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Improving Discharge Medication Education: Consideration of Health Literacy and Language
Stephanie S Squires1, Alaina K Kipps1, Sheila Gamuciello2
1Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.
Hospital Pediatrics
|July 7, 2025
Summary
A new medication adherence aid (MAA) improved discharge care for children with medical complexity, increasing access for non-English speaking families. This patient-centered approach enhanced medication safety post-hospitalization.
Area of Science:
- Pediatric Healthcare
- Patient Safety
- Health Literacy
- Health Disparities
Background:
- Medication errors are common in children post-hospitalization, particularly for those with medical complexity.
- Risk factors include low parental health literacy and non-English preferred language (LOE).
- Discharge medication lists often require improvement for better parental understanding.
Purpose of the Study:
- To develop and implement a low health literacy, language-concordant discharge medication adherence aid (MAA).
- To provide the MAA to over 95% of patients discharging from the acute care cardiology unit (ACCU).
- To improve medication adherence and reduce errors for vulnerable pediatric populations.
Main Methods:
- A multidisciplinary team developed a bedside nurse-generated MAA intervention.
- The MAA was designed to be low health literacy and language-concordant.
- Medical record review tracked the weekly average of MAA provision; statistical process control charts analyzed trends.
Main Results:
- The weekly average of patients discharged with an MAA increased from 21% to 75% within six months.
- This improved rate was sustained from July 2022 through October 2023.
- Language-concordant MAA provision was equitable, with 76% of LOE patients and 74% of English-preferred patients receiving an MAA.
Conclusions:
- A language-concordant, patient-friendly MAA was successfully implemented for 75% of discharging families from the ACCU.
- Piloting the intervention with a small nursing group enhanced implementation and sustainability.
- This intervention demonstrates a successful strategy to improve medication safety for diverse pediatric populations post-discharge.
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