How do hospitals help patients prepare for and participate in outpatient clinics?

BACKGROUND: Patients attending general medicine outpatient clinics (GM OPC) at hospital face multiple healthcare demands in an environment that has evolved with the clinician at its centre. The ideas, knowledge and understanding that patients bring to their clinic appointments are not well studied in the New Zealand setting. AIMS: To assess how hospitals prepare patients for their outpatient appointments and encourage people to participate actively in their own care. METHODS: A prospective survey of 50 patients attending follow-up GM OPC was performed. Participants' understanding of the purpose of their appointment and knowledge of their prescription medications was explored using a nine-item questionnaire. Patient-directed hospital communication was then analysed to assess the information supplied to patients. RESULTS: Two-thirds (66%) of participants attending follow-up GM OPC recalled being informed of an appointment at the time of leaving hospital; only half (54%) felt they had been informed of the purpose of these appointments. Patient-directed communication was not completed in half (50%) of the analysed discharge letters. One-third (36%) of participants did not have specific questions for their clinic visits. CONCLUSIONS: Limited information and support is provided to patients attending follow-up GM OPC and is not tailored to individuals' health literacy. This practice assumes patients have comparable health literacy to clinicians, which may have downstream impacts on the usefulness of the clinic experience. The information that health users bring to clinic may be improved by increasing pre-clinic user engagement and deploying patient-centred tools within the healthcare environment.

The 777 Planner: improving the resuscitation call experience at North Shore Hospital.

AIM: To ensure that staff at North Shore Hospital are competent and confident in the roles that they are performing during a 777 call, and to improve leadership and teamwork within the resuscitation team. METHODS: We introduced two 777 Planner meetings each day at 4pm and 10pm at North Shore Hospital, with a 777 Planner template to guide the meeting. The 777 Planner enabled members of the team to meet, introduce themselves and allocate roles in preparation for resuscitative events prior to later calls. We conducted pre- and post-implementation surveys to evaluate the experience of 777 calls prior to and after implementation of the 777 Planner. RESULTS: 68% of respondents felt that the 777 Planner improved their experience of 777 calls, and 78% found it a useful part of the handover. 50% of pre-implementation survey respondents were not clear what other team members roles were in emergency calls, and 53% were not aware who was leading the emergency call. Following the implementation of the intervention, this improved to 74% reporting clarity on roles and 79% stating they knew who was leading the 777 call. CONCLUSION: The 777 Planner ultimately improved members of the resuscitation teams experience of 777 calls at North Shore Hospital, particularly concerning leadership, communication and clarity of roles.

Can the communities of practice model explain the complex organization of an interprofessional student-led health clinic?

Interprofessional collaborative practice (IPCP) in healthcare has been shown to improve patient safety and healthcare staff satisfaction. However providing opportunities for pre-registration healthcare students to develop the skills required to practise in an interprofessional manner is challenging. Furthermore there is little theory-based literature exploring or describing the organization of these interprofessional student learning opportunities. This paper explores the organization of a student-led interprofessional healthcare clinic using Wenger's Communities of Practice (CoP) model as a framework. It modifies the CoP model to incorporate the routine yet shifting roles of students and patients, and builds on an earlier account of a Community of Clinical Practice (CoCP) by taking a different perspective. The CoCP model could act as a guide for the development of similar student-led interprofessional university clinics.