Using post-discharge home visitation to improve cultural sensitivity and patient-centered discharge planning by internal medicine trainees

J. Deanna Wilson, Katherine Clair Shaw, Leonard Feldman

Research output: Contribution to journalArticle

Abstract

Background. Patient-centered discharge planning improves transitional care and health outcomes for vulnerable adults. The HOME Initiative was an educational intervention aiming to improve trainees’ patient-centered discharge planning skills. Methods. Using a quasi-experimental design, 52 internal medicine residents at an academic medical center were randomized to intervention or control in 2014–2015. Intervention interns visited recently discharged patients during inpatient rotations. Interns addressed patient deficits in understanding, rectified medication errors, and provided health education. Results. Over three-quarters (77%) of intervention interns completed pre- and post-tests. Intervention interns reported significant improvements in patient-centered discharge planning skills and delivery of culturally sensitive care. Through improved communication skills, residents more effectively elicited patients’ illness narratives and assessed their patients’ safety (0.65; p=.05), functional status (0.79; p=.02) and health literacy (0.70; p=.01). Conclusion. Structured home visitation with recently discharged patients is a valuable tool for medical residents to learn patient-centered discharge planning and improve delivery of culturally sensitive care.

Original languageEnglish (US)
Pages (from-to)1288-1299
Number of pages12
JournalJournal of Health Care for the Poor and Underserved
Volume29
Issue number4
DOIs
StatePublished - Nov 1 2018

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Patient Discharge
Internal Medicine
Health Literacy
Medication Errors
Patient Safety
Health Education
Inpatients
Research Design
Communication
Health

Keywords

  • Cultural competency
  • Medical education
  • Safety-net providers
  • Transitional care

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Using post-discharge home visitation to improve cultural sensitivity and patient-centered discharge planning by internal medicine trainees. / Wilson, J. Deanna; Shaw, Katherine Clair; Feldman, Leonard.

In: Journal of Health Care for the Poor and Underserved, Vol. 29, No. 4, 01.11.2018, p. 1288-1299.

Research output: Contribution to journalArticle

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