Reader Questions
Reader Questions
If you schedule it, will they attend?
Taking the uncertainty out of program attendance
Question: "How do I get people to attend patient education programs that are linked to pre-op and post-op education or the chronic disease that they have? What have you found to be the best incentive? What are some of the barriers that keep people from attending, and how have you overcome them?"
Answer: First, make sure the class is necessary, advises Susan Karlins, MPH, director of health education for Santa Clara Family Health Plan and Valley Health Plan in San Jose, CA. Determine how much teaching time is needed. Perhaps it would only take five to 10 minutes of nursing staff time. "Often, it seems like it would be more efficient to have people come to classes, but with all the effort it takes, it is better to just teach them while they are in the office," explains Karlins.
Conflicting schedules that make it impossible for patients to attend a class in a convenient group present one of the major barriers. Other barriers that prevent people from attending patient education programs include lack of child care, transportation problems, and overcrowded parking lots, says Karlins.
Mary Wolcott, RN, MSN, patient education coordinator at Methodist Hospital in Omaha, NE, sees the same barriers to patient education in her work. "Often, I think it is other issues that come into play, rather than not being motivated to come to class. The weather, the distance, and transportation needs all play a part," she says.
Always be sure to tell people why it is important for them to attend a patient education program and ask if there are any reasons why they might not be able to attend, advises Karlins. To open the conversation, name something that might be a barrier.
For example, ask if the class is scheduled at a time when the patient will be at work and if it is possible for the patient to get time off to attend the class. "Make it socially acceptable for them to tell you about the barriers so you can problem-solve with them," says Karlins. It also helps if you know your patients and know what some of their barriers might be, she says.
Busting down barriers
Following are a few suggestions from patient education managers on how to overcome barriers that keep patients from attending health education programs:
• Tie education to a health fair.
Schedule a patient education program on diabetes or cholesterol right after a health fair. People who attend health fairs are usually motivated to live a healthier lifestyle. When they participate in a screening at a health fair and find out they have high blood glucose levels or high cholesterol, they want to know what to do. A class offered right after the fair will be well-attended, says Janet Swift, RN, BSN, patient education coordinator at Memorial Hospital of Sheridan County in Sheridan, WY.
• Provide an alternative.
Patients having total knee and hip surgery at Methodist Hospital in Omaha are given a choice: They can either attend the class or watch a take-home video. "We live in a rural state, where we get about 30% to 40% of our referrals from farm areas. If the weather is bad, it isn’t practical for patients to attend the class. It would be nice if they could, because their questions would be answered and they could share information with other people," says Wolcott.
The fact that the classes are multidisciplinary, with the physical therapist demonstrating some of the equipment the patient might use, often provides the incentive for patients to attend.
Whether patients attend a class or watch the video at home, they are always given a number to call with any questions. For example, they can call the 24-hour nursing hotline. They also are given the telephone number of the care manager who helps teach the class.
• Remind patients of the class.
If patients need to attend an education program following discharge, you can sign them up while they are in the hospital, but remember that this never guarantees attendance, says Karlins. Follow-up is essential. Send patients a reminder postcard, and then call them the day of the class.
• Obtain physician support.
Attendance often increases if the physician recommends to the patient that he or she take the class, says Swift. A week-long asthma camp for kids sponsored each summer by Memorial Hospi tal of Sheridan County is well-attended because the physicians promote it to their patients. A patient education program that has physician support usually is better attended, says Swift.
• Offer incentives.
You can increase the likelihood that patients will attend a class by offering them something that is helpful for their self-care, says Karlins. For example, provide a metered dose inhaler for patients with asthma. Newly diagnosed patients might pick up a prescription at the class, where a pharmacist would instruct them on how to take the medication.
• Network with outside organizations.
Go beyond hospital walls and work with other organizations in the community. Businesses, community centers, and places of worship often are convenient places to hold health education classes, and they help with promotions as well.
To help promote a chronic disease management class being offered by Methodist Hospital, the hospital’s clergyman networks with local churches that often are searching for activities in which their members can be involved. Neighbor hood churches provide convenient places for people to attend classes. Churches usually have more parking than medical centers, says Wolcott.
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