714 - Improving Health Literacy in the Pediatric Emergency Department Using Descriptive Medical Illustration Aids

Publication Number: 3691.714

Shannon Kostin, Atlantic Health System- Morristown Medical Center, Dover, NJ, United States; Christina Melchionne Miseo, Morristown Medical Center, Morristown, NJ, United States; Cosimo Laterza, Atlantic Health System- Morristown Medical Center, Morristown, NJ, United States

Background: Low health literacy affects over half of families presenting to pediatric emergency departments (PEDs) and is associated with higher ED utilization and poorer outcomes. Improving communication may reduce non-urgent visits and enhance family experience. Visual tools, particularly simple medical illustrations, may be more effective than written or verbal explanations alone. We developed descriptive, condition-specific illustrations displayed on patient room monitors to address common chief complaints (CCs) and frequently asked questions (FAQs).

Objective: This study evaluated PED staff perceptions of whether these illustrations improved communication and family understanding.

Design/Methods: A single-center observational cohort study was conducted at a children’s hospital in Northern New Jersey (annual PED volume 28,000). A physician–medical illustrator created 50 illustrations covering 92 of the 287 most common CCs, reviewed by a health literacy expert. Families were shown CC-specific images on in-room monitors during their PED stay. Physicians, nurses, residents, and child life specialists completed surveys pre and post intervention rollout. Surveys included pre (n=12) and post (n=13) Likert-scale items on communication and monitor utility. Demographics (age, gender, role, shift, years in role) were collected. Fisher’s exact test or chi squared tests were used to compare demographics; Mann-Whitney U tests compared pre- vs post-intervention responses.

Results: Twenty pre and seventeen post surveys were completed. Fisher’s exact tests revealed no significant demographic differences between groups (Gender p=0.212, Age p=0.349, Role p=0.288, Years in Role p=0.505). For additional questions the responses were very high (medians at 4–5) in the pre-survey, with no significant differences with the post survey due to this: communication with parents (U=200; p=0.053), communication with child (U=184, p=0.472), verbal communication (U=202, p>0.999), written communication (U=187.5, p=0.531), useful to refer to monitor (U=175, p=0.422), monitor increases understanding (U=146, p=0.602).

Conclusion(s): Displaying descriptive medical illustrations in PED rooms was well-received by staff, though measured improvements in communication were not statistically significant, likely due to high baseline scores. Strengths include matched demographics and incorporation of health literacy review. Limitations include small sample size, single-center design, and reliance on staff rather than family input. Future research should assess family understanding, explore multi-center implementation, and evaluate impact on ED utilization.