Chinese hospital designed a CHF education packet with the needs of their patient population in mind.
Many of our patients are elderly with comorbidities and don’t speak English as their first language. For these patients, a CHF diagnosis is very hard to manage because it involves changing many habits and managing many medications. Education is very important for these patients, but their conditions are complex and they can get overwhelmed quickly with all the technical terms in a foreign language.
Chinese Hospital is a non-profit hospital in San Francisco, CA. It has 54 beds and serves a primarily elderly (average age of 76) monolingual population with most patients speaking only Chinese. Their transitions program began in 2008 and is influenced by IHI’s Transforming care at the Bedside and the Care Transitions Program.
What We Tried
We modified our materials to create an information booklet especially for our elderly CHF patients. All of the language is very simple and it’s in both English and Chinese. We keep the information to the basics, just what they need to take care of themselves. We also illustrate everything with pictures so even if the patients can’t read they will know how to manage their condition. An example is with diet—we have pictures of high sodium foods like takeout and dried fish with a big “x” through it and then pictures of the fresh food they should be eating.
Both the nurses and the patient educators teach this booklet with patients during their stay to reinforce the information. We also give them a copy to take home so that what they see at home is the same as what they saw in the hospital.
One particularly helpful aspect of the booklet is the zones chart. It uses color and imagery to help patients know when they should come back to the hospital. We give patients two copies of this—one in the booklet for reference and a separate one to pin up on the wall by their scale—and teach them how to use it. Having a copy on the wall makes it easier for them; it reminds them to weigh themselves every day and to report worsening CHF symptoms to physicians.
Our patients understand a lot more of what we teach them and are able to teach it back to us. Because of the simple teaching materials, CHF patients understand better about how to manage their disease and follow the instructions that were provided. The materials have been so successful that other hospitals also use it. Since then we’ve developed a COPD packet and are also working on creating one for renal failure patients.