A patient education model others want to emulate

Provides pre-op education for successful surgeries

Hospital for Special Surgery, a 142-bed acute care surgical orthopedic facility in New York City, has developed a patient education model that others want to duplicate. Most recently, Great Britain's National Health Service asked staff from this New York hospital to help them design a similar program for a new orthopedic center that includes pre-op teaching.

This educational model makes sure the patient has all the information he or she needs for a successful surgery. Patients are taught everything from A to Z in a pre-op class so they know what will occur during the course of their hospitalization. At that time, they meet their health care team and discharge planning is begun, explains Suzanne Graziano, RN, MSN, ONC, CNA-BC, director of patient education programs.

Education is part of clinical pathways developed by interdisciplinary teams for orthopedic populations. A 10-chapter manual for patients that covers every topic pertaining to surgery and recovery is given to all patients.

At the helm of these efforts is Graziano, who oversees and provides direction for all patient education programs and initiatives at the hospital.

"As part of my role in this position, I take a look at different trends and patient issues that we may need to develop an interdisciplinary response to in regards to patient care needs," she says.

There are several committees that she either chairs or sits on as a regular member. These include the Executive Nursing Council, Fast Track Total Hip Team, Patient Education Council, Arthroplasty and Spine Team, Nursing Practice Council, Discharge Utilization Review Team, and Quality Improvement Committee.

About 5,000 patients attend the pre-op education program annually. Patient educators conduct the classes with the aid of a physical therapist. Graziano oversees three full-time patient educators, two of whom are RNs and one who is a social worker; one part-time educator; and a secretary. She reports to the vice president of nursing.

Graziano came on staff at Hospital for Special Surgery 19 years ago as a new graduate. Within a year she was promoted to a head nurse position, and a year later she became a nurse manager. She has been director of patient education programs for 12 years.

In a recent interview with Patient Education Management, Graziano discussed her job, her philosophy on patient education, challenges she struggles with, and the skills she has developed that help her in her profession. Following are the answers to the questions posed:

Question: What is your best success story?

Answer: "We are celebrating our 10-year anniversary of our interdisciplinary pre-op patient education program. During that 10 years, the team and I have provided patient education to over 30,000 patients and their family members. That is a huge milestone and an unbelievable success story.

Our model is a program that works again and again. It really features the patient and how we can best provide his or her care and educational needs."

Question: What is your area of strength?

Answer: "I have very strong leadership qualities. I am not a procrastinator; I get the job done. Also, I am a quick thinker and I look at the whole picture.

Really, I am very compassionate in regards to the care and the needs that outpatients go through. I'm a good listener and very organized, and I think those are all strengths in regard to this position."

Question: What lesson did you learn the hard way?

Answer: "Everything is a process. It takes time to do things right, especially when you use a team approach and you are depending upon other interdisciplinary team members. You need everyone's input and you need to take a look at the whole picture."

Question: What is your weakest link?

Answer: "I try to do too much in a given day. When your schedule is so full you tend to lose focus. In order to be creative and again to see the whole picture you need to have balance in your life, not overloading the day but approaching it from a more holistic view."

Question: What is your vision for patient education for the future?

Answer: "Education is a critical part of patient care and I believe all health care providers need to keep that as a top priority and stress its importance. Every health care organization needs to put patient education as their top priority, and it is something that definitely needs to be budgeted. If you want patient satisfaction to be high and compliance to be high, there needs to be budgets developed to help improve patient education. Technology is very important, but we can't lose that human communication, that human touch."

Question: What have you done differently since your last JCAHO visit?

Answer: We were surveyed in June of 2004, and in preparation for that visit we needed to implement an interdisciplinary patient education record for the whole hospital. We now have a division in the patient's record, a tab titled specifically for patient education, on which the staff documents. It is easy to use, and you can see exactly when the education was provided and the response from the patient or family member.

"Creating the form was a process that took three years."

Question: When trying to create and implement a new form; patient education material; or program where do you go to get information/ ideas from which to work?

Answer: "First we do a literature search to see what is out there already. In addition, at the Hospital for Special Surgery, we have experts from all areas so whenever we are developing something we pull together the experts and we listen to our patients. Overall a literature search, pooling together the staff as experts, and listening to our patients gives us the information we need to build or work on."