Intranet can standardize use of education materials

Teach staff to search database for approved resources

The intranet at MultiCare Health System in Tacoma, WA, was a valuable tool in the process of standardizing patient education within the large health care organization that employs 5,000 people in four counties. 

In addition to three hospitals, the health care system has physician practices, urgent care centers, and home care and hospice facilities. 

For more information on creating an intranet database to manage patient education materials, contact:
  • Faith Hammel, RNC, MN, Patient and Family Education Specialist, MultiCare Health System, Tacoma, WA 98405. Telephone: (253) 403-5243. E-mail:

To obtain the goal of a single standard of care across this massive system, a multidisciplinary committee created a policy that defined a standardized education process that not only included the components of all the Joint Commission standards, such as the evaluation of learning needs, but also direction on which educational materials to use. 

"We were in material overload. Every area was using something different and our printing services were stocking multiple versions of similar materials. Patients weren’t receiving consistent materials in education," says Faith Hammel, RNC, MN, patient and family education specialist at MultiCare Health System.

To remedy the problem, committee members decided to clean house with two goals in mind: First, to discard outdated or incorrect information; and secondly, to create a web site that tracked the materials approved by the committee for educating patients.

Materials throughout the health care system were reviewed to answer several questions. Committee members wanted to know where the material was kept, how it was used, if it was reference-based, if it was up-to-date, if it was the best piece available for the target patient population, and if the material met the policy. 

All patient education materials must now go through the approval process before staff members in a department can use them. For example, the cardiac educator received material from the Dallas-based American Heart Association (AHA) that he determined was better than the commercial booklets the health care system was using. He presented them to the patient and family education committee for approval, and they have now replaced the commercially purchased material. 

The committee devised three methods for gaining control of the material. The first was Noah’s Ark — so named because they picked up material two-by-two to sort, evaluate, and enter into a database. 

Material that had been written in-house became part of the database and can be accessed and printed from the health care system’s intranet. Materials from a reliable source, such as the AHA, that have been approved also are posted on the intranet so people do not have to go to another site to view them.

To help people find information in the database materials were separated into categories; formats, such as a book, booklet or brochure; and topics and subtopics. 

If the material is an item that cannot be printed out, such as a book or booklet, the database lists the most common place on campus it can be found. 

Another method used to gain control of information distributed to patients (dubbed "Thief in the Night") was a raid on clinic files discarding inappropriate materials such as those that were not from approved sources, those with copyright issues, and those produced by a company as an advertisement that had no value. Hammel says a good example of something of value might be a diary to track migraine headaches distributed by a drug company. 

Controlling copies

In some areas, Hammel and committee members had to help staff break the habit of storing multiple copies of all types of patient education sheets that took up space in file cabinets. In addition to the database, patient education material is available via the computer from the health care institution’s clinical reference system, and staff were encouraged to use it as a starting point for basic patient education materials.

Hammel says people often printed copies off copies and therefore distributed outdated materials. The clinical reference system is updated twice a year, and the database provides information on where to find the latest educational materials. 

Yet, in some clinics, there was a need to keep a few copies of heavily used materials on hand, such as consent forms. In these cases, staff were encouraged to have printing services create copies. 

The unit secretary was asked to keep about 20 copies of a certain education sheet on hand. For example, obstetrics sends 10-15 people a day home on one of 10 discharge medications; therefore, the unit keeps a few copies of each medication information sheet on hand so the nurse does not constantly have to print copies each time they are needed.

"Any time we change people’s practices, we have to work carefully so we don’t disrupt their workflow," says Hammel. 

Another method the committee used to standardize patient education was "One Size 

Fits All." For example, for the 15 physical and occupational therapy departments within the system, materials at each site were sorted, and those that weren’t from approved sources, had copyright violation issues, or were outdated were tossed. Then content experts from the departments selected appropriate material. 

Also, policy on which materials to give patients was created so patients did not experience information overload. For example, patients received a certain teaching sheet as a starting point and, if they wanted more information, there were second- and even third-level resources to distribute. 

Staff education was an important part of the process. "One of the detriments I saw to using the intranet was technology phobia. Some were terrified of the concept that educational materials were on the computer, and it was a change in their practice," says Hammel. 

To help staff learn the new standardized method of patient education, some were asked to attend new employee orientation. Also some computer-based training was designed. 

"We [conducted] lots of classes on which material on the web was actually specific enough to give to patients, and we worked a long time on copyrights and trademarks. Even though we are a nonprofit, we are still a commercial venture and some copyright laws don’t allow us to print material and give it to patients," says Hammel. 

Web materials must meet all the criteria for an approved source before they can be given to the patient. If criteria are met, but distributing the material would violate copyright law, patients are given the web site address so they can obtain the material on their own.