Tailor programs, materials to patients
Get input at every stage of planning process
Question: How much input should patient education managers get from patients when developing education programs and materials? When should the target population be involved, and how do you involve them?
Answer: "My recommendation is to involve patients as much as possible at every stage of development," says Barbara Hebert Snyder, MPH, CHES, president of Making Change, a health education consulting company in Cleveland. Otherwise, managers could be investing their energy and resources into a program that is off target, she explains.
Each time a need for a program is identified, verify it with patients who are familiar with the disease or health care problem the program targets, she advises. The need for the program can be validated by assembling a focus group, mailing out questionnaires, or conducting telephone interviews. To find appropriate participants, check hospital admittance records. ( To learn more about using focus groups, see Patient Education Management, August 1997, pp. 95-97.)
"You want to talk with people who would have a vested interest in the program. What they tell you may match what the staff thinks, but if there is a discrepancy, don’t ignore what the patient thinks," says Hebert Snyder.
Focus groups, questionnaires, and telephone interviews also should be used when designing program content. While staff may want a comprehensive program for cardiac patients with congestive heart failure, those patients might want to focus on diet. For example, the patients may need help planning a low-fat diet, finding low-fat recipes, and making appropriate selections when grocery shopping or eating out. People with the health problem can determine the scope of the program and help identify the importance of the topics covered. Thus, time won’t be wasted providing information of little interest to patients.
When designing the program, allow time for a pilot phase, and obtain feedback from patients to refine the format.
"No one gets a perfect program off the drawing board," says Herbert Snyder. "That is why it is important to design in a pilot phase and monitor closely all the aspects of the program,"
Continue to get patient input
Patient input is important even after the program has been up and running for a while, says Patricia Mathews, RN, MHA, president of Mathews Associates, a patient education consulting firm in Chambersburg, PA. Routinely and randomly call patients who have participated in a program, and ask what they liked about it and what they didn’t, she advises. Ask them what education they wished they had during treatment.
"It’s a way of refining the program and, in some cases, developing new pieces of the program," she says.
Of course, patients should always be involved in determining their educational needs. Therefore, an initial learning assessment should be conducted when a patient enters the system whether in pre-surgery orientation or admission to the hospital.
In this way, they will be guided to the programs that are right for them, and the teaching will be tailored to meet their learning needs, explains Mathews. For example, not all women on the maternity unit need to be taught how to breast feed.
Educational materials, whether designed to complement a program or stand alone, also should have patient input before they go to press. Dorothy Ruzicki, PhD, RN, director of educational services at Sacred Heart Medical Center in Spokane, WA, recommends a systematic approach. Write a rough draft, and ask a few non-medical professionals with a specific condition for their opinion. Ask them to rate the information included from most important to least important to determine where to focus educational efforts.
Use that input to design the booklet or handout, and take it to a small group from your target population, perhaps 10 people. Ask the patients if there is anything missing, any areas that need more emphasis, or information that isn’t necessary.
"You can also have them circle words they don’t understand," says Ruzicki.
When a final draft has been completed, take it to about 20 to 30 people from your target population. You can use patients that are admitted to your hospital. Have this group verify that the information is in the order they find most helpful, and make sure they can understand the content.
Don’t forget to have patients review purchased materials, warns Hebert Snyder. "Often, we get patients to critique pamphlets that are being created inhouse, but we don’t get their input on the purchased ones. It’s valuable in both cases," she says.
Prepare a few questions, sit down with a patient, and go through the booklet. For example, during the session, you might ask the patient what he or she thinks is happening in the illustrations to make sure the pictures aren’t misleading. Many times appropriate patients can be found in the clinic waiting room.
Involve family members in your evaluations as well. "Family members use the materials or may be helping the patient follow a program at home, so it is useful to get their perception too," says Hebert Snyder.
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