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Each year Lovelace Health Systems in Albuquerque, NM, produces about 30 patient education booklets in spite of the time it takes to research, write, and get material approved.
To create this large number, Cathy Black, BSN, patient education coordinator and the interdisciplinary patient education committee created a system that is followed each time a topic for a booklet is proposed.
First, the committee determines if the booklet will benefit more than one clinic. "About 80% of the time, we develop booklets because there is a need and the topic is generic enough that it can be used throughout the health system," explains Black. Also, cost is a factor. If the booklets on the topic printed by commercial publishers are expensive $1.25 to $1.50 a piece the committee may decide to create the booklet in-house. Because Lovelace has its own printshop, booklets cost from four cents to 11 cents to print in-house. In addition to saving money, having the Lovelace name on the pamphlet promotes good will for the institution and is a good publicity tool, says Black.
Following is the process Lovelace uses to create booklets in-house:
• Patient education coordinator in charge.
Once a subject for a booklet has been approved by the committee, it takes an average of two to three months to write, illustrate, review, and print the material. To keep the process moving in a timely manner, Black is in charge of the production of each booklet. It’s important to have one person in charge to oversee the others involved and make sure each is doing his or her job, says Black. Also, keep the number involved in the production process to a minimum, she advises. Once the committee approves the topic, Black researches the topic and writes the material. A graphic designer in the print shop illustrates the piece, and about three experts on the subject review the content.
• Research limited to information on-hand.
Black researches the topic for each booklet. To streamline the process, she keeps the sample booklets she receives from commercial publishers in a file folder. "I gather the booklets to see what is written on the topic," she explains. Also, she uses nursing reference books and a software program called House Calls. As she goes over the material, she makes notes on points that should be covered in the booklet.
• Writing follows a format.
The information in each booklet is separated into several categories.
a description of the condition, exam, or procedure;
the signs and symptoms;
the cause of the condition and who is at risk;
the treatment options and the benefit and risks of each;
important facts that don’t fit any other category;
when a person’s provider should be contacted.
Black can research and write a booklet in eight hours. Some booklets take less time, depending on how complicated the subject is and the length of the booklet. When there is a backlog of booklets to write, she often schedules a day for research and writing.
• Language is kept simple.
Although Black does not use a computer program to assess the reading level of each pamphlet, she keeps sentences short and uses simple words. If a word has several syllables, its meaning is included in parentheses. She tries to write each pamphlet at a sixth grade reading level, and to ensure that the copy is easily understood, she has several non-medical staff people read the material before it is printed.
• Experts review the copy.
A rough draft of the copy is sent to several providers who have expertise on the topic. "Before I send the booklet, I ask the provider if he or she has time to review it," says Black. Even though providers agree to review the copy, Black sends a cover letter with each booklet informing the provider that if corrections are not made in two weeks she will assume the material is approved. Black encloses an inner office mail envelop addressed to herself to make the review process convenient.
Experts review the corrected copy before the material is sent to the graphic designer. They also review the graphics once the pamphlet has been illustrated.
"I keep a good relationship with reviewers. Once the booklet is in print, I send the reviewers about six copies to let them know it is available. I also send a thank you note to let them know I appreciated their help," says Black.
• In-house graphic designer provides illustrations.
"I give the graphic artist the text and let her design the graphics because I don’t want to interfere with her creativity; but if the illustration is unsuitable, I send it back," says Black. Only once did she ask for a new illustration, and that was when the designer drew a picture of a syringe to illustrate a diabetes booklet. Black asked for an illustration that showed that people with diabetes can lead a normal, healthy life. The graphic designer replaced the syringe with a drawing of a family walking together.
All pamphlets include color, since some sort of color catches a person’s eye, says Black. Also, bullets are used to identify categories and each is in bold print and a slightly larger font then the rest of the text, so readers can quickly find the information they need.
• Copy is delivered to the printer.
Once the copy has gone through the final approval, Black sends the computer disk to the printer along with a hard copy of the manuscript. The text is then put in the correct format, and type and font size is selected by the graphic designers.
• New booklets are publicized to staff.
Black sends a quarterly newsletter to patient education liaisons at each clinic and the hospital that provides details on all the new booklets along with ordering information. A single copy of all the new booklets is also sent with the newsletter.
• Revisions are made annually.
To make sure material is up-to-date, once a year, all pamphlets printed in-house are divided among patient education committee members for review. "We take input from staff throughout the year, then evaluate the copy to see if any changes or corrections are needed once a year," says Black. For example, when Congress changed food labeling laws, the pamphlet on how to read food labels had to be revised. If something life threatening or medically necessary is identified, then the booklet is changed immediately, Black says.
[Editor’s note: For more information on how Lovelace creates in-house publications, contact Cathy Black, patient education coordinator, Lovelace Health Systems, 5400 Gibson Blvd. SE, Albuquerque, NM 87108. Telephone: (505) 262-7696.]
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