Reader Questions

Written process ensures proper materials review

Provide checklist, review forms for easy evaluation

Questions: "What process do you have in place for the approval of teaching materials before they can be given to patients? How do you make sure staff follow this process? What are the legal implications of having a pamphlet put into distribution without medical overview?"

Answer: All handouts at Sumner Regional Medical Center in Gallatin, TN, are routed through the patient education department, where they are reviewed by the patient education coordinator (and the appropriate specialty if necessary). "If the handout is out of my area of expertise, I review the material for appropriate reading level to determine if it is user-friendly and has good graphics and large enough text for people who are visually impaired. For content, I would refer it on to the appropriate member of my patient education committee," explains Deborah Gray, RN, BSN, CWOCN, patient education coordinator at Sumner. (See copy of policy/procedure and literature evaluation worksheet, inserted in this issue.)

At The Ohio State University Medical Center in Columbus, a separate review process is in place for handouts created in-house and commercial materials. The author of any new materials must first discuss the project with his or her immediate supervisor. With supervisory approval, the author submits a request to develop material to the departmental patient education committee chair. If the committee approves the development of the material, the author may write the material, explains Sandra Cornett, RN, PhD, program manager for consumer health education at the medical center.

A checklist describing the criteria for each pamphlet is available to aid authors in developing new materials or to assist people submitting commercial materials. (See copy of review criteria, inserted in this issue.) The author of new material must submit it to the appropriate disciplines for review before giving it to the patient education committee for approval. "The review process must always include a physician who cares for that patient population," says Cornett. (See interdisciplinary content review form, inserted in this issue.)

The committee submits the handout to Cornett along with the signed content review form. She analyzes the reading level and distributes the handout to two health education advisory committee members along with a material review form.

"Usually, I choose one who has expertise in the topic and one who does not, to get somewhat of a lay perspective. Sometimes I send it to several additional people in the institution for review if the handout needs a wide perspective," explains Cornett. Lengthy handouts are pilot-tested with the patient group they were written to educate.

If the department in which the material is created does not have a patient education committee, the material is sent to Cornett. It is reviewed by the consumer health education department’s health education advisory committee.

Approval of commercial materials requires fewer steps. Two copies of the handout with a request to review and a content review form are submitted to the department’s patient education committee chair. If approved, the materials are submitted to Cornett for inventory. When a cost is attached to a handout, it is sent to the department manager for final approval and funding before it is inventoried.

Several steps also are in place for the approval of patient education materials at the University of Utah Hospitals and Clinics in Salt Lake City. Authors of new materials are asked to use a booklet called An Author’s Guide while writing the draft. (For information on this publication, see editor’s note at end of article.)

Once the handout is completed, the authors use a checklist to review the material that covers such criteria as definition of technical terms and appropriate language level, explains Jackie A. Smith, PhD, patient education coordinator at the health care facility. Authors also are asked to have eight to 10 patients review the material using a survey form. The survey asks patients to rate the material on a scale of one to five in the following categories:

• The title reflects the contents.

• The information is clearly presented.

• The medical words are explained.

• The sentences are short and simple.

• The print is large enough to read.

• The information is useful.

• The diagrams and drawings are easy to understand.

The finished product is submitted to the office of patient education along with the appropriate forms. It is then reviewed by a member of the patient education clearinghouse committee and two content experts. If approved, it is cataloged and put on-line.

The existence of written criteria gives staff ready access to the information necessary for following the process, says Cornett. At The Ohio State University Medical Center, the criteria are available in the Patient Health Education Resource Manual and are covered during orientation. (For information on legal implications of having material distributed without medical overview, see article, p. 152.)

Gray, who uses a lot of commercially printed materials, went straight to the source rather than to staff. She spoke to the company representatives who distribute free materials and asked that all material be routed to patient education for approval first. In areas where she does not meet with company representatives, she speaks with the appropriate department head, such as pharmacy. "I will review the material to see whether or not it is appropriate or if it needs to have additional review before it is distributed," says Gray.

(Editor’s note: In the November 1998 issue of Patient Education Management, information was published on how to obtain a copy of An Author’s Guide from the University of Utah Hospitals and Clinics. The piece did not mention that Health Facts for You: An Author’s Guide, created at the University of Wisconsin Hospital and Clinics in Madison, provided the framework for this booklet. The editor apologizes for this oversight.)


For more information on creating an approval process before distributing patient education materials, contact:

Sandra Cornett, RN, PhD, Program Manager, Consumer Health Education, The Ohio State University Medical Center Department of Consumer/Corporate Health Education & Wellness, 1375 Perry St., 5th Floor, Columbus, OH 43201. Telephone: (614) 293-3191. Fax: (614) 293-3730. E-mail:

Deborah Gray, RN, BSN, CWOCN, Patient Education Coordinator, Sumner Regional Medical Center, 555 Hartsville Pike, Gallatin, TN 37066. Telephone: (615) 451-6139. Fax: (615) 451-6145. E-mail: grayd@

Jackie A. Smith, PhD, Patient Education Coordinator, The University of Utah Hospitals and Clinics, 50 North Medical Drive, Salt Lake City, UT 84132. Telephone: (801) 581-4804. Fax: (801) 585-5280. E-mail: Web site:

For more information on avoiding legal implications by having a pamphlet put into distribution without medical overview, contact:

Penny Daubney, RN, BSN, CPHQ, Senior Risk Management Consultant, Optima Healthcare Insurance Services, 22 Sembrado St., Rancho Santa Margarita, CA 92688. Telephone: (949) 888-5770. Fax: (949) 888-5769. E-mail: