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Most patient education managers agree that having written materials reviewed by the potential users of the pieces is a good idea. Yet such review is not always a part of the process unless a plan has been set in place.
There are two issues to consider when creating a formal review process for educational materials. The first is to determine how the review process will occur, and the second is to decide on the selection process of reviewers.
How patients and family members are incorporated into the process often depends on the system set in place for writing new teaching materials.
At Cincinnati (OH) Children's Hospital Medical Center, all requests to write a handout are submitted to the clinical content committee, a multidisciplinary committee that meets once a month. If it's a new topic, the author is given permission to write the piece, says Jennifer Willoughby, RN, BSN, the committee chairperson.
Once the piece is completed, the author submits it to the patient education council at the unit level, which is responsible for making sure the content is evidence-based. If the council approves the copy, it is passed on to a clinical content liaison, who reviews the editorial style of the piece.
To get feedback from consumers, the liaison now hands the written material to a parent who has been trained for the review process, and he or she completes a form. The liaison and parent each have one week to review the content before it goes to the clinical content committee for implementation, says Willoughby.
Historically, families always have been involved in material review at Seattle (WA) Children's Hospital. Yet the process was not formal.
Now, a team of volunteers from the Family Consultant Program at the children's hospital has been assembled. Health educators will distribute the pieces created by clinicians to families for review. These family members use a form for the review.
"Our target goal is to have families review one out of every 10 new health education pieces that clinicians create. Our goal is for randomly selected pieces to be reviewed by seven to 10 families," explains Devora E. Chavez, MA, MPH, CHES, coordinator for family-centered care at Seattle Children's.
Larger, more complex pieces will have more in-depth family review through focus groups. For example, last fall Chavez worked with health educators to organize three family focus groups to get input on what should and should not be included in standardized admission packets that families receive when they first arrive at the hospital.
For patient education managers to know if written materials will benefit a particular patient group, the reviewers must fit a health care institution's demographics. Chavez worked with Chris Hanssmann, MPH, CHES, a health educator at Seattle Children's to create a reviewer profile. The ideal mix includes families of varying literacy levels and English-language proficiency. Also, parents selected as reviewers should reflect a range of experiences with respect to their child's situation and issues, such as chronic versus acute illness.
"We are also hoping to balance the degree to which families are familiar with our hospital and health education materials," says Chavez.
As time goes on, the institution will use interpreters and translated surveys to get responses to health education materials from families that speak a variety of languages other than English. "This will help us to identify problems and validate that our approach of translating English materials is an effective strategy," says Hanssmann.
According to Chavez, families are still being recruited for the review of health care materials, because the perfect balance has not yet been achieved.
Reviewers for patient handouts created by clinicians at Cincinnati Children's Hospital were selected from the community.
"We contacted churches, day care centers and people we knew, trying to get a different mix of parents who were interested in reviewing patient education. We got about 30 volunteers," says Joan Morgan, MSHA, MBA, RN, the education consultant for Patient/Family Education Center for Professional Excellence/Education at Cincinnati Children's.
Each family reviewer is paired with a member of the content committee and assigned a total of three topic areas. The reviewers are not familiar with the topics they are given. Patient education managers wanted the reviewers to act as first learners of the info.
All volunteers participated in a two-hour orientation in a computer lab. During this time, they met with their partner to learn how to complete the online review form. Dummy e-mail accounts were established for participants to practice.
Everyone participating at Cincinnati Children's must have access to a computer and understand how to send e-mail messages with attachments, says Morgan.
Family involvement in the review process is more likely if barriers are reduced, says Chavez. If families are expected to be available by phone at a certain time to discuss material or travel to the hospital to respond to questions, they are less likely to participate. E-mail or mail is easiest for busy families who need flexibility and a generous time-period to respond, explains Chavez.
The use of patient and family reviewers helps ensure that written materials are user-friendly in their final format. In addition, it helps improve writing overall. Morgan says a comment from a parent stating "I had no idea what you wanted me to do" really impacts an author.
They realize the material they are writing to teach the parent is missing the mark, says Morgan.
For more information about using patients and family members for educational material review, contact:
Devora E. Chavez, MA, MPH, CHES, Coordinator/Family Centered Care Seattle Children's Hospital, M/S T-5112, P.O. Box 5371, Seattle, WA 98105. Telephone: (206) 987-6009. E-mail: email@example.com.
Joan Morgan, MSHA, MBA, RN, Education Consultant, Patient/Family Education Center for Professional Excellence/Education Cincinnati Children's Hospital Medical Center, MLC 8006, 3333 Burnet Ave., Cincinnati, OH 45229-3039. Telephone: (513) 803-0031. E-mail: firstname.lastname@example.org.