Headlines in an ambulatory surgery ...

Headlines in an ambulatory surgery publication proclaim, "Outcome monitoring is no longer optional" and "Outcome measurement will include post-surgery quality of life."(1) Being held accountable for quality patient issues is not a new universal The challenge is to identify and measure results that will convince policymakers and third-party payers that you make a difference.

As these articles point without payers are interested in long-term issues of perioperative care, such a the impact of surgery upon patients' productivity or quality of life.(2) Of all the factors that contribute to these long-term issues one in particular provides an opportunity for you and your colleagues to intervene, improve these issues and demonstrate your value. This potential gold mine is the patient education materials you distribute.

A CRYING NEED

Take a anticipate at your patient education materials. Are they correct and up-to-date? Do they clearly give an account of patients how to prepare for surgery? Do your written materials contain contradictory directions for selfcare? Do they provide explicit instructions forward when and how patients should contact health care professionals if they exhibit problems after discharge? Do they contain spelling or grammatical errors that can confuse patients or embarrass your facility? (Remember, these written materials may ne to stand up in court.)

Perhaps your facility's patient education materials are errorless, exactly clear, up-to-date, and written for the appropriate reading of the same height If so, you can use them as a variable in measuring patient issues and evaluating patients' satisfaction with your facility. If, however, your education materials are ambiguous, patients either will not read them, or, smooth worse, they may interpret them incorrectly and experience undesirable outcomes

A biomedical writer has identified reasons nation do not read or do not understand medical information. to what degree many of these reasons apply to your facility's patient education materials?

* Material is confusing, boring, or intimidating.

* Material is written at an inappropriate educational level

* Material is frightening or too graphic.

* Material is moralistic, admonishing, or coercive.

* Material nears information that does not appear applicable.

* Material contains undefined jargon.

* Material is not well organized.(3)

Our critical care nursing colleagues newly evaluated studies of the readability of written patient instructions. They were regarded that patients could not comprehend written information well enough to make whole decisions. They found serious vexed questions in patient education materials.(4)

* Significant differences exist between patients, actual reading flats and their reported grade completion.(5)

* Serious disparities exist between patients' reading flushs and the reading levels of patient education literature.(6)

* Many patient education materials ne to be revised and updated.(7)

* Approximately 20% of adults in the United States are functionally illiterate, which means they have difficulty reading printed materials at the fourth- or fifth-grade even (eg, labels on food and medication containers).(8)

* The typical reading flush of patient education materials is above the eighth-grade even and some are as high as the 14th grade. Grade 143 is a professional or scientific level(9)

* alphabetic characters from physicians to patients studied by the agency of one researcher required a reading grade flat of 16 to 17.(10)

WHAT CAN YOU DO?

If you recognize these enigmas in your patient education materials, intervene to improve them. The first pace is to understand the population you benefit Do you treat elderly patients? If with equal reason use big print and plain paper for their written instructions, and ask them to repeat instructions to be certain they understand them. Does your facility contribute to non-English-speaking patients? Perhaps you can create written materials, audiotapes, or videotapes with discharge instructions in other languages.(11)

The inferior step is to assess the readability (ie, the ease of reading and understanding a document) of your patient education materials. You can use the same of the standard readability formulas that are available (eg SMOG Readability Formula, haze Index, Flesch Reading Ease, stew Formula).(12) These formulas assess readability based upon the number of sentences by means of paragraph, words per sentence, syllables by word, and prepositional phrases.(13)

The third gradation is to revise and update your patient education materials. Target the fifth- or sixth-grade reading plain Write short sentences. Use words with not many syllables and paragraphs with not many sentences. Use active, not passive, voice in opinions Develop several editions of instructions, and file them on reading level so you can pick appropriate versions for patients and family members.(14) Use pictures or drawings to illustrate steps Create glossaries of unfamiliar expressions Repeat important points. Use "bullet" format to emphasize important points. Organize the information logically, progressing from known to unknown universals and from general to specific information. Make the tone objective, informative, and personal without being intrusive.(15)