Rewriting consent form creates challenges

As a model for increasing the readability for all documents at Carney Hospital in Boston, a hospital Literacy Task Force rewrote theInformed Consent for Routine Treatment and Care. Members of the task force selected the consent form after doing a readability study on 35 hospital documents. Although most materials averaged an 11th-grade reading level, the informed consent document had a reading level above college level.

"It was not written in a lay person’s language. It had several difficult words and concepts. We decided to tackle that project because it was the most difficult document we looked at and because everyone admitted signs it," says Helen Osborne, MEd, OTR/L, director of health education at Carney Hospital.

The task force that rewrote the consent form was a subgroup of the patient and family education committee. It consisted of six members of the education committee who had participated in the readability study of 35 hospital documents. In addition, people who could contribute valuable legal information were invited to join the group. They included a vice president from administration who was a doctor and a lawyer, a nurse with a law degree, a house officer (a resident or intern), and representatives from risk management, admissions, and medical records.

The work on the document was divided among the members with some doing research, some rewriting sections, and some field testing the piece to see if it was understood by a lay audience.

"We would use meetings to look at how we would approach the process and organize the work. People worked on their tasks between meetings, and then we would approve each step at the next meeting," says Osborne.

During the revision of the consent form, the Literacy Task Force used a book titled Literacy, Health, and the Law that addresses writing easy-to-read consent forms. It is published by the Philadelphia-based Health Promotion Council. (For information on where to purchase a copy of Literacy, Health, and the Law see source box, p. 19.)