Patient-Paced Education

For postpartum discharge

In collaboration with UChicago Medicine Family Birthing Center

Profile Picture of Kim Erwin

Kim Erwin

Associate Professor of Healthcare Design and Design Methods, Director, Equitable Healthcare Lab

Meghna Prakash

Assistant Director, Equitable Healthcare Lab

Elizabeth Graff

Master of Design, 2024

Anna Marzano, RN, BSN, C-EFM, CBC

Perinatal Services Quality & APORS Specialist at UChicago Medicine Family Birthing Center

Sanjana Kumar

Master of Design, 2025

Caley Schroeder

Patient Care Manager at UChicago Medicine Family Birthing Center

Abbe Kordik, MD

Director of Obstetrics and Gynecology at UChicago Medicine Family Birthing Center

CHALLENGE

How might we improve postpartum patient education so that it’s easier to understand and deliver?

Poor quality discharge education is associated with more newborn Emergency Room and Urgent Care visits. But short hospital stays limit the time for clinicals staff to effectively address a new mother’s learning needs, especially given the large amount of mandated education required by various agencies. Patient satisfaction scores for the Family Birthing Center (FBC) suggested significant gaps in patient readiness to succeed at home after giving birth. 

Citing a need to improve its patient discharge education, the FBC Quality Improvement team identified several aspects of patient education as needing attention. These include: refining patient education materials; establishing a consistent education process that begins at admission; improving and standardizing the quality of patient education provided by nurses; improving coordination & communication within care team members, & between care team members & patients.

APPROACH

We led a 9-week design sprint to engage patients and staff in development of a more coordinated and effective patient-centered discharge education experience. We engaged 63 stakeholders, including obstetricians, postpartum patients, nurses, midwives, pediatricians, lactation consultants, community health workers, social workers, patient care managers, and clinical educators.​

We developed a framework to organize patient education into discrete challenges — Content development, Delivery improvement, and Team Coordination. — and built design requirements for each component.

A sense-making framework for patient education

A sense-making framework for patient education

The design requirements for each component are as follows:

Content that is: 

  • Organized and easy for patients to understand

  • Patient-paced so patient have an active role in their own learning

  • Consistent so that all patients are taught the same core topics

Delivery that is:

  • Scripted to support staff in providing consistent key messages

  • Timed to the middle of the hospital stay, rather than at day of discharge

  • Delivered with confidence to create better educational outcomes

Coordinated and visual so that:

  • All stakeholders can see the patient’s progress when they walk in the room 

  • All stakeholders can track the patient’s self-assessed confidence with topics

SOLUTIONS

We identified and structured 36 topics that needed to be covered before a patient went home. We then prototyped solutions to address each framework component, but work together as a communication system:

  1. A Patient Education “Menu” (Content);

  2. Educational Pathways for each of the 36 topics that include key messages and a “hook” for engaging patients and a suite of implementation support tools (Delivery);

  3. An in-room whiteboard with education topics, visible from the bed and the door (Coordination).

1. Content: Patient Education Menu

All 36 educational topics are organized clearly and simply in the Patient Education Menu. Patients can choose and pace the sequence of topics.

3. Coordination: In-patient whiteboard

A templated whiteboard to visualize the patient’s learning progress. Content matches the patient education menu. Iterative testing and refinement ensures the readability and usability by all disciplines and the patient and family.

2. Delivery: Suite of support tools for implementation

A ‘script book’ to standardize key talking points for each educational topic. To help staff adopt these standards, we developed a suite of delivery support tools:

  1. The script book provides step-by-step guidance and scripting for nurses on how to effectively deliver the content associated with each topic on the Patient Education Menu.

  2. Nurse break room posters model effective language to use when delivering care and are designed to be hung in the nurse break room.

  3. Badge cards summarize the messages on the posters and can be quickly referenced at any point in time.

  4. Role play teaching activities can be initiated by clinical educators with nurses during lulls in their shifts to give nurses practice and feedback on how they talk with patients.

Human factors refinement with the FBC staff

NEXT STEPS

We are working with FBC leadership and staff to detail and launch the new patient-paced education system, set for January 2025. Preparation includes:

  • Co-designing key messages for each of the 36 topics with multiple disciplines

  • Training staff and launch the new patient paced education system

  • Monitoring patient engagement and provider satisfaction