Get it `write' with focus on written documents

The topic of health literacy can be daunting, as there are many factors to address and it impacts the culture of an institution. It is difficult to know how to get your arms around the issue, says Becky Smith, RN, MA, manager of the Section of Patient Education at the Mayo Clinic in Rochester, MN.

Smith advises patient education managers to start small and to create a written document to provide the direction. At Mayo Clinic, the patient education department first focused on practical direction for written materials.

"In the Section of Patient Education we began to look at how to write materials in a way that was more understandable to patients and culturally sensitive," says Smith.

The research arm of the Section of Patient Education has been studying patient opinions and behaviors in response to patient education for eight years. The researchers have been accumulating evidence in support of plain language for more than five years. They summarized their findings in a paper titled, "The Case for Plain Language" and guidelines for writing in plain language titled, "Elements of Plain Language."

The "Case for Plain Language" was written for several reasons, according to Smith. These include showing evidence to support the use of plain language, gaining the endorsement of leadership as well as health care provider buy-in, providing a method to communicate a consistent message, providing a reference for authors, and keeping everyone in a large institution on the same page. The information in the documents has been used to improve written materials and, in particular, to determine what message to highlight in a material. At the same time, editorial style and design guidelines were reviewed to reflect plain language principles.

Several of the document's authors, including Smith, give presentations on the use of plain language to staff in different departments, including nursing and clinical dietetics, who are among the super-users of patient education materials. "We worked hard to identify what would be the benefits of plain language," says Smith, "and to help those make our case."

Benefits associated with the use of plain language cited in the document include finding information faster, improving comprehension, decreasing frustration and increasing satisfaction, improving reading time, increasing task compliance, decreasing errors in following instructions, and saving money and time.

Although 23 studies are listed in the appendix supporting the case for plain language, Smith says they will study and evaluate the benefits as plain language becomes part of the culture at Mayo Clinic and collect their own data.


For more information about creating documents to address health literacy issue, contact:

• Becky Smith, RN, MA, Manager, Section of Patient Education, Mayo Clinic, 200 First St. SW, Rochester, MN 55905. Telephone: (507) 266-4764. E-mail: