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Skills for patient education managers continue to evolve; role gains respect
As health care changes, so does the role of patient educator
As health care changes, the skills needed to effectively manage patient education change as well. Those who have been in the position of patient education manager or coordinator for a while have found that the job has evolved over time. While the skills they needed when they entered the job still are pertinent, now many more are required.
Patient education has gained respect over the years. Before the Oakbrook Terrace, IL-based Joint Commission on Accreditation of Healthcare Organizations (JCAHO) introduced a separate chapter for patient education standards, many viewed patient education as fluff, recalls Annette Mercurio, MPH, CHES, manager of patient, family, and community education at City of Hope National Medical Center in Duarte, CA.
"When at the University of Virginia, before the Joint Commission chapter on patient education, I spent so much time trying to justify patient education. Over and over again, I heard people refer to it as fluff. There has been such an evolution in terms of the recognition within hospitals, the contributions, and integral role of patient education I don’t have to spend much energy justifying it anymore," she says.
Health care institutions have recognized a direct link between patient satisfaction and patient education. Surveys have shown that involvement in care decisions and understanding tests and treatments improve satisfaction and both relate to patient education, says Mercurio.
The position of patient education coordinator that Mary Szczepanik, MS, BSN, RN, manager of cancer education, support, and outreach at OhioHealth Cancer Services in Columbus, originally had was created to improve patient teaching. However, it soon became a job to help the organization provide a higher standard of care. What brought this about was the shortened length of stay and the nursing shortage, she explains.
Nurses had less time to teach because patients were in the hospital for a shorter time. Complicating the issue was the fact that patients were much sicker, making it difficult for them to learn. Also, there were fewer nurses to do the teaching.
Therefore, patient education managers had to find the most efficient way to provide education determining what needed to be taught in the hospital and what patients might learn in other settings. Education needed to be standardized as well so that materials were consistent across settings to prevent the patient from becoming confused. Documentation of education was key as well to track what the patient had been taught, says Szczepanik.
In the beginning . . .
When Carol Maller, MS, RN, CHES, diabetes project coordinator for Southwestern Indian Polytechnic Institute in Albuquerque, NM, looks back at her position of patient education coordinator at the New Mexico Veterans Affairs (VA) Health Care System from which she retired in 2002, it is easy to see that it evolved from very simple beginnings.
Her career began when she was identified by administration as someone who was good at patient teaching and was asked to chair a nursing committee designed to help other nurses improve their teaching. As the accomplishments of that committee were recognized, the emphasis became multidisciplinary and the principles for good teaching went hospitalwide.
Gaps in patient education became obvious to Maller while she was working as a nurse in the emergency department (ED). Most patients could have avoided the trip to the hospital if they had understood how to take their medicines or if they had been more aware of signs that signaled a health problem.
To improve education, multidisciplinary classes were implemented for such frequent diagnoses as diabetes. And as the need for these group classes grew, so did the need for someone to coordinate them. Maller was given that oversight responsibility.
"The job of patient education coordinator was to coordinate teaching so that classes were not only scheduled, but the right disciplines were involved in the teaching. I actually continued to do some teaching, but the role got smaller and smaller," she says.
To do her job well, Maller needed to be able to identify people in various disciplines, such as the pharmacy and the dietary department, who were patient advocates and therefore would want to teach. She also had to develop interpersonal skills to interact with people at higher administrative levels. To have a pharmacist teach in a diabetes class, permission had to come from the top. These skills were learned by trial and error, says Maller.
Mercurio had a master’s degree in public health when she entered her first job in patient education management, and this training equipped her with many of the skills that she needed. She also had acquired some management skills and budget development know-how from courses.
Evolution of skills
Skills Mercurio had to hone while in her position or develop included supervision, materials development, and team facilitation.
"Team facilitation is a key part of a patient education manager’s role and I didn’t have a lot of experience in facilitating teams going into my first job. This skill is still a key part of my role," she says.
To aid in materials development, Mercurio also had to learn about health literacy. She did this by reading the latest research and attending classes.
The initial skills Szczepanik needed when she was hired to coordinate patient education included the ability to assess the current state of patient education. She also needed an understanding of adult education principles, organizational skills, project management skills, writing skills, and to be able to communicate effectively. Knowing where the points of care were within an organization and the appropriate contacts were essential as well.
Magdalyn Patyk, MS, RN, BC, patient education consultant at Northwestern Memorial Hospital in Chicago, needed to have good written and verbal communication skills when first hired for her position in patient education management. The major focus of her job responsibilities was on written brochures and content for the closed circuit television system at the health care facility.
Not long after entering a job in patient education management, most managers discover that new skills are needed to do their job effectively. For example, the written brochures that Patyk helped create now are kept in an on-line database and accessed via the intranet or Internet. As the institution moved closer to a paperless system, she had to develop technology skills and did so by attending nursing informatics conferences and networking with internal and external resource people.
Computer technology had a significant impact on patient education management. It has provided managers with the tools they need to collect data for more effective outcomes measurement, to show quality improvement, and to communicate more effectively. "It became critical to be able to track the exchange of information and track data as well as to make sense of the data because one chart or graph is worth a thousand words," says Maller.
In a time when institutions are cutting costs, patient education managers must be able to show the value of patient education interventions with data proving there are fewer trips to the ED or that patients don’t have to remain in the hospital as long following surgery.
However, technology also has increased a patient education manager’s workload because he or she must sort through all the information. There is an avalanche of information every day, not only through journal articles but also the in media, e-mails, listservs, and the Internet.
"Organizational skills are more critical than ever because you have to organize the information otherwise you become bombarded," notes Maller.
For example, a shortcut she learned for e-mail management is to create a folder for all e-mails she receives when out of the office on a business trip or while on vacation. In this way, Maller can sort through them as time allows, and she has a fresh start the first day back to the office.
It’s about time
Time management skills are vital in the job of patient education managers today, she notes. That is why she made everything she did while in the job of patient education coordinator count twice. For example, when she developed an exercise to prepare staff for a JCAHO visit or if she developed a poster presentation, she would use the information to write a journal article.
This helped Maller become more articulate as well, which is a skill needed when interacting with people in administrative positions. It also showed that she had expertise in patient education and helped to prove her value to the organization.
To better manage time, she also selected projects with care, finding that it was better to do a few jobs well then to try to do lots of things but not have enough time to do a good job. "If everything I did was done well, then everything seemed to lead to a path of excellence and I got better and better," says Maller. For example, each time she presented at a conference, she would get ideas from other presenters and from those attending the session that pushed her to another level.
The ability to conduct performance improvement initiatives also is a job skill that has become important in recent years, says Mercurio. She has had to learn about performance improvement methods and tools.
In addition, patient education managers must understand that they are part of the leadership of an organization. Therefore, some of their work may be outside the realm of patient education and focused more on organizational needs, says Mercurio.
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