A patient education program aimed at helping acute myocardial infarction (AMI) patients understand their medications could lead to greater patient satisfaction scores for medication understanding and lower readmission rates, according to research presented at the ACC Quality Summit: NCDR and Accreditation Annual Session & Expo in New Orleans, LA.

As part of ACC's Patient Navigator Program: Focus MI, Tara See, RN, BSN, of Olathe Medical Center in Olathe, KS, and colleagues developed and implemented a medication education communication process in April 2018. The initiative involved a multidisciplinary care team that included an assigned bedside registered nurse, cardiology nurse navigator, floor pharmacists and outpatient cardiac rehabilitation (rehab) staff.

Under the initiative, the assigned bedside nursed reviewed new medications with the patient, family or caregiver after admission. Once the physician had written prescriptions for discharge medications, the cardiology nurse navigator asked the patient to write the medication information – including the medication's purpose, dose and frequency – on a visual aid form. Then, the floor pharmacist educated the patient in greater depth about their medications and explained potential side effects and what to do for missed doses. After discharge, patients received a transition of care phone call within 48 hours. During the call, the care coordinator or nurse navigator used a medication teach back technique, requiring the patient to recall the medication name and instructions or to read them from the prescription bottles. Finally, at the patient's first outpatient cardiac rehab appointment, they were asked to review a list of common cardiac medications and place a check mark next to their medications, helping to ensure they understand their prescriptions.

The researchers used the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey – a satisfaction survey required by the Centers for Medicare and Medicaid Services for all U.S. hospitals – to assess the hospital's HCAHPS scores for medication understanding. The scores increased by 10 percent between quarter one and quarter two, after the program was implemented. In addition, the unadjusted readmission rate decreased following implementation – from 8.2 percent in quarter one to 3.4 percent in quarter two and 3.6 percent in quarter three.

"We realize improving medication understanding is only part of what hospitals need to do to help reduce readmissions," See says. "We are also continuing to focus on other goals, such as increasing risk assessment and appropriate interventions placed on high-risk patients. We believe this will optimize our process and further decrease readmissions."

AstraZeneca is the founding sponsor of the Patient Navigator Program: Focus MI.

Keywords: Quality Summit, Patient Satisfaction, Patient Readmission, Patient Transfer, Physicians, Patient Discharge, Myocardial Infarction, National Cardiovascular Data Registries, Risk Assessment, Chest Pain MI Registry

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