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Methods for managing time when in the process of creating written materials
Good policy provides a foundation on which to build best practice
Creating educational handouts can be time-consuming and makes it difficult to complete all the other tasks within the job description of a patient education coordinator or manager.
Many factors contribute to the amount of time needed to write in-house teaching materials. When the author submits a handout that is fairly well developed, those who oversee patient education projects at The Ohio State Medical Center review it for readability and place it in the established formatting before submitting it to the patient education review committee. That usually takes one to three hours, says Diane C. Moyer, BSN, MS, RN, program director for patient education at The Ohio State University Medical Center in Columbus.
"On the other hand, if a clinician comes with an idea and has nothing developed, we may work for several hours to create a draft and then go back to the initiating clinician for feedback. Those projects can eat up 10 to 15 hours depending on the topic," adds Moyer.
To keep the creation of written materials from consuming all her time, Moyer encourages clinicians to at least develop an initial draft. However, sometimes it is less time-consuming to meet with the clinician, talk through the content, and formulate a draft for him or her to review.
Simplifying language on an initial re-write can easily take three to four hours, says Moyer.
While involving multiple experts in the process of creating a handout often results in a better product, it can take longer due to differences of opinion that must be resolved, says Nancy Goldstein, MPH, FAHCEP, patient education program manager at the University of Minnesota Medical Center, Fairview in Minneapolis.
"I have the most difficulty if there is disagreement between clinicians on the content/protocol. That takes a lot of time to work out and to come to consensus," says Goldstein.
Moyer agrees that if multiple experts are willing to discuss their differences about priorities and other issues related to content, the product is often much better than those developed with just one person. However, it can be hard to get a consensus with some groups, and then you have to determine how to move on.
"Often, those are the situations that take months to finish, if they ever get finished. It usually requires getting all the players in a room and working it out. Those who don't show up or send their comments must live with what the others agree to," says Moyer.
Handouts on complex topics can be more difficult to write, as well. In such instances, it is helpful to ask the author to clarify the intended audience as well as the key message or messages. Often, they won't think about providing the details that will make a piece more effective, but a few telephone conversations or e-mail messages and the author usually understands how to write the copy, says Moyer.
A guided process
Because the process of creating written materials can be so time-consuming for patient education coordinators, it is best to have guidelines in place to help prevent problems from occurring.
"Before creating anything new, I will suggest staff seek existing materials, such as those available through our CareNotes system or other online resources that provide reputable patient education handouts," says Christine Hess, MEd, patient and family education coordinator at Wellspan Health in York, PA. "If it is deemed necessary to create something new, I give the guidelines to the person and serve as a guiding force."
The guidelines cover the development and approval process, standards for patient education materials, tips for developing effective material, simple word substitutions, calculating the reading level via computer and without it, finding illustrations, and referencing materials.
Development begins at Wellspan Health with the identification of a need and the generation of the idea. Then, a check must be done to find if a teaching sheet on the topic is already available. If a new document is necessary, the guidelines are followed to draft the piece. Colleagues and content experts are then asked to review the copy, and their feedback is used to make revisions.
At this point the author submits the material to the patient education coordinator with a submission form, a printed copy of the material, literature references, and illustrations with permission for their use.
Once this process is completed, written material is reviewed by a medical layperson review board, revised, and formatted. Then, it is returned to the coordinator. It's then printed and entered into the patient education catalog.
The process at The Ohio State University Medical Center begins with a request to develop copy directed to the patient education office and then to the patient education committee. Before permission is given, the patient education coordinator checks the inventory to see if there is similar material.
"We recently had a request from rehab to develop a handout about falls risk, and we already had four or five titles that dealt with issues about falls. We notified the author and then discussed the proposed title and how it would address different content from things already in the inventory," says Moyer.
Once given permission, the author submits the content for readability review and formatting. If illustrations are needed, ideas for those illustrations are submitted to the medical center's contracted illustrator. The readability is assessed by Moyer or someone in the patient education department, and the formatting also is completed by staff in this department.
The author reviews the copy following the readability assessment to make sure the message was not changed when copy was simplified. Once this is completed, the copy is reviewed by the patient education review committee, but the author is expected to have several clinicians read the piece before submitting it for a readability check.
If the committee makes suggestions for major changes, it goes back to the author. Once finalized, it is added to the online inventory.
Although there are writing templates available, most often authors pull a document from the inventory and use that as a guide, says Moyer.
Each facility should create policy based on what resources are available. Ideas for handouts at the University of Minnesota Medical Center, Fairview are presented to either the patient education department or Fairview Press, a systemwide department that provides publications and materials for all the hospitals and clinics.
If nothing is available, staff in these departments begin developing a draft with the help of clinical experts and current practice guidelines, policies, and research. That draft is then circulated among the clinical experts for their feedback. This process is done via e-mail, says Goldstein.
If issues arise, a meeting for the clinical experts is organized, and further literature searches are completed to help with the discussion.
"The good news is that as patient education inventories decrease, newer materials are needed when new titles are generated based on new treatments or identified need," says Moyer.
For more information about creating a system for developing written materials, contact:
Nancy Goldstein, MPH, FAHCEP, Patient Education Program Manager, University of Minnesota medical Center, Fairview and University of Minnesota Children's Hospital, Fairview, Minneapolis, MN. Telephone: (612) 273-6356. E-mail: email@example.com.
Christine Hess, MEd, Patient and Family Education Coordinator, Wellspan health, 1001 South George St., York, PA 17405. Telephone: (717) 851-5859. E-mail: firstname.lastname@example.org.
Diane Moyer, BSN, MS, RN, Program Director, Patient Education, The Ohio State University Medical Center, 660 Ackerman Road, Room 667, P.O. Box 183110, Columbus, OH 43218-3110. Telephone: (614) 293-3191. E-mail: Diane.Moyer@osumc.edu.