Background

Medication changes during transitions of care is a recognized challenge that has been linked to adverse events. The delivery of medication instructions during transition from hospital to home is a priority area for improvement.

Objective

The goals of this work were to 1) understand the current experiences of patients and families; and 2) co-design tools to improve medication information transfer during transitions of care together with patients, families, and providers.

Methods

A participatory action approach, using mixed methods within a design thinking framework was used. Participants were chosen from patient groups at higher risk of adverse events, guided by extreme user design, which posits that needs of extreme users can also fit the majority. Providers, patients and family (users) were interviewed to understand current experiences with medication information transfer during transitions of care and to solicit input on potential elements to inform tool design. Users were engaged in iterative creation of prototypes.

Results

A total of 116 patients, family caregivers, and providers were engaged throughout this project. Findings highlighted challenges currently experienced, strengthening the case for tools that engage the patient and family in medication information transfer. Important information included why medications were prescribed, how to take them, side effects, and an explanation of the role of community pharmacists. Displaying information in a grid format was preferred. Two tools were prototyped: (1) A Medication Whiteboard for engaging patients and families in creating their medication routine, and (2) A Patient Oriented Medication List for providing medication instructions and as a reference once patients are home.

Conclusions

Through the use of mixed methods within a design thinking framework, the team was able to understand the challenges and design prototypes of tools that both engage patients and families in developing their medication routine and improve medication information transfer during transitions of care.

中文翻译：

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在护理过渡期间改善向患者传递药物信息的工具开发：一种参与式行动研究和设计思维方法方法

背景

护理过渡期间的药物变化是公认的挑战，与不良事件有关。在从医院到家的过渡期间提供药物指导是需要改进的优先领域。

客观的

这项工作的目标是 1) 了解患者和家属的当前经历；2) 协同设计工具，与患者、家属和提供者一起在护理过渡期间改善药物信息传输。

方法

使用了一种在设计思维框架内使用混合方法的参与式行动方法。在极端用户设计的指导下，从不良事件风险较高的患者群体中选出参与者，该设计假设极端用户的需求也可以满足大多数人的需求。对提供者、患者和家人（用户）进行了访谈，以了解在护理过渡期间药物信息传输的当前经验，并就潜在元素征求意见，以告知工具设计。用户参与原型的迭代创建。

结果

共有 116 名患者、家庭护理人员和提供者参与了整个项目。调查结果突出了当前遇到的挑战，加强了使患者和家人参与药物信息传输的工具的案例。重要信息包括开药的原因、如何服用、副作用以及对社区药剂师作用的解释。以网格格式显示信息是首选。设计了两个工具的原型：（1）用于让患者和家人参与创建他们的用药常规的药物白板，以及（2）一个以患者为导向的药物清单，用于提供药物说明并作为患者回家后的参考。

结论

通过在设计思维框架内使用混合方法，该团队能够理解工具的挑战和设计原型，这些工具既可以让患者和家属参与制定他们的用药常规，并在护理过渡期间改善用药信息传输。