Family education center offers detailed instruction

Educator empowers parents to participate in care

Eight years ago when the opportunity to create a learning center at The Children’s Hospital of Philadelphia came up, Linda S. Kocent, RN, MSN, coordinator of patient-family education, applied for the job and got it. As a result, she now oversees the learning center at the Connelly Resource Center for Families at the hospital. She also supervises the registered nurses who teach at the center and an administrative assistant for the patient education program.

In her role, Kocent coordinates all the patient education materials throughout the institution that includes a 430-bed hospital, 27 pediatric and adolescent care practices, eight specialty care centers, and four primary care centers.

Kocent also chairs the patient and family education steering committee and sits on 14 patient-family education committees such as the primary care committee, the neonatal committee, and trauma prevention committee.

She works with the committees on the development of patient education materials. The committees assess the need for materials, conduct the research, and complete the drafts of the documents, and Kocent helps with graphics and makes sure the copy is at the appropriate reading level.

A third of the Connelly Resource Center, which is 4,000 square feet, is devoted to teaching. Another third is a family and children’s library, and the remaining space is devoted to hospitality. The hospitality area has sleep and breast-feeding rooms, a large lounge space, a kitchen, and laundry facilities.

In addition to her regular duties, Kocent frequently takes on other projects as assigned. She currently is spending a lot of time on cultural effectiveness initiatives, looking at how her institution teaches people from different cultures and who speak a language other than English. She also is setting up systems for translating materials in a quality and cost-effective way.

Another role that she recently has been assigned is a seat on the web advisory committee. "Our web team has an advisory panel that is made up of professionals from just about every discipline who talk about where we are going with our web initiatives and specifically with patient family education on the web," says Kocent.

She began her career as a burn critical care nurse and earned her master’s degree in pediatric critical care, and was a clinical nurse specialist for the pediatric intensive care unit for several years before applying for the newly created position of patient-family education coordinator.

In this position, Kocent reports to the director of nursing practice and research, who in turn reports to the chief nursing officer.

In a recent interview with Patient Education Management, she discussed her job, her philosophy on patient education, the challenges she has met, and the skills she has developed that helps her to do her job well. The following are excerpts from the interview:

Question: What is your best success story?

Answer: "What makes me the most proud is the parent satisfaction with the learning center. Watching families who are frightened and anxious about doing certain skills on their child at home go through the process and leave visibly calmer. Empowering them to participate in their child’s care."

Pediatric nasogastric (NG) tube insertion is one of the high-volume classes in the learning center. Data collected on the classes showed that the initial visit time for a home care nurse was reduced by 62% if a family learned NG insertion/care in the learning center. Once home, 85% of families who had been taught in the learning center were independent in inserting an NG and providing enteral feeds, and 88% of families were confident and prepared to care for their child at home.

Growing with the job

Question: What is your area of strength?

Answer: "On a very personal level, I would say it is the ability to work among disciplines and across systems and just being extremely organized. My job isn’t concrete anymore. It started off as something small because it was brand new, and now it has just blossomed. I am involved in a hundred different things."

In eight years, the hospital has grown from a hospital to a system. Also, Kocent says her director is a visionary and encourages creativity.

As the system grows, she must keep everyone in the loop so efforts are not duplicated; and the health care system provides a seamless transition from department to department for the patients and families it serves.

Question: What lesson did you learn the hard way?

Answer: "You can have too much of a good thing. When we first opened the learning center, no one wanted anything to do with us, and it was very disheartening. Nurses love to teach; they find it very rewarding. Now there has become a dependency on us doing the teaching that I have had to work on. I have had to reinforce that teaching is part of everyone’s job and not just the staff at the Connelly Resource Center for Families."

An orientation class teaches new staff members how everyone works in concert to make sure patient education is successful, including unit-based teams, staff at the learning center, case managers, and the home care companies.

If one unit calls the learning center frequently for a particular type of teaching, such as central-line care, learning center staff will do an inservice to demonstrate their method of teaching and to help boost the comfort level of unit staff on teaching the particular skill.

Question: What is your weakest area?

Answer: "Documentation and getting staff to document. We can tell by clinical outcomes and by the way families come in for outpatient visits they have been taught but documentation is not what we want it to be, and we have tried a variety of things."

Compliance varies from unit to unit. Research on what keeps staff from documenting currently is being done. The patient-family education documentation sheet always makes it to the chart because unit clerks are responsible for placing it there. Also, a survey showed that staff did not find the form difficult to complete, nor did they dislike it. Now charts are being looked at to determine if staff are documenting on progress notes or the discharge instruction sheet. Documentation of patient education will only be recognized if it is completed on the proper form.

Questions: What is your vision for patient education for the future?

Answer: "I think it would be great to have satellite learning centers within our system. I would like to see them in the surgical centers. I think we are showing with parent satisfaction that we are doing a really good service. Also, I would like to see more bedside instruction via the computer. Having something that is interactive at the bedside will help support us."

The first satellite learning center was opened in January to serve the gastrointestinal and endocrine patient populations. This will help with patients who need to be taught within 36 to 48 hours because the Connelly Resource Center is usually booked that far in advance.

Question: What have you done differently since your last Joint Commission on Accreditation of Health Care Organizations visit?

Answer: "We moved from having hundreds of teaching plans, which was essentially our patient family education documentation. We had one for just about every diagnosis and every procedure that listed all the teaching that needed to be done, and staff had to sign off against each line item. Since the last Joint Commission visit, we went to a single-sheet, generic teaching plan that is blank and staff have to fill it in."

Also, patients were being given information about pain control upon admission but it got mixed with all the other papers, and families did not remember receiving the material. There-fore, the health care system switched to a different method, putting professional posters on all the units that explain the concept of families partnering with health care professionals to assess their child’s pain to make him or her more comfortable. Plus, the information is in the family handbook. Now pain management information doesn’t get tucked away in a folder and forgotten.

The Children’s Hospital of Philadelphia is due to be surveyed by the Joint Commission this year.

Question: When trying to create and implement a new form, patient education materials, or program, where do you go to get information/ ideas from which to work?

Answer: "Each committee is interdisciplinary; and they are the clinical experts, so they do literature searches, they benchmark with colleagues at other hospitals, they connect with their professional association, and they get on their listserv. They put all that work into their projects; and they document all the information, so we know where it came from and what our good outlying resources are." 

Sources

For more information about patient education at The Children’s Hospital of Philadelphia, contact:

  • Linda S. Kocent, RN, MSN, Coordinator of Patient-Family Education, The Children’s Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104. Telephone: (215) 590-3661. E-mail: kocent@chop.email.edu.