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Although the learning center in the medical library at Grant-Riverside Methodist Hospitals is very successful, it isn’t always convenient for patients or staff. When a local foundation offered grant money for educational projects, Mary Szczepanik, BSN, clinical program coordinator at the hospital system in Columbus, OH, wrote a proposal and received funding to create library extensions throughout the health care system.
"Staff in nursing units and departments are getting busier and busier, so they have less time to even send a patient to the library. Also, patients are sicker and aren’t able to get up and move around the way they did 10 years ago when length of stay was longer," explains Szczepanik.
The grant proposal requested money to renovate space on nursing units and in-patient care departments so there would be a location for patients to either be taught one on one by a health care professional or go independently and research a topic. A secondary use for the small learning units was staff education. Staff could use the space late in the evening or during the night shift, when patients wouldn’t likely be there, to watch a video on an inservice they missed or on a new product.
To determine where to place the small libraries, Szczepanik sent a letter to all heads of nursing units and departments. She received 16 responses and used the grant to fill those requests. The first year, she received $125,000 with a promise of $25,000 a year for three years after that.
No two patient and family learning centers are alike. The largest is on the cardiac unit, where two patient rooms were used. Because classes often are conducted at this center, one of the bathrooms was left intact, and the second was converted into storage. A mini refrigerator tucked into the storage area provides a place to keep drinks for patients.
One ambulatory/urgent care center wanted learning space, so they created mini-learning centers in each of the five exam rooms. "We either purchased small TV/VCRs or we mounted charts and posters and installed a pamphlet rack on the wall. It depended on the area, but we tried to create easy access to information and put educational materials right at the physician’s finger tips," explains Szczepanik. Educational materials that wouldn’t be appropriate for all patients to see or are expensive, are kept in a file cabinet in the nursing area.
At the clinic on the hospital campus, two small stations with built-in desks were installed near a pod of exam rooms. Each station has models and materials that pertain to the patient population of that section of the clinic. For example, in the OB section, each exam room has a breast model. Also, in each exam room, there is a pamphlet rack and a bookshelf so patients can read information while waiting.
"In most cases, we used an empty patient room or a room that used to be used for conferences. It just depended on the need of each unit," says Szczepanik.
A team from each department or unit designed each learning center and selected appropriate educational materials. "I would identify a core group of people with the help of the nurse manager on the unit selecting those who were very interested in patient education or very frustrated by the lack of it," says Szczepanik. She would then conduct brainstorming sessions to pinpoint the objectives of each learning center. To help focus needs, she would ask the group questions such as:
• What do you hope to accomplish by having the learning center on your unit?
• How will you measure whether it is successful?
• What equipment and materials do you need? Do you need a TV/VCR, a projection screen, better lighting, a telephone, chairs, tables, anatomical models, print resources?
"When we did the brainstorming with the staff, we found there is always a certain amount of general wellness and prevention information they want to have around. In some cases, that information is used as much as the disease-specific information because visitors use the learning center as much or more than actual patients do," says Szczepanik.
In recent years, computers with interactive software were installed in many of the extension libraries. However, if patients want Internet access, they must go to the learning center in the hospital’s medical library where librarians are available to help them navigate the system.
To keep pamphlets stocked and make sure the small extension libraries remain an inviting place to do research, a liaison was selected from each unit or department to oversee the centers. The liaison alerts the patient education manager when the booklet racks are getting low or if equipment is needed.
A certain amount of policing is necessary to keep staff from using the space as a breakroom or a place to hold meetings. "We wrote clear guidelines for the use of the centers because we knew we had to stay within the grant proposal and use the rooms the way the foundation who donated the money intended the space to be used. That gave us a certain amount of authority," says Szczepanik.
To make sure patients know there is a learning center on their unit, they receive a 5 x 7 card that describes the library and how to use it when they are admitted to the hospital. "We don’t want the library to be used during the day or visiting hours for staff education because we don’t want patients to feel like they are intruding by being in that space," says Szczepanik.
Shortly after the libraries were opened, the hospital held an open house to introduce staff and patients to the concept. At that time, staff on each unit designed a poster board to show patients the use of the learning center. Blueprints for the posters were given to the graphics department where they were polished and laminated so they would be permanent.
Although there is still grant money left to purchase equipment, plans had to be made to keep the libraries running once the money ran out. Szczepanik asked each unit to determine which printed materials in their library could be produced in-house. As a result, they have significantly reduced the number of materials they have had to purchase from outside the hospital. It costs about $10,000 a year to stock print materials in the 16 learning centers. "We know that we will be able to get that money either from the hospital foundation’s general fund or the operating budget for patient education," says Szczepanik.
[For more information on creating extension libraries, contact Mary Szczepanik, clinical program coordinator, Riverside Cancer Institute, 3535 Olentangy River Road, Columbus, Ohio 43214. Telephone: (614) 566-4475 Fax: (614) 447-0652.]