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Expert reveals how to meet the needs of a large system
Incorporate all disciplines in process, be creative
As patient and family education coordinator for a large Miami-based health care system, Sharon Sweeting, MS, RD, LD, CDE, is the resource person for the bedside or clinic-based educators. She makes sure that they have the strategies to teach and as many resources as the budget of a publicly funded health care facility will allow. "We are publicly funded; therefore, we don’t have enough of anything — money, time, people, or resources — so we get quite creative," says Sweeting.
Other duties include making sure the Jackson Health System adheres to the guidelines for all accrediting agencies that cover patient/family education from the Joint Commission on Accreditation of Health Care Organizations based in Oakbrook Terrace, IL, to the Commission on Accreditation of Rehab Facilities.
Jackson Health System is comprised of two hospitals with a total of 1,800 beds, 12 primary care centers, two homeless clinics, seven school-based clinics, two long-term care facilities, seven clinics in correctional health, an HMO, and a downtown medical office.
Sweeting is responsible for all the content editing for written patient education materials distributed within the system. She also manages the patient education section on the web site, the Plain-Language Library of Medical Information. In addition, Sweeting teaches continuing education classes and coordinates the patient education committee, which has representatives from every area of the system.
Patient education is within the department of education and development. There are 25 employees in the department, and Sweeting is the only one assigned to patient education — the rest are involved in staff education. All report to the director of education, who reports to the senior vice president of patient care services.
During new employee orientation every two weeks, Sweeting provides a half-hour of instruction on patient education, and part of it covers adult education strategies.
Before taking the position of patient education coordinator seven years ago, Sweeting was manager of patient services within nutrition services at Jackson Memorial Hospital. She held that position for eight years, and prior to that, she was the chief dietitian at the main hospital within the same system.
According to Sweeting, the move from nutrition to patient education was a natural evolution because she has taught night classes at four universities for 15 years. Sweeting’s bachelor of science degree and master of science degree are both in nutrition. Also she is a certified diabetes educator, a CPR instructor, first-aid instructor, insulin pump trainer, and is certified in adult weight management.
In a recent interview with Patient Education Management, Sweeting discussed her philosophy on patient education, the challenges she has met, and the skills she has developed that help her to do her job well. Following are the answers to the questions posed:
Question: What is your best success story?
Answer: "Drawing in all the health care providers as content authors for patient education. Traditionally, most of the products that were produced were [created] by the nursing staff. When I came into the position of patient and family education coordinator, I reached out to everyone else, including respiratory therapists, pharmacists, dietitians, social workers and radiology techs. Now education is truly interdisciplinary — from the product, to the delivery, to the documentation. Everybody has a piece, and I think the product reflects that."
Question: What is your area of strength?
Answer: "I am a leader, and I am not afraid to take chances. I have a real passion for the underserved, particularly giving them the information about health literacy they need, and I am able to ignite that passion in other people [by] encouraging them to do things out of the box.
"Health literacy is a huge challenge. It is amazing what people, regardless of their backgrounds, don’t know about their bodies that we assume is common knowledge. In new employee orientation, I pick a geographical direction, and I have those people attending point to it. I get seven or eight different hands going in different directions. I use that as an illustration to show that not everybody has the same body of knowledge so, when teaching, you need to be sympathetic to that."
Question: What lesson did you learn the hard way?
Answer: "Three years ago, I tried to get an interdisciplinary documentation form approved and in place prior to our Joint Commission Survey. One step before implementation, it was stopped. I learned a couple of things from that experience. Change in the arena of documentation is not easy, and interdisciplinary documentation of anything is a challenge at best. So if you don’t take something familiar and make it accessible to everybody, you are doomed to failure.
"We took our patient education protocols and made [them] so that everyone on the team could use them rather than create a new form. Familiar is better and less threatening."
Question: What is your weakest link or greatest challenge?
Answer: "I am very impatient, and I am not a passive individual. Sometimes that works for me, and sometimes against me. I would really like to have the ability to get things done quicker, but when you work in a large organization you have to be patient. It takes a while to get consensus."
Question: What is your vision for patient education for the future?
Answer: "I am a big proponent of self-management. I think, in the future, health literacy is going to be a huge issue — it is now. Equipping people to deal with self-management issues of chronic disease by the use of kiosks in the mall, the Internet, newsletters, or audio — I think we will see more and more of that. We need to equip people to make the best choices for themselves, and I think we are going to do that through more outlets. You never have enough communication."
Question: What have you done differently since your last JCAHO visit?
Answer: "We have much more information on our intranet and the web, and it is simpler. Our corporate standards for readability are fourth to fifth grade. Our corporate partners have used the plain-language library a lot, making it the second most active piece of our web site. The information is translated into low-literacy Spanish, and there is very little of that on the web.
"In a system as large as ours geographically, people can’t always come down to the main hospital or wait for me to ship materials when they need it, so the intranet is very helpful. Also, making the material as simple as we can is helpful. Our corporate standard is one page. We don’t do books or booklets because people throw those away, and that is expensive. We tend to use a question/answer format, and I have a pamphlet on how to write for the Jackson Health System [that includes] templates. For example, if someone is creating a medication brochure, it lists the questions he or she needs to answer. The templates have encouraged a lot of content authors that ordinarily wouldn’t have tried at all."
Question: When creating and implementing new forms, patient education materials, or programs, where do you get information and ideas?
Answer: "We go to the patients and families. Also I go to the patient education listserv and throw questions out to get immediate answers. I try to read the popular information that comes across on the media and be sensitive to that as well as the professional information. Also, [whenever] product lines are being developed, we try to have a companion piece available for that."
For more information about the ideas and issues covered in this article, contact:
• Sharon Sweeting, MS, RD, LD, CDE, Coordinator, Patient and Family Education, Dept. of Education and Development, Jackson Health System, 7th Floor, Jackson Medical Towers, 1500 N.W. 12th Ave. Miami, FL 33136. Tele-phone: (305) 585-8168. E-mail: firstname.lastname@example.org.