Give them an offer they can’t refuse
Give them an offer they can’t refuse
Dangle carrots for better oversight
Question: "What policies do you have in place to ensure that groups and/or departments don’t develop patient education programs or materials on their own without the knowledge of the patient education department or an oversight committee? What steps do you have in place to evaluate duplication, consistency, and continuity of care of the programs and materials that are being created?"
Answer: "What works the best is that we have made it very advantageous to contact our department for assistance with patient education projects," says Nancy Goldstein, MPH, patient education program manager at Fairview-University Medical Center in Minneapolis.
There are several "carrots" that draw people into the oversight process, she says. A central budget for the production of materials managed by the patient education department is one of those carrots. The department secretary has mastered desktop publishing and has access to an in-house print shop that offers a good selection of printing options.
It is a tremendous advantage for departments and groups to work with the patient education department because it has a system of distribution for materials that includes annual updates and copies are efficiently distributed to users, explains Goldstein. The department has an order form that lists all the approved materials in the health care system — over 1,300 items. The form is distributed to all patient care units and clinics and has 23 categories to make items easy to find.
Incentives work well, agrees Virginia A. Forbes, MSN, RNC, CNA, patient education coordinator at New York-Presbyterian Hospital in New York City. New and revised resources are placed on the approved resource list only when they are submitted to the patient education coordinator with the appropriate approval forms. If materials haven’t been approved, they won’t be used. "Orientation classes and mandatory annual updates inform staff to use only approved resources," explains Forbes.
For best results, there needs to be a system in place to manage the process. At New York-Presbyterian, there are several steps in place to oversee the development and approval of patient and family education materials. A hospitalwide policy describes the overall process, and detailed instructions are included in the patient and family education handbook, which is available in every unit and in each clinical department office. The handbook is also on the Intranet in the "Patient Education Webzine" for easy staff reference.
The representative from each department, location, or discipline who sits on the Patient and Family Education Advisory Committee manages the development and approval of materials in their departments under the preset guidelines and reports on them.
Provide access to resources
Standards alone will not ensure adherence, but many factors indirectly play a part, says Cezanne Garcia, MPH, CHES, manager of patient and family education services at the University of Washington Medical Center in Seattle. Interdisciplinary involvement on the committee that created the content and graphic standards for materials helps create buy-in.
Also steps have been put in place that make it easier for staff to follow the standards than not. For example, there are several free resources offered by patient and family education services for those who adhere to the standards, such as a health education review or graphics check at no charge.
Grant resources secured by education services are used for desktop publishing of four-page documents in a graphic template and for patient education-related artwork. Only materials that follow the graphic standards are entered full text onto the medical center’s Intranet Web site, which is an inventory and distribution system for patient education materials.
Flowchart promotes consistency
Good standards prevent duplication of patient education materials and promote consistency and continuity of care. At New York-Presbyterian Hospital, when a new resource or program is requested, staff are asked to compare their request with existing approved materials and programs. "If the existing resource or program does not meet their needs, a new resource is developed and may replace the existing one," says Forbes. A step-by-step flowchart depicting the process is included in the patient and family education handbook. (See flowchart, inserted in this issue).
Liaisons from the Patient Learning Center at Fairview-University Medical Center update patient care units on programs in the center and keep abreast of patient education needs and gaps in the teaching programs at the center. "We use our biweekly newsletter to let patient care units and clinics know of new or revised patient education materials," says Goldstein.
It is difficult to ensure that all materials and resources go through the established channels, even when a good system has been put in place, says Forbes. The program at New York-Presby-terian is relatively new and not yet perfect.
"In an institution as large as this, with 2,200 inpatient beds and over 40 ambulatory care sites, it would be unrealistic to believe that nothing slips through the cracks at this point in time," she says. It will take time and persistent efforts to move toward universal adherence to the guidelines and policy.
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