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June 2019; 9 (3) Research

Patient-perceived value of a specialty-specific welcome letter

What you say and how you say it

Katharina M. Busl, Janelle Alongi, Ashley Anderson, Michael Jaffee, Jacqueline Baron-Lee
First published April 9, 2019, DOI: https://doi.org/10.1212/CPJ.0000000000000633
Katharina M. Busl
Chief of the Neurocritical Care Division and Physician Director of Quality (KMB), Department of Neurology, University of Florida; Neuromedicine Interdisciplinary Clinical and Academic Program (JA), University of Florida; Department of Neurology (AA, MJ), University of Florida, Gainesville; and Neuromedicine Interdisciplinary Clinical and Academic Program (JB-L), University of Florida, Gainesville.
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Janelle Alongi
Chief of the Neurocritical Care Division and Physician Director of Quality (KMB), Department of Neurology, University of Florida; Neuromedicine Interdisciplinary Clinical and Academic Program (JA), University of Florida; Department of Neurology (AA, MJ), University of Florida, Gainesville; and Neuromedicine Interdisciplinary Clinical and Academic Program (JB-L), University of Florida, Gainesville.
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Ashley Anderson
Chief of the Neurocritical Care Division and Physician Director of Quality (KMB), Department of Neurology, University of Florida; Neuromedicine Interdisciplinary Clinical and Academic Program (JA), University of Florida; Department of Neurology (AA, MJ), University of Florida, Gainesville; and Neuromedicine Interdisciplinary Clinical and Academic Program (JB-L), University of Florida, Gainesville.
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Michael Jaffee
Chief of the Neurocritical Care Division and Physician Director of Quality (KMB), Department of Neurology, University of Florida; Neuromedicine Interdisciplinary Clinical and Academic Program (JA), University of Florida; Department of Neurology (AA, MJ), University of Florida, Gainesville; and Neuromedicine Interdisciplinary Clinical and Academic Program (JB-L), University of Florida, Gainesville.
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Jacqueline Baron-Lee
Chief of the Neurocritical Care Division and Physician Director of Quality (KMB), Department of Neurology, University of Florida; Neuromedicine Interdisciplinary Clinical and Academic Program (JA), University of Florida; Department of Neurology (AA, MJ), University of Florida, Gainesville; and Neuromedicine Interdisciplinary Clinical and Academic Program (JB-L), University of Florida, Gainesville.
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Citation
Patient-perceived value of a specialty-specific welcome letter
What you say and how you say it
Katharina M. Busl, Janelle Alongi, Ashley Anderson, Michael Jaffee, Jacqueline Baron-Lee
Neurol Clin Pract Jun 2019, 9 (3) 228-232; DOI: 10.1212/CPJ.0000000000000633

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Abstract

Background Patient experience and clinical outcomes are improved when patients know what to expect. Providing valuable, appropriate information proves challenging considering variation in patient education, literacy, and limitations specific to patients with neurologic disease. Scaffolding of what to expect, care team members, needed materials, procedures, directions to facilities, and methods of communication are core aspects of improving patient readiness.

Methods This study employed standard quality improvement methods. An existing (original) patient welcome letter was first analyzed to assess its literacy levels. Surveys were then administered to patients with neurologic disease assessing perception of readiness for ambulatory appointments and the overall value of the welcome letter. In addition to Likert-type scales, patients also provided open feedback on what should be included in the letter. A revised letter was then created with added content, improving literacy levels. The letter was further assessed through clinical and nonclinical groups including our neuromedicine Patient and Family Advisory Council. Response data were analyzed comparing the original vs the revised score using a t test assuming equal variances.

Results The “overall value” score of the original welcome letter (3.79 of 5.0) improved to the revised score (4.63 of 5.0). Patients perceived the revised welcome letter as improving their readiness significantly as ambulatory patients with neurologic disease.

Conclusions Preparing patients for their neurology visits is important and affects visits' value. Sensitivity to literacy levels is an essential component of person-centered care among neurologic patients. Carefully created and assessed welcome letters help to achieve these goals by improving readiness for outpatient appointments and increases perceived overall value significantly.

Footnotes

  • Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.

  • Received July 20, 2018.
  • Accepted September 4, 2018.
  • © 2019 American Academy of Neurology
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