TEACH-BACK FOR EVERYONE YOU-TUBE IN YOUR OFFICE Patients remember - - PowerPoint PPT Presentation

2/24/2017 1

CLINICAL PEARLS

FACULTY AND AUDIENCE

A CLINICAL PEARL IS

• A distillation of clinical knowledge that is useful for solving

every day medical problems

• It may be a tip, a way to remember something, a framing
• f a problem
• May be evidence-based or experience-based

TEACH-BACK FOR EVERYONE

• Patients remember less than

50% of what their doctors tell them

• Literacy depends on content

and context

• Assessing for understanding

improves recall

• Teach-Back

YOU-TUBE IN YOUR OFFICE

• Great for teaching yourself new techniques but also for patients
• Use of inhalers, discus
• Exercises
• Epley maneuver
• SVT reverse maneuver at home

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COMPASSION SATISFACTION & “THE GOOD LIFE”

• Pleasure that comes from

helping others

• Increases connection
• Protects against burn-out
• The “ Good Life” full of

meaning, aimed at greater good rather than ease.

• What is meaningful in what

you do?

• What are you grateful for in

your work?

• What core values are

expressed through your work?

INSULIN AND HOMELESSNESS: KNOW YOUR OPTIONS

• Common misconception: Insulin must be kept

in refrigerator

• Truth! Insulin can be kept at room

temperature for up to one month. Can be carried with belongings, taken to shelters, etc.

• Common misconception: Pens require a PA

and are hard to obtain

• Truth! Pens are increasingly covered as first-

line treatment, are more portable and less likely to be stolen than bottles and syringes, and have auditory clues for the visually impaired

MOST POWERFUL THING WE DO TO DECREASE MORTALITY & MORBIDITY? SMOKING CESSATION

• One evidence-based step toward cessation?
• Smoke-free homes –voluntary no smoking at home
• Associated with:

Reduced secondhand smoke exposure Decreased consumption Increased cessation Reduced relapse to smoking

DIRECT ORAL ANTICOAGULANTS AND ATRIAL FIBRILLATION

• Switching appropriate patients off

Warfarin and onto DOACs can benefit patients who are low literacy and/or have inconsistent Vitamin K intake due to food insecurity

• But make sure NO huge co-pay….

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THEY TOLD ME EVERYTHING WAS OKAY…

• Patients, particularly with low health literacy or limited English

proficiency, have little understanding of what we might be looking for, what we might find from different diagnostic tests

• When ordering labs and other let patients know what you are
• rdering and why……

Elizabeth Rogers

ADHERENCE AIDS FOR LOW LITERACY PATIENTS

• I buy pill boxes of all shapes and sizes

and fill them with patients at their appointment.

• 2 For patients who can't read or are

confused by all their pills, I tape one of each pill to a piece of paper with a picture

• f breakfast on it for am, another page

with a bed for bedtime, etc.

• Miriam Maher MD

WHAT’S THAT RASH?

• An homage to my father-in-law

public health dermatologist..

• "All unexplained rashes are syphillis

until proven otherwise.”

• Lisa or Mo

IT’S FLU SEASON: REMEMBER

• Healthy folk, no treatment if >48 hr sx
• High risk treatment even if more than 48

hrs sx: PG, young, old, DM, lung disease, immunosuppressed, pregnant, sickle cell, ESRD, ESLD, Native ethnicity, nursing home and

• CAD :Getting the flu risk for MI
• Obesity predisposes severe disease
• VACCINATE
• Remember to ask about

work, who is in the family

• etc. for all patients with

flu–HR need post- exposure prophylaxis and vaccination

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COMPASSION SATISFACTION & “THE GOOD LIFE”

• Pleasure that comes from

helping others

• Increases connection
• Protects against burn-out
• The “ Good Life” full of

meaning, aimed at greater good rather than ease.

• What is meaningful in what

you do?

• What are you grateful for in

your work?

• What core values are

expressed through your work?

ASSESSING NUTRITIONAL STATUS

• ASK
• How far is it to travel get to a store?
• What type of store, i.e.

Convenience(7-11), Fruit stand, Small Grocery, Large Supermarket

• Think about food deserts, urban

and rural

• Don Hernandez

THE TEETH: REMEMBER TO SMILE!

• I always ask my patients (of all ages) how many times a day they brush their

teeth and for how long. I've been so surprised to hear how uncommon brushing twice daily for 2 minutes is! Flossing is a whole other story….

• Best,
• Sandeep Lehil, FNP-C

MOST POWERFUL THING WE DO TO DECREASE MORTALITY & MORBIDITY? SMOKING CESSATION

• One evidence-based step toward cessation?
• Smoke-free homes –voluntary no smoking at home
• Associated with:

Reduced secondhand smoke exposure Decreased consumption Increased cessation Reduced relapse to smoking

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MORE ORAL CARE

• Remind your obese patients that changes made in the diet for

weight loss improve their dental health

• Susan Fisher-Owens

AUDIENCE: SHARE YOUR CLINICAL PEARLS

• Email to Margaret.Wheeler@ucsf.edu
• We will collate them on to slides for presentation tomorrow!
• TOP TEN will win a copy of Medical Care of Vulnerable and

Underserved Populations