Margaret Samuels-Kalow, M.D., M.S.H.P.
Assistant Professor of Emergency Medicine & Pediatrics
Massachusetts General Hospital
Assistant Professor of Emergency Medicine & Pediatrics
Massachusetts General Hospital
Key Words: Emergency medicine, Medication safety, Health disparities, Implementation science
Multiple studies have shown that patients and families leave the emergency department (ED) without full understanding of their discharge instruction and without knowing how to safely dose medications for their children. These communication challenges are particularly severe for families with limited health literacy or limited English proficiency. Understanding how best to teach families complex information in the time-limited and hectic setting of the ED can help us improve patient outcomes and safety following emergency care, and improve teaching of families across a variety of pediatric care environments—including day surgery, procedures, and sick visits to primary care. Ultimately, the goal of this work is to develop a structured system for teaching and ensuring comprehension to improve child health outcomes and reduce disparities in care.
We have developed an intervention, MEDS (Medication Education for Dosing Safety), designed from best practices from the literature with patient and family perspectives. In a small pilot trial, the MEDS intervention improved parents ability to safely dose medications for their children. We now propose a larger trial of the MEDS intervention delivered in a “real world” setting, by ED staff as part of routine clinical care. We will also test two different strategies for training providers to deliver the intervention. At the conclusion of this study, we will have established the effectiveness of the MEDS intervention for improving parental ability to safely dose medications and determined how to best train providers to deliver the intervention. We will have developed an evidence-based strategy to improve parental teaching of complex information, and tested it in a diverse population in both English and Spanish. The information gained from this work will be useful to all providers who care for children and support families in delivering optimal care at home.