WO2001035299A1 - A method for determining the contents of a self-care kit - Google Patents

A method for determining the contents of a self-care kit Download PDF

Info

Publication number
WO2001035299A1
WO2001035299A1 PCT/US2000/030902 US0030902W WO0135299A1 WO 2001035299 A1 WO2001035299 A1 WO 2001035299A1 US 0030902 W US0030902 W US 0030902W WO 0135299 A1 WO0135299 A1 WO 0135299A1
Authority
WO
Grant status
Application
Patent type
Prior art keywords
self
materials
care
procedures
care kit
Prior art date
Application number
PCT/US2000/030902
Other languages
French (fr)
Other versions
WO2001035299A8 (en )
Inventor
Sylvia D. Aruffo
Shirley P. Grey
Original Assignee
Care Products, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F17/00First-aid kits
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B50/00Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • GPHYSICS
    • G06COMPUTING; CALCULATING; COUNTING
    • G06QDATA PROCESSING SYSTEMS OR METHODS, SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL, SUPERVISORY OR FORECASTING PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL, SUPERVISORY OR FORECASTING PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q10/00Administration; Management
    • G06Q10/10Office automation, e.g. computer aided management of electronic mail or groupware; Time management, e.g. calendars, reminders, meetings or time accounting
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/90Identification means for patients or instruments, e.g. tags
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61GTRANSPORT OR ACCOMODATION FOR PATIENTS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G12/00Accommodation for nursing, e.g. in hospitals, not covered by groups A61G1/00 - A61G11/00, e.g. trolleys for transport of medicaments or food; Prescription lists

Abstract

The present invention provides a method (10) for determining the contents of a self-care kit, preferably for conducting an in-home medical procedure. The present method first includes identifying the medical procedure to be conducted (12) in the patient's home using the self-care kit. After identifying the specific medical procedure to be conducted, the procedures and materials are identified for incorporation into the self-care kit (18). A prototype of the self-care kit is prepared and then verified to determine that all the procedures and materials are included. The self-care kit is provided to patients for in-home use.

Description

A METHOD FOR DETERMINING THE CONTENTS OF

A SELF-CARE KIT

PRIORITY CLAIM This application claims the benefit of provisional application, Serial

No. 60/165,026, filed November 12,1999.

DESCRIPTION The present invention relates in general to a method for determining the contents of a medical self-care kit, and in particular to a method for determining the specific contents including the supplies and instructions, related to a medical procedure, for a medical self-care kit.

BACKGROUND OF THE INVENTION Millions of people undergo inpatient and outpatient surgical and other medical procedures each year. After completing an outpatient procedure or concluding a hospital stay after an inpatient procedure, hospital personnel such as nurses normally try to provide the patient with instructions and either give away supplies for the patient to care for themselves including their wounds, or at least try to provide a list of supplies the patient must find at a retail outlet. Properly taking care of the patient's wounds after such procedures is critical to the recovery of the patient. Often however, these instructions are inadequate and confusing for the patient. Moreover, when the supplies are given away, they may be haphazardly collected and not exactly what the patient needs. When the patient must shop retail, the supplies can be difficult to obtain, use or manage. Shopping, figuring out what to do with the supplies and remembering the instructions is especially difficult considering the mental and physical state of the patient after completion of inpatient or outpatient medical procedures.

When hospitals and doctor's offices prepare their own instructions for instructing patients on how to take care of themselves and assemble the supplies for the patient from their own inventory of supplies, they sometimes rely on an in-home-care provider, a health-care professional such as a visiting nurse or therapist, to review and understand the instructions and to obtain any missing supplies for the patient. However, only about twenty percent of patients needing self care receive a professional visit, and that percentage is declining. This results in unfinished teaching and inadequate supplies when the organization performing the discharge incorrectly assumes there will be professional follow-up. In those cases where a professional health care organization does follow-up, several different nurses or therapists may visit. Each health-care professional providing instructions will do so based on their unique experiences or training, resulting in different and sometimes conflicting directions. Professionals will take extra time to assemble the additional supplies, a cost for agencies, especially under fixed payment plans. Often, knowing the difficulty in obtaining supplies retail, patients will claim they did not receive any supplies at the hospital in order to get duplicate supplies from a visiting nurse. These haphazard methods create supply and billing problems, requiring the medical staff to spend extra time monitoring their own inventory of supplies. If the medical staff simply assembles the supplies and provides them to the patient without charge, billing and profit problems arise for the hospitals and doctor's offices. It is also obvious that the procedures and supplies can vary, not only from office to office, but from staff member to staff member, depending on who prepares the instructions and assembles the supplies. Additionally, the current state of the health care system in the United States makes it more difficult for medical staff to adequately provide the needed supplies and extra time to these patients. The current systems for helping patients take care of themselves after surgery or other medical procedures is haphazard at best.

One solution to this problem is a pre-assembled medical self-care kit. In its ideal form, a self-care kit includes all the materials or supplies and detailed easy-to-read step-by-step instructions required for the patients to take care of themselves. In the past, the few self-care kits available on the market were based on materials that the manufacturer of the kits determined were optimal for the promotion of certain self- manufactured products, and were not based on what users, in-home care professionals, caregivers or patients needed to properly and easily complete the procedure. Another method for forming self-care kits was to gather hospital nurses, home-care nurses and patients in a room to discuss the contents of a self-care kit. However, this method is impractical, not only due to scheduling problems, but due to the great variation in view points of such people. Therefore, a need exists for a standardized reliable method for determining the contents of medical self-care kits, patient discharge systems and patient education systems which include easy to understand step-by-step instructions and all of the supplies necessary for patients to take care of themselves after surgical or other medical procedures.

SUMMARY OF THE INVENTION The present invention provides a method for determining the contents of a medical self-care kit, patient discharge system and patient education system (alternatively referred to herein as "kit," "self-care kit," or "medical self-care kit") for use by patients after undergoing medical procedures, incorporating specific step-by-step instructions to be followed and supplies to be used by the patient to carry out a complete self-care procedure.

The method for determining the contents of a self-care kit for a patient generally includes the steps of: (a) identifying a self care medical procedure to be conducted by the patient using the self-care kit; (b) determining procedures the patient needs to follow and the materials to be incorporated into the self-care kit; (c) preparing a prototype of the self-care kit including step-by-step instructions; (d) testing the prototype to determine that all of the procedures and materials are appropriate for the self-care kit; and (e) modifying the procedures and materials in the self-care kit based on the testing. In one embodiment, the procedure determining step includes identifying and interviewing at least one hospital nurse to determine the materials to be incorporated in the self- care kit and the procedures for using the materials. In a preferred embodiment of the method of the present invention, the procedure determining step includes: (i) identifying and interviewing a plurality of hospital nurses to determine the materials to be incorporated in the self-care kit and the procedures for using the materials; (ii) causing the hospital nurses to reach a consensus on the procedures and materials; (iii) preparing a draft of the self-care kit; (iv) identifying and interviewing a plurality of in-home nurses to determine the materials to be incorporated in the self-care kit and the procedures for using the materials; (v) causing the in-home nurses to reach a consensus on the procedures and materials; (vi) identifying and interviewing a plurality of patients to determine the materials to be incorporated in the self-care kit and the procedures for using the materials; and (vii) causing the patients to reach a consensus on the procedures and materials. The determining step could alternatively include identifying and interviewing at least one patient to determine the materials to be incorporated in the self-care kit and the procedures for using the materials. The determining step could alternatively include identifying and interviewing at least one in-home nurse to determine the materials to be incorporated in the self-care kit and the procedures for using the mateπals.

An alternative embodiment of the method of the present invention for determining the contents of a self-care kit for a patient includes: (a) identifying a self care medical procedure to be conducted using the self- care kit; (b) obtaining information about said medical procedure including procedures to follow and material to include in the self-care kit from at least one medical professional; (c) preparing a draft self-care kit incorporating said procedures and materials; (d) obtaining information about said medical procedure including procedures to follow and material to include in the self-care kit from at least one in-home medical professional; (e) revising the draft self-care kit; (f) obtaining information about said medical procedure including procedures to follow and material to include in the self-care kit from at least one in-home subject; (g) preparing a prototype of the self-care kit; (h) obtaining information about said medical procedure from at least one different medical professional to determine that all said procedures and materials are included; (i) obtaining information about said medical procedures from at least one different in-home medical professional to determine that all said procedures and materials are included; (j) asking at least one different in- home subject to act out all said procedures and mateπals in performing said self care medical procedure, forming a tested self-care kit; (k) approving said tested self-care kit, forming the self-care kit; and (I) providing the self-care kit for in-home use.

It is therefore an object of the present invention to provide a standardized reliable method for determining the contents of a self-care kit including step-by step instructions.

Other objects, features and advantages of the invention will be apparent from the following detailed disclosure, taken in conjunction with the accompanying sheets of drawings, wherein like numerals refer to like parts, step or processes.

BRIEF DESCRIPTION OF THE DRAWINGS Figs. 1A and 1 B are flow diagrams depicting an overview of method of the present invention;

Figs. 2A, 2B and 2C are flow diagrams depicting the documenting of procedures and materials based on the medical care professional or hospital nurse interviews and evaluation process of the method of the present invention;

Figs. 3A, 3B and 3C are flow diagrams depicting the documenting of procedures and materials based on the in-home medical care professional or home-care nurse interviews and evaluation process of the method of the present invention;

Figs. 4A and 4B are flow diagrams depicting the documenting of procedures and materials based on the in-home subject or patient interviews and evaluation process and the design of prototype self-care kits of the method of the present invention; and

Figs. 5A and 5B depict flow diagrams of the additional nurse, home-care nurse and patient benchmarking process of the prototype self-care kit of the method of the present invention; DETAILED DESCRIPTION OF THE INVENTION

Identifying the Medical Procedure

The method for determining the contents of a medical self-care kit of the present invention, generally indicated by numeral 10, is illustrated in Figs. 1 though 5B. Figs. 1A and 1B depict an overview of the method of the present invention. A person or organization intending to implement the present invention (i.e., the implementor) knows of, learns of or identifies a medical self-care procedure generally from one or more of a variety of sources including health care organizations, medical centers or facilities, or the like, as indicated by block 12. It should be appreciated that the implementor could be a health care professional, an individual or separate entity associated or otherwise affiliated with the medical profession, or any other individual or entity desiring to use the method of the present invention. The implementor preferably works with health care professionals or organizations such as hospitals who may purchase the self-care kits developed using the method of the present invention. Such people or organization are well suited to: (i) identify procedures that patients undertake at home alone or with the aid of a non-professional caregiver; (ii) provide access to hospital and home-care nurses; and (iii) provide access to patients that have undergone medical procedures and have cared for themselves (i.e., usually without an in-home professional caregiver). When the implementor decides to determine the contents of a self-care kit for an identified procedure, the implementor, assigns a facilitator to the procedure from the implementor's staff, as indicated by block 14.

Generally, the facilitator gathers in-hospital nurses for a brainstorming session at a first medical site regarding the procedure as indicated by block 16, drafts the self-care kit as indicated by block 18, gathers home-care nurses for a session relating to the procedure as indicated by block 20, revises the self-care kit as indicated by block 22, and gathers patients for a session relating to the procedure as indicated by block 24. The facilitator then prepares a prototype of the kit including benchmark instructions as indicated by block 26. Thereafter, at a remote or second medical site, the facilitator gathers hospital nurses for a session relating to the procedure as indicated by block 28, gathers home-care nurses for a session relating to the procedure as indicated by bock 30, and gathers patients for a session regarding the procedure as indicated by block 32. The facilitator then revises the prototype self-care kit based on said sessions as indicated by block 34. Thereafter, preferably, at a further remote or third medical site the facilitator gathers in-hospital nurses for a session relating to the procedure as indicated by block 28A, gathers in-home-care nurses for a session relating to the procedure as indicated by block 30A, and gathers patients for a session regarding the procedure as indicated by block 32A. The facilitator revises the self-care kit based on these sessions as indicated by block 34A. The self-care is then reviewed and approved as indicated by block 36.

Hospital Nurse Interview More specifically, the facilitator is a person designated by the implementor and who preferably has at least some general medical knowledge, and may have specific knowledge of medical procedures. The facilitator could be a nurse or other medical care professional, but does not need to have such background. If the facilitator is a nurse or other medical care professional, the facilitator may want to downplay or not reveal this information to the individuals who the facilitator interviews, so that the individuals do not rely on the facilitator's knowledge when discussing the procedures for taking care of the patient and do not assume that the facilitator knows any medical procedures or medical terminology. Preferably, the facilitator is a person who is skilled at leading group discussions, taking uncritical notes during the discussions, and leading people toward agreement or reaching a consensus on the best practices or procedures to be followed by the patient.

As shown in Figs. 2A, 2B and 2C, as the implementor identifies a home-care medical procedure and assigns a facilitator to the self-care medical procedure as indicated by blocks 13 and 15, respectively, the facilitator initiates and arranges an initial face to face brainstorming meeting or session with at least one and preferably two or more hospital nurses or similar medical-care professionals, as indicated by block 17. The hospital nurses are preferably employed full or at least part-time by a health care organization, medical center or other facility, or institution where patients undergo the medical procedure for which a patient self- care kit is being developed.

At the meeting, typically by way of introduction, the facilitator asks the hospital nurses to chronologically explain each and every step or action that the patient will need to perform the self-care medical procedure in detail, as indicated by block 38. The hospital nurses explain the self care medical procedure from the patient's point of view, assuming the patient is at home, as indicated by block 40. This explanation includes noting whether the patient is likely to receive any materials from the hospital or doctor's office or whether the patient must obtain the materials on her own. In providing this explanation to the facilitator and detailing each action, the nurses must assume that the facilitator knows nothing of the self care medical procedure and has no knowledge of medicine, medical procedures, or health care in general. It is important that the facilitator not ask the nurses "What should go in the kit?" Rather, the facilitator asks the nurses "How do you do this procedure?" Such open-ended questions elicit more complete responses. The facilitator records or notes in a non-critical fashion the explanation provided by the nurses of the self care medical procedure and makes a list of all of the supplies and materials mentioned by the hospital nurses, as indicated by block 42. Each nurse is allowed to give their own explanation of the self care medical procedure.

After the nurses completely describe the self care medical procedure, the facilitator uses the facilitator's notes to act out or pantomime each of the steps of the self care medical procedure chronologically, as indicated by block 52. The nurses are asked to correct any steps by the facilitator, as indicated by block 54. One key responsibility of the facilitator during the meeting is to flush out or clarify actions that are incomplete, unclear or misleading. One approach is for the facilitator to deliberately omit a step or action or do it incorrectly, if it is possible to misconstrue the nurses' instructions in this way. This enables the nurses to clarify or correct any action that is incomplete, unclear or misleading. Further, having at least two nurses enhances the reliability of the nurses' responses to the facilitator's pantomime. The greater the number of participating nurses, the greater the likelihood that the facilitator's pantomime will include all the steps and that such steps are the best possible procedure. However, cost and convenience weigh against including too many nurses.

During the pantomime of each step, the facilitator guides the nurses to a consensus on the exact description and order of each step and exact materials necessary for performing the procedure, as indicted by block 56. This consensus leads to the best way to undertake the steps and materials therefor that is currently known to the participant. Alternatively, the nurses and facilitator may reach consensus on the best way they know to undertake the step and materials therefor, and agree that a better way or better materials may exist.

Typically, the facilitator makes a written record of the meeting although the facilitator may also make an audio, video, or other suitable recording of the discussion on the self care medical procedure, as indicated by block 42. Preferably, each procedural step contains only one physical action or mental decision to ensure the procedure is kept simple, although a step may contain any combination of physical actions and mental decisions that occur simultaneously. For example, in preparing to cover a wound with a gauze pad, one nurse may describe tearing several strips of tape at once, affixing one end of each piece of tape to the edge of a table until needed. Another nurse may describe tearing each strip of tape one at a time as needed, and affixing the strip directly to the gauze. The facilitator will guide the nurses towards a consensus of which way is the most convenient for the patient while meeting the clinical requirements of the procedure, e.g., cleanliness. The facilitator records both physical actions occurring simultaneously with this step, i.e., the tearing and the affixing.

In recording each procedural step, the facilitator divides the step's actions into two categories, as indicated by block 48: (i) actions that the hospital nurses think that a patient at home would be willing to do, either alone or with the aid of a non-professional caregiver; and (ii) actions that the nurses think that a patient at home would not be willing to do, either alone or with the aid of a non-professional caregiver. If the medical procedure contains too many steps that the patient cannot or will not perform, the implementor may decide not to produce a self-care kit for the medical procedure. Also, the self-care kit's instructions must include and discuss a procedure even if a patient cannot or will not perform a particular step at home. The facilitator's record should list all the necessary materials, not just specifically provided medical supplies, as they are spontaneously mentioned by the nurses in describing each step. In recording each step's materials as indicated by block 42, the facilitator preferably divides the materials into two categories: (i) materials that the hospital nurses are fairly sure that a patient would have at home, such as a plastic garbage bag or clean towel, as indicated by block 44; and (ii) materials that the nurses think that a patient would not have at home or would have difficulty obtaining, as indicated by block 46. For each item of material, the facilitator records whether the nurses believe that the material must be brand specific, or whether a generic substitute is acceptable, as indicated by block 50. For cost reasons, the self-care kit preferably includes generic substitutes rather than brand name items.

When the facilitator has acted out a procedural step, and concluded the recording specified above, the facilitator should record all corrections made by the nurse(s). The facilitator may ask the nurses, at the facilitator's discretion, open-ended questions to determine if there is any step, action or material associated with the self care medical procedure that they haven't disclosed, as indicated by block 58. For example, the facilitator may ask "if anything is bugging or nagging the nurses" to elicit a step, action or material not previously mentioned, as indicated by diamond 60. The facilitator will consider whether any subsequently disclosed step, action or material is a separate step, as indicated in block 62, and may repeat the processes specified above for the new, additional information. Otherwise, if none of the hospital nurses adds any additional steps, actions or materials, the facilitator concludes the hospital nurse meeting, as indicated by block 64. Draft of Self-Care Kit

After the consensus is reached at the hospital nurses meeting, the facilitator or the implementor prepare a draft of the self-care kit for the self care medical procedure using the information learned at the meeting. The facilitator reviews and evaluates all the information received during the meeting with the in-hospital nurses described above, as shown in block 66, and prepares a draft of easy-to-read step-by-step instructions for the self care medical procedure and assembles all of the materials or supplies listed by the facilitator during the meeting, as indicated in block 67. When the instructions are complete and the materials are assembled, the first draft of the self-care kit is complete.

Home-Care Nurse interviews In Figs. 3A, 3B and 3C, the facilitator arranges a face-to-face meeting with at least one and preferably two or more home-care nurses, as indicated by block 68. Home-care nurses are generally employed by a home-care medical organization, may work at least part-time at a hospital, may work at a doctor's office separate from a hospital, or may work for other institutions such as schools, churches, etc.

As with the hospital nurse meeting, the facilitator begins the meeting by telling each of the home-care nurses to chronologically explain each and every action of the self care medical procedure in detail, as indicated by block 69. The home-care nurses explain the self care medical procedure from the patient's point of view, assuming the patient is at home, as indicated by block 70. This explanation includes noting whether the patient is likely to receive any materials from the hospital or doctor's office or must obtain the materials on her own. In instructing the facilitator and detailing each action, the home-care nurses must assume that the facilitator knows nothing of the self care medical procedure and has no knowledge of medicine, medical procedures, or health care in general. Again, it is important that the facilitator not ask "What should go in the kit?" Rather, the facilitator asks "How do you do the procedure?" Such open-ended questions elicit a more complete response. The facilitator records the steps in a non-critical fashion and makes a list of each material or item mentioned by the nurses, as indicated by block 72. Each home-care nurse is given the opportunity to explain the procedure. After the home-care nurses completely describe the instructions, the facilitator acts out or pantomimes each of the step of the self care medical procedure chronologically based on the facilitator's notes, as indicated by block 82. The facilitator may also use the instructions of the draft self-care kit in the pantomime to further facilitate the discussion. Again, a major responsibility of the facilitator during this session is to flush out or clarify the steps that are incomplete, unclear or misleading. Like the initial brainstorming session described above, the facilitator may deliberately omit a step or action or do it incorrectly. This enables the home-care nurses to clarify or correct any action that is incomplete, unclear or misleading, as indicated by block 84.

Having at least two nurses enhances the reliability of corrections to the pantomime to obtain all of the steps in the self care medical procedure. The greater the number of participating nurses, the greater the likelihood that the facilitator's pantomime will include all the steps of the self care medical procedure. However, cost and convenience weigh against including too many home-care nurses.

The implementor may determine that it prefers more or less home- care nurses than hospital nurses. For example, the implementor may determine that in practice, the home-care nurses mainly concur with the hospital nurses. Therefore, to optimize cost and benefits, the implementor may employ more hospital nurses than home-care nurses. In another example, the implementor may learn that, in general, either the hospital nurses provide better information than the home-care nurses, or vice versa, and employ a number of nurses accordingly.

During the pantomime of each step, the facilitator guides the home-care nurses to a consensus on the exact steps and exact materials necessary for performing the procedure, as described in block 86. This consensus preferably leads to the best way to undertake the steps and materials therefor, or alternatively the best way they know to undertake the step and materials therefor, and an agreement that a better way or materials may exist.

Again, the facilitator typically makes written records although the facilitator may also make an audio, video, or other suitable recording of the step, as indicated by block 72. Preferably, each procedural step contains only one physical action or mental decision to keep the procedure simple, although a step may contain any combination of physical actions and mental decisions that occur simultaneously.

In recording each procedural step, the facilitator divides the step's actions into two categories, as indicated by block 78: (i) actions that the home-care nurses think that a patient at home would be willing to do, either alone or with the aid of a non-professional caregiver; and (ii) actions that the nurses think that a patient at home would not be willing to do, either alone or with the aid of a non-professional caregiver. Home- care nurses may have special knowledge in judging what procedural steps a patient will be willing to perform at home. If the medical procedure contains too many steps that the patient cannot or will not perform, the implementor may wish to re-evaluate whether it wants to produce a self-care kit for the medical procedure. The facilitator's record includes all the necessary materials, not just specifically provided medical supplies. In recording the material for each step, the facilitator preferably divides the materials into two categories: (i) materials that the home-care nurses are fairly certain that a patient would have at home, as indicated by block 74; and (ii) materials that the nurses think that a patient would not have at home or would have difficulty obtaining, as indicated by block 76. Again, home-care nurses may have special knowledge in judging what materials a patient will likely have at home. For this reason, the implementor may wish to place more weight on the home-care nurses' opinions with respect to the ownership of the necessary materials. For each material, the facilitator records whether the nurses believe that the material must be brand specific, or whether a generic substitute is acceptable, as indicated by block 80. When the facilitator has acted out and discussed all of the procedural steps, and concluded the recording specified above, the self care medical procedure should be described and recorded in its entirety. The facilitator may ask the home-care nurses some open-ended questions to determine if there is any step, action, or material associated with the procedure that they haven't discussed, as shown in block 88. For example, the facilitator may ask "if anything is bugging or nagging the nurses" to elicit a step, action or material step not previously mentioned, as indicated by diamond 90. The facilitator will consider whether any subsequently disclosed step, action or material is a separate step, as described in block 92, and repeats the process specified above for the new, additional information. Otherwise, if none of the in-home nurses knows of a step or action, the facilitator concludes the hospital nurse meeting, as indicated by block 94. Draft Design Revision

After a consensus is reached at the home-care nurses meeting, the facilitator or the implementor revises the draft self-care kit for the self care medical procedure. The facilitator reviews and evaluates all the information received during the interview with the home-care nurses described above, as indicated by block 96, and revises the previously prepared draft list of standard, easy-to-read step-by-step instructions and assembles all (or possibly eliminates some of) the materials disclosed during the meetings not previously included, as indicated by block 97. When the instructions are revised and the materials are assembled, the revised draft self-care kit is complete.

Patient Interview Process

As depicted in Figs. 4A and 4B, the facilitator arranges a face-to- face meeting with at least one and preferably two or more patients who can perform the self care medical procedure alone or with the aid of non- professional caregiver, as indicated by block 98. The chosen patients are, or at one point were, under a doctor's care or medical orders and performed the procedures addressed by the self-care kit being developed. The selected patients should be age-appropriate with a majority of the patients with the condition for which the self-care kit is designed. Both male and female patients may be included, although preferably not at the same session. It is further contemplated that including patients with a low reading level may be advantageous, to verify that the step-by-step instructions are easy to follow. A non- professional caregiver may be included in lieu of, or in addition to, an actual patient, if it is contemplated that such a non-professional caregiver may be the targeted user. To ensure reliability, the ideal patient participant will still be under a doctor's care and actually perform the procedure while the facilitator observes. When patients currently performing the procedure are not available, the facilitator begins the meeting by telling each of the care patients to chronologically act out, or pantomime, and explain each and every step of the self care medical procedure, as indicated by block 100. Alternatively, the facilitator could have the patients prepare in advance of the meeting. The patients act out the self care medical procedure as if the patients are the teacher and the facilitator is the student. The act, or pantomime, includes gathering all materials necessary for the procedure, including mock trips outside the home to procure supplies. Preferably, the facilitator provides the patients time during the meeting to individually prepare for the pantomime by having each patient carefully recall each procedural step. In recalling each step, the patients must assume that the facilitator knows nothing of the procedure and has no knowledge of medicine, medical procedures, or health care in general.

The patients act out each of the self care medical procedure's steps chronologically, as indicated by block 100. The patients may act out each step individually, one patient at a time, in unison, or each patient may act out the entire pantomime separately. It is important that each patient act independently, according to their own recollection or list to ensure reliability. As with the nurses, the greater the number of independently-acting patients, the greater the likelihood that the pantomime will include all the medical procedure's steps, particularly if any of the patients are relying on memory because they no longer need to perform the procedures themselves. However, cost and convenience weigh against including too many patients.

For each procedural step, the facilitator records each patient's rendition of the step and all materials each patient mentions or says he or she uses, as indicated by block 102. The facilitator makes written records although the facilitator may also make an audio, video, or other suitable recording of the step. Preferably, each procedural step contains only one physical action or mental decision to ensure simplicity, although a step may contain any combination of physical actions and mental decisions that occur simultaneously.

The facilitator's record includes all the necessary materials that the patients use, not just medical supplies. The patients may have fashioned unique devices or used alternative materials that competently perform specific steps of which the nurses have no knowledge. Also, the patients may have markedly differing opinions concerning which materials that they have at home, and what steps they are willing to perform alone or with the aid of a non-professional caregiver.

The facilitator also records any discrepancies between the information disclosed by the patients and the information disclosed by the nurses, as indicated by block 104. For each discrepancy, when the pantomimes are finished, the facilitator discloses to the patients the nurses' differing information, if any, as indicated by block 104. The facilitator asks the patients why the discrepancy has occurred and which method or material that they prefer or believe that they would prefer, as indicated by block 104. The facilitator records the patients' explanations, as indicated by block 104.

In addition to recording the information specified above in which the facilitator obtains information primarily from open-ended recall and questioning of the patients, the facilitator asks and records specific information. With reference to the patients' and the nurses' method and/or materials, the facilitator asks and records whether: (i) the patients find or believe the step is awkward, as indicated by block 106; and (ii) the patients find or believe the step is unpleasant, as indicated by block 108. With reference to the only to the nurses' method and/or materials, the facilitator asks and records whether: (i) the patients find or believe the step is impossible to perform, as indicated by block 110; and if (ii) the patients find or believe the step will produce an unintended result, as indicated by block 112. Again the facilitator guides the patients to a consensus on the steps and materials each patient's rendition requires, as indicated by block 114. This consensus results in the best way to undertake the steps and materials therefor; or the best way to undertake the step and materials therefor, and an agreement that there may be a better way.

Prototype Design Process After the consensus is reached with the patients at the patient meeting, the facilitator or implementor prepares a prototype self-care kit, preferably in-house but may outsource the prototype to a medical supply house or similar organization, as indicated by block 118. The facilitator reviews and evaluates all the information received from the patient interviews described above, and indicated by block 116, and revises the revised draft list of standard, easy-to-read step-by-step instructions and assembles all (or eliminates some of the) materials based on the notes taken at the meetings. The facilitator may prepare a word processing version of the step-by-step instructions or may have professionally printed version of the documentation prepared. The prototype should be made as complete as possible. At this point, the prototype is a benchmark for all further evaluation and testing of the self-care kit. Further Hospital Nurse Meeting

As shown in Figs. 5A and 5B, the implementor identifies at least one, and preferably two or more independent or remote health care organizations, located in separate regions of the country, that enable the implementor to repeat the process to verify the prototype self-care kit, as indicated by block 118. The remote health care organizations provide the implementor with a source for locating and employing remote hospital nurses, remote home-care nurses, and remote home-care patients. The remote hospital nurses, home-care nurses, and home-care patients have the same qualifications and attributes as their local counterparts (i.e., those qualifications and attributes specified above).

The facilitator locates and employs at least one, and preferably two or more remote hospital nurses and arranges a face-to-face meeting, as indicated by block 119. At the meeting, the facilitator asks each of the nurses to explain each and every step of the self care medical procedure. The nurses are to explain the medical procedure from the patient's point of view, assuming the patient is at home. The entire process described above for the hospital nurses meeting is repeated, as shown in block 120. The facilitator knows more about how each nurse and patient views the procedure and knows the contents and instructions for the prototype self-care kit. This enables the facilitator to ask better or more specific questions about each step in the self care medical procedure. When the hospital nurses have reached a consensus on the self care medical proceeding, the facilitator concludes the hospital nurse meeting.

Further Home-Care Nurse Meeting The facilitator locates and employs at least one and preferably two or more independent home-care nurse and arranges a face-to-face meeting, as indicated by block 121. The facilitator asks the remote home-care nurses to explain each and every step of the self care medical procedure according to their own knowledge. The entire process described above for the home-care nurses meeting is repeated, as indicated by block 122. The facilitator knows more about how each nurse and patient views the procedure and knows the contents and instructions for the prototype self-care kit. This enables the facilitator to ask better or more specific questions about each step in the self care medical procedure. When the in-home nurses have reached a consensus on the self care medical procedure, the facilitator concludes the in-home-care nurse meeting.

In-Home Patient Meeting

The facilitator locates at least one and preferably two or more patients who can perform the self care medical procedure alone or with the aid of a non-professional caregiver and arranges a face-to-face meeting, as indicated by block 123. At the meeting the facilitator asks each of the patients to prepare to chronologically act out, or pantomime, each and every step of the self care medical procedure, as indicated in block 124. The ideal patient is one who will actually do the procedure while the facilitator observes. The entire process described above for patients is repeated, as indicated by block 126. The facilitator knows more about how each nurse and patient views the procedure and knows the contents and instructions for the prototype self-care kit. This enables the facilitator to ask better or more specific questions about each step in the self care medical procedure. When the patients have reached a consensus on the self care medical procedure, the facilitator concludes the patient meeting.

Revision and Modification of Prototype The facilitator or implementor revised the prototype based on the notes from the meeting with the hospital nurses, in-home nurses and patients. The facilitator may add, subtract, modify, or replace the contents and documentation in the existing prototype self-care kit that improve the self-care kit's effectiveness using the knowledge gained from the round of nurse and patient interviews, as indicated by block 127. For example, the facilitator may have discovered a suitable generic substitute previously unknown to the facilitator. The facilitator may learn that an existing item may be more effective or less costly if made of a different material or in a different shape or size. The second round of meetings may also streamline the prototype's documentation and packaging. The facilitator or implementor determines if any changes are necessary and prepares a second prototype self-care kit with new instructions and supplies.

If the current remote health care organization is not the last remote health care organization(s) that the implementor wishes to employ for evaluation purposes, the implementor may select one or more remote health care organization in a different geographic location or part of the country and repeat the entire evaluation process described above, and as indicated by block 128. The prototype self-care kit may be revised each round of meetings. This evaluation process and revision of the prototype self-care kit may be repeated as many times as desired. Otherwise, the implementor submits the prototype self-care kit for approval.

Final Review and Approval The facilitator prepares and provides the final revised prototype of the self-care kit including the step-by-step instructions to the first health care organization for review and approval, as indicated by block 129. If such organization requests any changes, the facilitator can modify the self-care kit and repeat any of the testing process described previously. If the organization approves the self-care kit, the implementor produces the kit and provides the kit to the organization for distribution to patients, as indicated by block 130. Furthermore, the implementor may contemplate translating the procedures to follow into a language other than English to make the kit available to non-English-speaking patients.

While the present invention has been described in connection with what is presently considered to be the most practical and preferred embodiments, it is to be understood that the invention is not limited to the disclosed embodiments, but on the contrary is intended to cover various modifications and equivalent arrangements included within the spirit and scope of the claims. It is thus to be understood that modifications and variations in the present invention may be made without departing from the novel aspects of this invention as defined in the claims, and that this application is to be limited only by the scope of the claims.

Claims

CLAIMSThe invention is hereby claimed as follows:
1. A method for determining the contents of a self-care kit for a patient, said method comprising the steps of: identifying a self care medical procedure to be conducted by the patient using the self-care kit; determining procedures the patient needs to follow and the materials to be incorporated into the self-care kit; preparing a prototype of the self-care kit including step-by-step instructions; testing the prototype to determine that all of the procedures and materials are appropriate for the self-care kit; and modifying the procedures and materials in the self-care kit based on the testing.
2. The method of Claim 1 , wherein said determining step includes identifying and interviewing at least one hospital nurse to determine the materials to be incorporated in the self-care kit and the procedures for using the materials.
3. The method of Claim 1 , wherein said determining step includes identifying and interviewing a plurality of hospital nurses to determine the materials to be incorporated in the self-care kit and the procedures for using the materials.
4. The method of Claim 3, wherein said determining step further includes causing the hospital nurses to reach a consensus on the procedures and materials.
5. The method of Claim 4, wherein said determining step further includes preparing a draft of the self-care kit.
6. The method of Claim 1 , wherein said determining step includes identifying and interviewing at least one in-home nurse to determine the materials to be incorporated in the self-care kit and the procedures for using the materials.
7. The method of Claim 1 , wherein said determining step includes identifying and interviewing a plurality of in-home nurses to determine the materials to be incorporated in the self-care kit and the procedures for using the materials.
8. The method of Claim 7, wherein said determining step further includes causing the in-home nurses to reach a consensus on the procedures and materials.
9. The method of Claim 1 , wherein said determining step includes identifying and interviewing at least one patient to determine the materials to be incorporated in the self-care kit and the procedures for using the materials.
10. The method of Claim 1 , wherein said determining step includes identifying and interviewing a plurality of patients to determine the materials to be incorporated in the self-care kit and the procedures for using the materials.
11. The method of Claim 10, wherein said determining step further includes causing the patients to reach a consensus on the procedures and materials.
12. A method for determining the contents of a self-care kit for a patient, said method comprising the steps of: identifying a self care medical procedure to be conducted using the self-care kit; obtaining information about said medical procedure including procedures to follow and material to include in the self-care kit from at least one medical professional; preparing a draft self-care kit incorporating said procedures and materials; obtaining information about said medical procedure including procedures to follow and material to include in the self-care kit from at least one in-home medical professional; revising the draft self-care kit; obtaining information about said medical procedure including procedures to follow and material to include in the self-care kit from at least one in-home subject; preparing a prototype of the self-care kit; obtaining information about said medical procedure from at least one different medical professional to determine that all said procedures and materials are included; obtaining information about said medical procedures from at least one different in-home medical professional to determine that all said procedures and materials are included; asking at least one different in-home subject to act out all said procedures and materials in performing said self care medical procedure, forming a tested self-care kit; approving said tested self-care kit, forming the self-care kit; and providing the self-care kit for in-home use.
13. The method of Claim 12, wherein the medical professionals are nurses.
PCT/US2000/030902 1999-11-12 2000-11-10 A method for determining the contents of a self-care kit WO2001035299A8 (en)

Priority Applications (4)

Application Number Priority Date Filing Date Title
US16502699 true 1999-11-12 1999-11-12
US60/165,026 1999-11-12
US70991700 true 2000-11-09 2000-11-09
US09/709,917 2000-11-09

Publications (2)

Publication Number Publication Date
WO2001035299A1 true true WO2001035299A1 (en) 2001-05-17
WO2001035299A8 true WO2001035299A8 (en) 2002-01-03

Family

ID=26861041

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2000/030902 WO2001035299A8 (en) 1999-11-12 2000-11-10 A method for determining the contents of a self-care kit

Country Status (1)

Country Link
WO (1) WO2001035299A8 (en)

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5117981A (en) * 1988-09-27 1992-06-02 Becton, Dickinson And Company Kit with tourniquet and rolled gloves
US5544753A (en) * 1994-12-08 1996-08-13 Monica; Julianne H. Kit for the care of back ailments
US5660176A (en) * 1993-12-29 1997-08-26 First Opinion Corporation Computerized medical diagnostic and treatment advice system
US5752234A (en) * 1995-08-18 1998-05-12 Patient Solutions Method and apparatus for managing disposable medical supplies appropriate for a single patient visit
US5785650A (en) * 1995-08-09 1998-07-28 Akasaka; Noboru Medical system for at-home patients
US5848700A (en) * 1997-08-22 1998-12-15 Horn; Nathaniel Emergency medical care kit with medical emergency instructions
US5961446A (en) * 1995-10-06 1999-10-05 Tevital Incorporated Patient terminal for home health care system

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5117981A (en) * 1988-09-27 1992-06-02 Becton, Dickinson And Company Kit with tourniquet and rolled gloves
US5660176A (en) * 1993-12-29 1997-08-26 First Opinion Corporation Computerized medical diagnostic and treatment advice system
US5544753A (en) * 1994-12-08 1996-08-13 Monica; Julianne H. Kit for the care of back ailments
US5785650A (en) * 1995-08-09 1998-07-28 Akasaka; Noboru Medical system for at-home patients
US5752234A (en) * 1995-08-18 1998-05-12 Patient Solutions Method and apparatus for managing disposable medical supplies appropriate for a single patient visit
US5961446A (en) * 1995-10-06 1999-10-05 Tevital Incorporated Patient terminal for home health care system
US5848700A (en) * 1997-08-22 1998-12-15 Horn; Nathaniel Emergency medical care kit with medical emergency instructions

Also Published As

Publication number Publication date Type
WO2001035299A8 (en) 2002-01-03 application

Similar Documents

Publication Publication Date Title
Wise et al. The family health worker.
Wiles et al. Providing appropriate information to patients and carers following a stroke
Donaldson et al. Primary care: America's health in a new era
Rantz et al. Nursing home care quality: A multidimensional theoretical model integrating the views of consumers and providers
Donabedian An introduction to quality assurance in health care
Moxley Practice of Case Management
Waltz et al. Measurement in nursing and health research
Hood Leddy & Pepper's conceptual bases of professional nursing
Butow et al. Patient participation in the cancer consultation: evaluation of a question prompt sheet
O'Connor Clinical instruction & evaluation: A teaching resource
Kane et al. What older people want from long-term care, and how they can get it
Nolan et al. ‘It’s not the same as him being at home’: creating caring partnerships following nursing home placement
Sixma et al. Quality of care from the patients' perspective: from theoretical concept to a new measuring instrument
Shelton Measuring and improving patient satisfaction
Katz When the child's illness is life threatening: Impact on the parents
Roter et al. The effects of a continuing medical education programme in interpersonal communication skills on doctor practice and patient satisfaction in Trinidad and Tobago
Grogan et al. Development of a questionnaire to measure patients' satisfaction with general practitioners' services.
Fink Evaluation Fundamentals: Insights into the Outcomes, Effectiveness, and Quality of Health Programs: Insights Into the Outcomes, Effectiveness, and Quality of Health Programs
Donley et al. Revisiting the American Nurses Association’s first position on education for nurses
Mislevy et al. A cognitive task analysis with implications for designing simulation-based performance assessment☆
Booth et al. Measurement of communication skills in cancer care: myth or reality?
Simon et al. A practical guide to applying lean tools and management principles to health care improvement projects
Kramer et al. Rehabilitation care and outcomes from the patient's perspective
Velasquez et al. Application of motivational interviewing to prenatal smoking cessation: training and implementation issues
Lurie Nurse practitioners: issues in professional socialization

Legal Events

Date Code Title Description
AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): AT BE CH CY DE DK ES FI FR GB GR IE IT LU MC NL PT SE TR

121 Ep: the epo has been informed by wipo that ep was designated in this application
DFPE Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101)
AL Designated countries for regional patents

Kind code of ref document: C1

Designated state(s): AT BE CH CY DE DK ES FI FR GB GR IE IT LU MC NL PT SE TR

CFP Corrected version of a pamphlet front page
CR1 Correction of entry in section i

Free format text: PAT. BUL. 20/2001 UNDER (30) REPLACE "NOT FURNISHED" BY "09/709917"

122 Ep: pct application non-entry in european phase