Ideas for avoiding those budget cut blues

Job satisfaction impacted when funds are cut

In the 2007 Reader Survey conducted by Patient Education Management, readers said the "topic" that most affected their job satisfaction is a reduced budget and the impact of cost-cutting on quality of care. Why does the budget impact job satisfaction?

According to seasoned workers in this field there are many reasons. A reduced budget means patient education managers will need to devote time to creatively working around limited funding to accomplish goals, says Nancy Goldstein, MPH, patient education program manager at the University of Minnesota Medical Center, Fairview in Minneapolis.

Also it is difficult seeing the impact of cost-saving measures on patient experiences, she adds.

Patient education managers are generally very passionate about what they do, says Annette Mercurio, MPH, CHES, manager of patient, family, and community education at City of Hope Medical Center in Duarte, CA. That's why many work more than 50 hours a week to make the greatest possible difference.

"Clearly seeing the education needs that exist and not having adequate resources, whether staff and/or funding for materials and programs to close those gaps for patients and families is a continual stressor," she explains.

When patient education departments conduct assessments and determine needs for the overall institutional program or specific patient populations and then have no money in the budget to develop resources for teaching, it is frustrating, agrees Louise Villejo, MPH, CHES, executive director of the patient education office at the University of Texas M. D. Anderson Cancer Center in Houston.

Often medical centers will consolidate staff and patient education to save money and when that happens the staff education component begins to dominate, says Yvonne Brookes, RN, manager of clinical instructors-onboarding, Versant RN Residency, and a patient education liaison at Baptist Health South Florida in Coral Gables. The majority of time is spent on orientation and training of staff, not on patient education processes, she says.

If staff within the patient education department are eliminated then the scope of the manager's job usually increases, says Mary Szczepanik, MS, BSN, RN, manager of cancer education, and support and outreach at OhioHealth Cancer Services in Columbus. Job satisfaction is always affected if employee cuts are part of the budget projection or reality, she says.

Strategies to avoid cuts

While it is not always possible to avoid budget cuts, there are some things patient education managers can do to make a reduction in funding less likely.

Szczepanik has a long list of suggestions. Those include:

  • talk about patient education all the time;
  • know what your insurance payers require in regards to patient teaching;
  • be willing to take on other responsibilities;
  • be as efficient as you can;
  • set standards and policies and procedures for patient education;
  • know what your accrediting bodies require for patient education.

Brookes advises patient education managers put processes in place to determine outcomes so the value of patient education can be shown; it is evident that educating a patient and family members reduces readmission and increases satisfaction.

According to Brookes, this can be done by focusing on a certain disease that is costly and determining readmission rates before and after an education program has been implemented. To gain information on patient satisfaction surveys, ask questions such as, "Did you receive the information you needed before discharge?"

Prove value of education

Goldstein agrees that statistics supporting patient education are important. "Collect data regarding the scope and range of services you provide and conduct ongoing outcome-based evaluations and research to demonstrate the impact your program makes," she says.

Help your institution achieve specific strategic objectives through patient education and make sure administrators recognize your efforts, advises Mercurio. For example, if patient safety is a top priority for your organization, collaborate with organizational leaders in various departments such as nursing to plan and implement partnerships in safety initiatives. If increasing patient satisfaction is an organizational priority, highlight ways that patient education can help accomplish that goal.

"As clinical programs are targeted as priorities for development, such as prostate cancer programs, make sure you're working closely with the leadership of that program to develop patient education as an integral component of that service," Mercurio adds.

Villejo says it is important to use your entire budget and keep a list of projects that have been identified as important as well. Often if funds are not used, the budget for patient education will be cut so know the mechanics of how the budget is created at your institution, she says.

If you experience budget cuts despite all you do, persevere, says Mercurio.


For more information about reducing the impact of budget cuts, contact:

  • Yvonne Brookes, RN, manager clinical instructors-onboarding, Versant RN Residency, patient education liaison, organizational learning, Baptist Health South Florida, 1500 Monza Ave., Suite 200, Coral Gables, FL 33146. Phone: (786) 596-1333. E-mail:
  • Nancy Goldstein, MPH, patient education program manager, University of Minnesota Medical Center, Fairview, 420 Delaware St. SE, Minneapolis, MN 55455. Phone: (612) 273-6356. E-mail:
  • Annette Mercurio, MPH, CHES, manager, patient, family, and community education, City of Hope National Medical Center, 1500 East Duarte Rd., Duarte, CA 91010-0269. Phone: (626) 301-8926. E-mail:
  • Mary Szczepanik, MS, BSN, RN, manager, cancer education, support, and outreach, OhioHealth Cancer Services, 3535 Olentangy River Rd., Columbus, OH 43214. Phone: (614) 566-3280. E-mail:
  • Louise Villejo, MPH, CHES, executive director, UT M. D. Anderson Cancer Center, Patient Education Office, 1515 Holcombe – 21, Houston, TX 77030. Phone: (713) 792-7128. E-mail: