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  1. COMMUNICATION The Key to Treatment Implementation

  2. Health Care: the Whole Picture • The elements of successful health care implementation: • Quality investigation and scientific research on disease processes • Dissemination of knowledge to frontline health workers • Patient access to health facilities • Provision of diagnostic tools and medications • Ability to implement treatment plans in the home • Access • Understanding

  3. Child Wellness: The Role of the Caretaker • Children require their caretakers to act as intermediaries on their behalf. • Caretakers must be able to interpret health information during clinical visits and deliver care as instructed after returning home1.

  4. Improving Health Outcomes • In order to improve health outcomes, clinical visits must include the effective transfer of specific, actionable knowledge to caretakers who will carry out treatment plans. • Educatingcaretakers may thus be the most effective strategy to improve child health outcomes.

  5. The Role of the Caretaker • Caretakers must understand, recall, and implement prescribed treatments in order for a clinical encounter to be successfully completed. • To accomplish these tasks, caretakers must possess at least a minimum baseline of health literacy.

  6. What is Health Literacy? • According to the American Institute of Medicine (IOM), health literacy isthe level of ability that a person possesses to seek services needed and to understand basic health information in order to make appropriate health decisions2.

  7. The Problem: The Role of Health Literacy in Child Health • The considerable contribution that inadequate health literacy makes toward health disparities was recently outlined in an international collaborative research agenda on health literacy3.

  8. Research Correlation • Studies show that there is a direct link between health literacy levels and health outcomes. • Improving health literacy may additionally be the most significant and cost-effective intervention to improve health outcomes.

  9. The Role of Health Literacy in Child Health • According to the World Health Organization (2006), improving the provision of health information is a critical factor of effective health promotion and current empowerment strategies6. • Effective communication between providers and caretakers must occur in order for this to take place.

  10. The Role of the Clinician • Pediatric primary care providers may be in the most advantageous position to educate caregivers through improved communication and health education4.

  11. Improving Child Health Outcomes Positive Health Outcome Correct treatment given by caretaker Provider assessment Provider communication Caretaker Understanding

  12. Communication Tools: Protocols • Information and communications technology (ICT) and paper protocolsare becoming more commonly used to facilitate provider-caretaker communications in pediatric health care settings5. • Integrating ICT and protocols into systems development may prove to assist with the transition towards improved knowledge management4. • Enables consistency

  13. Communication Delivery • Many mobile phones can now support multimedia applications, such as video display, making new means for the delivery of educational material accessible. • Charts, demonstrations, and dialogue

  14. What Caretakers Need to Know • Lex Parsimoniae: Apply the logic of Occam’s Razor to health education constructs • Favor the simplest explanation of health information possible, rather than unnecessarily complex teachings. • Distill the most critical components to convey.

  15. Key Concepts: 3 Things • The 3 most important things to make sure caretakers understand when they leave the clinic: 1. The problem of the child 2. How to implement the treatment plan at home 3. When to return to the clinic if necessary

  16. PeDiAtrick Communication Aims • Improving: • The quality of advice given by clinicians • The amountof health information given to the caretaker • Caretaker understanding of the treatment plan • Caretaker adherence to the treatment plan

  17. Questions?

  18. References 1. Gentles, S.J., Lokker, C., & McKibbon, A. (2010). Health information technology to facilitate communication involving health care providers, caregivers, and pediatric patients: A scoping review. Journal of Medical Internet Research, 12(2), e22 2. Nielsen-Bohlman, L., Panzer, A. M., & Kindig, D. A. [Eds.] (2004). Health literacy: Aprescription to end confusion. Committee on Health Literacy. Board on Neuroscience and Behavioral Health. Institute of Medicine of the National Academies. The National Academies Press: Washington, D. C., Accessed September 10, 2010 at 3. Protheroe, J., Wallace, L. S., Rowlands, G., & Devoe, J. E. (2009). Health literacy: setting an international collaborative research agenda. British Medical Journal Family Practice, 10, 51 4. Van Olmen, J., Criel, B., Devadasan, N., Pariyo, G., De Vos, P., Van Damme, W., Van Dormael, M., Marchal, B., & Kegels, G. (2010). Primary care in the 21st century: Primary care providers and people’s empowerment. Tropical Medicine and International Health, 15(4), 386-390 5. Bukachi, F., Pakenham-Walsh, N. (2007). Information technology for health in developing countries. Chest, 132, 1624-1630.Gentles, S.J., Lokker, C., & McKibbon, A. (2010). Health information technology to facilitate communication involving health care providers, caregivers, and pediatric patients: A scoping review. Journal of Medical Internet Research, 12(2), e22. 6. HEN Feb. 2006, WHO Empowerment Strategies