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Promoting patient ed vital to keep it at the forefront
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Patient education must be promoted so clinicians will understand how to effectively teach patients and use the resources available to them to do a good job. Yet without support from leadership, patient education initiatives often falter.
"Many of the initiatives that are patient education-related need staff support to enact the principles, concepts, or ideas, and administrative support is needed to remove barriers to organizational wide acceptance and to enforce it," says Susan M. Kanack, BSN, RN, the patient education coordinator for ProHealth Care, Center for Learning & Innovation, Patient & Family Resource Center at Oconomowoc Memorial Hospital in Waukesha, WI.
When staff and administrators buy in to patient education, it leads to a more cohesive approach that ultimately impacts the patient, she adds.
Patients have the right to receive information about how to take care of themselves once they are discharged, says BJ Wingert, RN, BSN, MS, a patient education specialist at OhioHealth in Columbus, OH. One of the biggest challenges is to get staff to use the resources available for patient education and to provide patients with information to reference at home.
"I think teaching takes place but because recall is difficult when people are sick, they need something to take home to refer to at a later date," says Wingert.
Good patient education helps patients and family members feel more comfortable and less stressed, says Carol Klingbeil, RN, MS, CPNP, a clinical nurse specialist for education at Children's Hospital and Health Systems of Wisconsin in Milwaukee.
In addition, if patient education is not completed and documented, misunderstandings can occur and patients might not comply with selfcare instructions, medication regimens, or necessary lifestyle changes.
Documenting patient education as a part of the daily work routine helps explain how staff spend time, says Klingbeil. "People think you can do much more or take care of more patients when you are not really able to account for how much time you spend interacting and educating families," she states.
To help staff and leadership realize the importance of patient education and understand what constitutes best practices, patient education managers need to determine what points they want to get across and the best methods for delivering the message.
Pinpoint a strategy
When many changes and improvements are necessary, it is best to begin with something non-threatening, says Kanack. She chose health literacy and set about educating staff on the statistics of low health literacy and concepts of clear language. Soon they began to notice that many of the materials they used were at a 10th grade reading level.
"The organization began to ask for solutions, and then I knew they were ready to hear what we needed to change," says Kanack.
She delivered the message on health literacy in a presentation format at leadership meetings and sometimes one-on-one. She offered to do in-services as well and used health literacy month to highlight the information.
Kanack says she also quickly learned that linking patient education to the organization's strategic goals helps it gain acceptance as well as importance.
For example, due to the fact that ProHealth Care is a multi-hospital, multi-clinic health care system, a strategic goal was to have what leadership called more "systemness."
"I explained that we wanted to function as a system and integrate our services so if we moved toward a system approach with patient education it would help meet our goal," says Kanack.
Taking part in committees within a health care organization gives patient education coordinators the opportunity to advocate for patient education, says Klingbeil. For example, when a new computerized system was being implemented Klingbeil asked how it would improve the distribution of teaching sheets.
According to Wingert, promoting patient education initiatives to staff requires a different strategy than that used to reach leadership.
For nursing and other staff who teach, the biggest challenge is to convince them that the initiative is worth their time, and saves time and money with fewer follow-up calls and readmissions.
With staff, if some sort of prompter such as a flow sheet can be incorporated to make the process simple it is more readily embraced, says Wingert.
It is important to tell staff about patient education initiatives and resources once, then keep reminding them. Wingert finds newsletters helpful. "Often in our monthly newsletter, we focus on something that might not be brand new but is a resource we want to keep on the forefront," she says.
Leadership has a different mindset and will be more supportive of patient education initiatives that are linked to patient satisfaction surveys, key admissions, standards set by accreditation agencies such as The Joint Commission, or key focus areas such as patient safety. Now that The Joint Commission has focused on low health literacy, leadership is sending Wingert articles on the topic, even though she has been talking about it for many years.
Penny Morgan Overgaard, RN, manager of the Trach & Airway Program at Phoenix (AZ) Children's Hospital agrees that strategies to promote patient education are not the same for leadership and staff.
For administrators to appreciate patient education initiatives, link them to outcomes the healthcare organization is trying to achieve, advises Overgaard.
For example, patient satisfaction scores are important to administrators because they bring business to the health care facility. It's not just patients that need to be satisfied but insurance companies as well, for they will want to place their patients at a hospital with good education as that equates to fewer readmissions.
"In this day and age when health care dollars are hard to come by, it is not enough to say this is the right thing to do. You have to be able to follow that dollar into outcomes," says Overgaard.
Currently, the patient education committee at Phoenix Children's Hospital is focusing on educating patients, family members, and staff on follow-up because the survey score in this area was declining. Patients need to know who to call if there is a problem and when to call. Also staff need to make sure patients have this information upon discharge, says Overgaard.
"Frequently, in patient education, people think teaching someone how to do a skill is the education they will need to go home with. But the truth is the most important thing you can teach might not be the skill but to problem solve," says Overgaard.