Educator Profile

Keeping staff informed and on the same track

Teach standardization of patient education

After obtaining a nursing diploma in 1978, Marjorie Schirado, RN, went to work for Bismarck (ND) Hospital, which is now Medcenter One Health Systems, and she still is employed at the health care institution. In January 2001, she accepted the position of patient education coordinator but previously worked in medical-surgical, oncology, the "Ask a Nurse" program, and as an auditor of hospital bills in the business office.

In her oversight of patient education at Medcenter One Health Systems, Schirado oversees the patient education at a 200-bed hospital and nine clinics. Part of her duties includes assessing the need for programs and activities and helping plan strategies to put appropriate educational opportunities in place.

Ensuring that there are printed materials available for patients also is part of Schirado’s job, and she frequently researches and writes pieces when existing materials cannot be found. She acts as a consultant when clinicians create material and evaluates materials so all are printed at a fifth- to seventh-grade reading level. "I provide competency-based training for our associates in the area of patient education, look at the documentation of the patient education, and I am responsible for making sure that we meet the Joint Commission’s standards in patient education," adds Schirado.

Two of the clinics she works with are 100 miles away, but she communicates via e-mail, telephone, and courier service. Staff members call when they need a particular patient education piece, and materials created for local clinics are also supplied to the outlying clinics. "I have been to both clinics to do some staff education and assessments. It is very hard to communicate if you have never met the people and they are miles away," says Schirado.

Although Schirado is the only person in patient education, she works closely with two colleagues — one is responsible for the orientation of new staff, and the other coordinates ongoing staff education. Schirado reports directly to the head of human resources, but also is in collaboration with the vice president of patient care services. Currently, she is working on a master’s degree in nurse management at the University of Mary in Bismarck.

In a recent interview with Patient Education Management, Schirado 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: "We do about 200 bariatric gastric bypass surgeries a year because we have a physician that has a good success rate. However, the way we did patient education was not standardized, so we called together a multidisciplinary group and developed a patient education binder that patients receive in the clinic. "They take the binder home while the physician’s office is working with the insurance company to get the procedure approved. In that way, they have a month or two to read over the material before they meet with a nutritionist or have a psychological evaluation. An education record and pathway were also developed. We have had nothing but good reports from patients. They feel like they know exactly what they are getting into."

Question: What is your area of strength?

Answer: "My ability to organize, multitask, and give attention to detail. I often have 10-15 projects I am working on with our visual communications department and typesetters or that have been sent out to independent contractors. To track projects, I have a file system on my desk. I keep a copy of the changes or new materials that have been sent out, and I write down the date it was received by the contractor. Then I keep notes on all communication with them. I go through that file once a week and send e-mail messages or contact them by telephone."

Question: What lesson did you learn the hard way?

Answer: "To double-check all material before it goes to the printer — whether only one word is being changed or one illustration. Also, before materials are reprinted to send them to the appropriate department for review in case something has changed. Even with basic procedures, the way something is being done can change."

Question: What is your weakest link or greatest challenge?

Answer: "We live in an age of computers, and people will just type something up and assume that it can be used for patient education. Physicians especially don’t understand that they can’t just [write] something that they understand and give it to a patient. Part of the problem is that people don’t always understand my function. I have tried to improve that by doing orientation with new employees, and I meet with all the new physicians and physician assistants for 15 minutes."

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

Answer: "I envision either bedside computers or laptop computers available to patients and family members wherever they are. We can’t assume that all patients will be satisfied with what they are taught — some will want to know more. It would be an extension of personal verbal education. We give patients written material, and we could offer computers, too. We [would] need to give patients [documentation] for computer use, such as where the information is coming from, [and] who is sponsoring the site. We could provide links to established sites."

Question: What have you done differently since your last JCAHO visit?

Answer: "Our last visit was in July 2004, and we did fairly well. However, a few departmental areas were not complying with a new documentation form and therefore were not assessing barriers to learning or readiness to learning. Now they know they have to change."

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

Answer: "I belong to the patient education listserv and a few times I have posted questions or thoughts to find out how people are doing something. For example, we were doing individual two-hour teaching sessions with patients who were going to have hip and knee replacements, and we wanted to go to a group meeting [format] so I posted the question to see how other people were handling that. I often do an Internet search, but I am careful about what I look at, making sure that the information is researched well. Also, we have a health sciences library in our college of nursing, and I will do research there as well."


To learn more about the professional methods used by Marjorie Schirado in her job as patient education coordinator, contact: Marjorie Schirado, RN, Patient Education Coordinator, Medcenter One Health Systems, 300 N. Seventh St., Bismarck, ND 58501. Telephone: (701) 323-8805. E-mail: