Monday, December 21, 2009

PowerPoint for Pre-Op

A week after my surgery, the surgeon showed me an x-ray of what he had done to my collar bone. Screws protruded through it, holding a metal plate on top. Nobody had told me I was going to be treated like a piece of carpentry and have holes drilled in my bones. Jock Doc asked if I had any questions. I asked, "Why didn't you use bone glue?"

I've been seeing articles on bone glue for over a decade. All they told me at pre-op was they were going to put the pieces of my collar bone back together. They showed me somebody else's x-ray with a lot more pieces than mine, but that's a separate issue.

The doc said bone glue isn't strong enough to hold a clavicle. A collar bone is not a particularly weight-bearing bone. These articles seem to indicate that bone glue is a viable option.

http://www.csiro.au/solutions/novosorb.html

http://blogs.nationalgeographic.com/blogs/news/chiefeditor/2009/09/sandcastle-worm-bone-glue.html

The issue is how to help rushed and sleepy residents explain to potential surgery patients what the surgery is going to be.

PowerPoint seems to be a good answer. This is not an endorsement of Microsoft products. OpenOffice, Corel and Adobe all make equivalent products. I'm using the term PowerPoint here as a generic name for this type of software presentation.

Powerpoint presentations with graphics for each type of surgery and their side effects would provide a sensible solution. The resident would also read a script to the potential surgery patient from the notes of the ppt file. Printouts of the Powerpoint presentation and script could be given to the patient and family. In this mode, no information could be omitted or forgotten.

Powerpoint presentations to a patient enjoy several advantages over an oral explanation.

1) Powerpoint is visual as well as auditory. 60% of people do not learn well by audio presentation alone.

2) Residents are always sleepy and rushed. A Powerpoint presentation will make sure that no steps are left out.

3) A Powerpoint presentation can be tested and modified as improvements are noted.

I also suggest a quiz for the potential surgery patient to make sure he or she understood the explanation. The quiz would include simple questions, such as these for broken bones:
1) How many pieces of your broken bone will be put back together?
2) How will the bones be put back together?

Such a quiz would determine not only if the patient understood, but also if the patient was shown his or her own x-ray, or at least one that was substantially similar.

I'm just putting these ideas out there -- hoping hospitals all over the world will pick up on this idea. My motto is not -- sue the stuffing out of them. It's Never Again!

1 comment:

  1. Lots of places they make you watch a video (my dentist's office is one) to see what they're going to do to you and why.

    But it's generic, not personal.

    In this computerized age, I would think your ppt presentation should be individualized with your own X-rays inserted, and as you pointed out above, WEBSITES pointed to so you can read more.

    The thing is, to make this approach to health care work, you'd have to start training people in grammar school in how to understand and use such an info-dump.

    Jacqueline Lichtenberg
    http://jacquelinelichtenberg.com

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