Use the Web to give pre-op information
Directions, procedure information ready anytime
(This is the first part of a two-part series on using the Internet to communicate with patients preoperatively. This month, we tell you what information to offer, how to present it, what support you need, and what a Web site can’t do for you. In next month’s issue, we’ll tell you how to ensure the information you give patients is valuable.)
With increasing demands and smaller staffs, same-day surgery nurses have less time for pre-op teaching than previously and often see patients on the day of surgery. This lack of time before surgery makes patients feel as though they have unanswered questions and unaddressed concerns, say experts.
Using the Internet to provide much of the information on a 24-hours-a-day, seven-days-a-week basis addresses this communication problem.
"The challenge with preoperative teaching is that patients can’t absorb all of the information at one time, and they may selectively hear only parts of what you teach," says Denise M. Goldsmith, RN, MS, MPH, program manager of nursing informatics at Beth Israel Deaconess Medical Center in Boston. When she moved from clinical nursing within an ambulatory surgery setting to a technology-based position within nursing informatics, she looked at how technology could help with pre-op teaching.
Goldsmith began working with nurses within the same-day surgery program three years ago to develop a Web site that surgery patients could visit to gather information before their day of surgery. "Because patients are anxious about their procedure, they often have questions after pre-op teaching, but outpatients can’t ring a bell and ask a nurse to review the information the way an inpatient can."
Same-day surgery nurses wanted patients to be able to answer medical history and assessment questions on-line, but the technology needed to ensure a secure site was not available at her facility, says Goldsmith. "Our initial Web site contained logistical information the patients wanted, such as when to arrive, dos and don’ts regarding eating or medications, and where to go when they arrive. We’ve now added postoperative information such as pain management advice, and we are working on a wound care section."
The same-day surgery staff at Bay Care Health System in Green Bay, WI, also use the Internet to provide preoperative information. "Our Web site explains the different anesthetics and how to prepare for each one, as well as information about some of the most common procedures," explains Tammy Krueger, BSN, LNC, executive director of Bay Care Ambulatory Services, a division of Bay Care Health System. The Web site was developed by Bay Care marketing as part of the organization’s overall site; therefore, it required no additional funding, says Krueger. (For information on how to develop a Web site and potential costs involved, see Same-Day Surgery, October 1999, SDS Technology insert.)
Bay Care also gives patients a chance to "see" some of the key staff and physicians by including photographs and biographies of the management team and physicians. "If you include biographies or photos of physicians, be sure to have each physician sign a waiver and approve the information," says Krueger.
Other content on the Bay Care site is taken from the printed materials handed out by the surgery program and physicians. "Our printed materials’ content had already been reviewed by legal counsel, our medical director, and key physicians," says Krueger.
Be careful when you update information on your Web site, says Goldsmith. Make sure your information is consistent with printed information your pre-op nurses and physician office staffs are giving to patients.
At both Bay Care and Beth Israel, patients learn about the Web site from physician office staffs, pre-op nurses, and printed business cards that contain the Web address. The Web site address is also included on any pre-op printed information given to the patient, say Krueger and Goldsmith.
It would be impossible to build a Web site that answered every patient’s question about every procedure, so start your Web site by concentrating on the most frequently asked questions about your most common procedures, suggests Krueger. "Use your existing patient information as your initial content, and build from there."
The keys to success include ongoing, long-term support from administration in developing the site and technical support to keep the site updated and accurate, says Goldsmith. At Beth Israel, the nursing informatics department provides technical support, and at Bay Care, the marketing department provides technical and update support. In both cases, physicians review patient information before it’s placed on the site.
The Web site’s pre-op information doesn’t replace the effort to call the person the day before surgery, says Krueger. "We still call each patient to make sure they have a chance to ask questions and talk to a real person."
For more information about providing pre-op information via the Internet, contact:
• Denise M. Goldsmith, RN, MS, MPH, Program Manager of Nursing Informatics, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02115. E-mail: dgoldsmi@ caregroup.harvard.edu.
• Tammy Krueger, BSN, LNC, Executive Director, Bay Care Ambulatory Services, Bay Care Health System, 2733 S. Ridge Road, Green Bay, WI 54304. Telephone: (920) 490-9046. Fax: (920) 405-8007. E-mail: [email protected].
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