These tools can be used to help implement
improve patient satisfaction in their
medical education and decrease information
overload.
Background: The HCAHPS, Hospital Consumer
Assessment of Healthcare Providers and Systems, is
a national standardized, publicly reported survey
and data collection methodology for measuring
patients’ perceptions of their hospital experience.
It has several key topics, one of
which communication about patients’ medications
is the focus of this project. (U.S. Centers for
Medicare and Medicaid Services, 2021)
Proposed Solution: Individual medication
flashcards are to be made with simplified
information of commonly administered
medications for both the rooms and patients, post-
discharge.
Implication for Practice: Improvement of
educational materials and reinforcement can lead
to better perception of the hospital, improved
HCAPHS scores, and lower readmission rates. This
increases the hospital standing among competitors
and lowers overall costs.
Introduction and Description of
the Issue
Macro Description:
• HCAHPS is a tool used
to survey patients' perspectives of hospital care.
This survey includes instrument and data
collection tool
for measuring patients' perceptions of
their hospital experience ( CMS, 2021)
• The Teach-back method displays that a patient is
receiving information in a way they understand,
regardless of health literacy (AHRQ,2020).
• Medication education is important for patient
safety and helps reduce readmission rates (Hume
& Tomsik, 2014).
Micro Description: The Medical Surgical unit of
SFMC reported an HCAHPS score of 50% related
to “how often did the nurse educate you on
possible side effects in a way you can comprehend."
Bon Secours Memorial College of Nursing
Data and Analysis of the Issue
Based on interviews with nurse manager, and review of
patients, review of 13 survey responses by patients and 6
responses by nurses:
• Nurses spend an average of 10-15 minutes in each room
on medication education.
• 100% of nurses cited using the teach back method or
verbalized understanding.
• The unit has a medication cheat sheet that is reportedly
underutilized.
• Patient responses on time spent on medication
education varied. Most answered frequently or always
(8); 4 responded sometimes or rarely.
• Patients are not surveyed on learning style during
admission process.
• Majority of nurses and nurses stated they would use
individualized medication visual aids.
Summary of Supporting Litrature:
• Just over half of the nurses interviewed believe that it's
important to provide education on refill or old
medications (Bowen et al., 2017)
• Most spent an average of 5-9 minutes on medication
education per patient (Bowen et al., 2017)
• As for time spent on tasks, nurses spend most of their
time charting on patients in EHR (Yen et al., 2018)
• Nurses' confidence in patient's ability to
identify medication and potential side effects
after education:
Root Cause
Based on our analysis of collected data and literature
review, we believe the root cause is a lack of
reinforcement of medication information during the
hospital stay.
AIMProposed
- Proposed Solution
Solution Conclusion
We aim to increase medication education • Issue: There is a lack of reinforcement for
HCAPHS scores related to medication side medication side effect education as shown by
effects from 50% to 60% by December 2023. the reported HCAHPS score of 50%.
Hypothesis:
If we use visual aids with teaching, • Data analysis: We collected our data through
then the HCAHPS score for "how often staff and patient interviews, surveys, and
did the nurse educate you on possible side observation of patient medication education.
effects in a way you can comprehend”
will increase. • Root Cause: The identified root cause of a
Proposed Solution: HCAHPS score of 50% at SFMC is lack of
We propose the use of a medication flashcard medication information reinforcement.
index to promote reinforcement of education
material. We believe increased access to • Proposed Solution: Medication education will
material will improve retention and therefore be provided by a flashcard index that will
increase HCAPHS scores. contain visual aids for reinforcement.
Stake Holders
Logistics
• Obtaining list of common medications administered.
References
• Printing and creating medication flashcards for rooms and patients for
discharge
Agency for Healthcare Research and Quality. (2020,
September). Use the teach-back method: Tool #5. AHRQ. Retrieved
March 2, 2023, from https://www.ahrq.gov/health-
literacy/improve/precautions/tool5.html
Stakeholders
Bowen, J. F., Rotz, M. E., Patterson, B. J., & Sen, S. (2017). Nurses'
•
•
Clinical care lead
Nurses
attitudes and behaviors on patient medication
education. Pharmacy practice, 15(2),
•
•
Patients
Pharmacists
930. https://doi.org/10.18549/PharmPract.2017.02.930
Hume, K., & Tomsik, E. (2014). Enhancing patient education and
medication reconciliation strategies to reduce readmission
Potential costs rates. Hospital pharmacy, 49(2), 112–
• Relatively cheap to produce. 114https://doi.org/10.1310/hpj4902-112
• 4x6 card stock $7.99 per 500 cards
• Lamination sheets $19.89 per 100 pouches. U.S. Centers for Medicare and Medicaid Services. (2021, December
• 2" book rings- $11.59 per 50
• Laminator $33.49 (if none is available)
1). HCAHPS: Patients' perspectives of care survey. CMS. Retrieved
• Total Cost: 7 cents per card plus 23 cents per ringlet. (23¢ + 7(n) ¢) March 7, 2023, from https://www.cms.gov/Medicare/Quality-
Initiatives-Patient-Assessment-
Instruments/HospitalQualityInits/HospitalHCAHPS
Timeline
• Proposal of idea: 4/4/23
• Proposal brought before Administration: 5/23
Yen, P. H., & Leasure, A. R. (2019). Use and Effectiveness of the
• Approval of project: 6/23
Teach-Back Method in Patient Education and Health Outcomes.
• Survey of most common medications completed: 7/23
• Creation of medication flashcard index: 8/23
Federal practitioner : for the health care professionals of the VA,
• Implementation on unit: 9/23 DoD, and PHS, 36(6), 284–289.
Yen, P. Y., Kellye, M., Lopetegui, M., Saha, A., Loversidge, J., Chipps,
Data Collection E. M., Gallagher-Ford, L., & Buck, J. (2018). Nurses' Time Allocation
• Patient survey through leader rounds and Multitasking of Nursing Activities: A Time Motion Study. AMIA
• Quarterly HCAPHS survey scores ... Annual Symposium proceedings. AMIA Symposium, 2018, 1137–
1146.