Article from the Boston Globe’s On Call Magazine, July/August 2002

By Helen Osborne, M.Ed., OTR/L
President of Health Literacy Consulting

Whether you work in hospitals or see patients in their homes, in today’s economy you are apt to a have limited (or even non-existent) budget for patient education materials. Clinicians are challenged to find low-cost, high-quality, print and non-print teaching tools that meet the varied learning, literacy, and language needs of their patients.

Two clinicians who know how to meet the challenge of finding affordable teaching materials are Jane C. Wandel, RN, MS, a nurse specialist with the Beth Israel Deaconess Learning Center in Boston, and Janine Clifford-Murphy, RD, CDE, a nutritionist at the Visiting Nurse Association of Boston.

In her role at the Beth Israel Deaconess Learning Center, Wandel writes, edits, produces, and oversees the distribution of many of the organization’s printed patient education materials. These materials cover a wide range of topics, including information about specific illnesses, treatment options, medical procedures, discharge instructions, and medications. Despite a modest budget, Wandel has found economical ways to maintain the quality of these documents while meeting a variety of learning needs.

When Clifford-Murphy educates elderly homebound patients about complex nutritional plans, she primarily uses non-print teaching tools. She must select teaching materials that not only fit within her organization’s budget but also are consistent with the limited financial resources of many of the patients she treats.

Despite limited budgets, Wandel and Clifford-Murphy have found creative and cost-effective ways to educate patients. Here are some tips that you can use to find the teaching tools that meet the learning needs of patients while you stay within a budget your organization can afford.

How to Get Good Teaching Tools on a Budget

Create a template. Wandel often uses a template to produce written patient education materials that are visually appealing but not costly. A template is a preset form that helps ensure a consistent and attractive appearance for printed material. Wandel creates the template using word processing. The template has set margins and fonts and is printed so as to allow for the production of documents of varying size and page count. The template has the organization’s logo and masthead in color and is pre-printed in bulk. Then when teaching materials are needed, the text can be added and printed in black and white — a low-cost way to produce colorful documents.

Use basic design elements. There seldom is enough money on a limited budget to pay for fancy graphics or multi-color designs. Wandel finds that only a small percentage of patient education materials truly need these expensive design elements. To reduce costs yet still maintain visual appeal, she often uses basic word-processing design features such as bullet points, bold subheads, and plenty of white space on each page.

Use or adapt materials from other sources. To stretch limited patient education dollars, clinicians may decide to reprint or adapt materials from other sources. Not all materials are free, however. Clinicians need to consider copyright restrictions and be willing to pay for the rights to use or adapt any given document. Here are some sources for printed patient education materials:

• The Internet can be a rich source of patient teaching sheets. Wandel, however, advises clinicians to carefully scrutinize these materials to ensure that they are accurate and credible. A good place to find links to patient teaching materials is the Healthfinder Web site at www.healthfinder.gov. Developed by the U.S. Department of Health and Human Services, this site serves as a portal to selected consumer health publications, clearinghouses, databases, and Web sites. The Massachusetts Department of Public Health Web site at www.state.ma.us/dph is another good resource, with fact sheets and links to numerous healthcare associations and services. Before you reproduce and distribute materials from these or other Web sites, you should check each document’s copyright and make sure you have permission to use the material.
• Pharmaceutical companies can be a source of free or low-cost patient education materials. While some organizations are reluctant to use them because of concerns about advertising, others find that pharmaceutical materials are informative and attractive. Clifford-Murphy recommends that clinicians look carefully to determine whether these documents promote a particular treatment or medication.
• Many publishing companies and healthcare associations produce printed and online patient education materials. Before you can copy or adapt any of these documents, you need explicit permission from the publisher. While this may involve a reprint or licensing fee, you may find this cost is more than offset by the time and money it would take you to create a brand new teaching sheet.

Use items on hand when making a home visit. Rather than print materials, Clifford-Murphy uses food and kitchen utensils to teach homebound patients about proper nutrition. As her organization’s budget cannot afford plastic or rubber food models, she teaches with items she finds in a patient’s refrigerator or cupboards. For example, she teaches patients about portion control by showing them what a three-ounce serving of chicken looks like or using a serving spoon to measure out a half-cup portion of rice.

Create a picture book. Patients often want Clifford-Murphy to suggest specific foods to buy. She shows them pictures from local supermarket circulars that she has cut out and put into a loose-leaf binder. She finds that this picture book is not only cost-effective but also allows her the flexibility to add new items like reduced sodium soups or low-sugar cookies. In addition to pictures, Clifford-Murphy also keeps a supply of product labels. When patients ask for specific food recommendations, she gives them a label to take to the grocery store. This makes it easy for people, especially those with limited reading skills, to simply match the label to the product they are looking for.

When money is an issue, be creative about ways to pay for the teaching tools you need. Look to other sources of funding, both within your organization and without. If your organization is promoting a new healthcare initiative, for example, see whether the marketing or communications department will allocate a part of their budget for patient teaching materials which can be combined with marketing brochures or booklets. Consider, too, donations from outside vendors or grateful patients. When people contribute, they can feel good knowing that they are helping educate patients and families about important healthcare information.

To Learn More:

Janine Clifford-Murphy, RD, CDE is a nutritionist at the Visiting Nurse Association of Boston. You can reach her by phone at: (617) 333-7563

Jane C. Wandel, RN, MS, is a nurse specialist with the Beth Israel Deaconess Learning Center in Boston. You can reach Wandel by e-mail at: jwandel@bidmc.harvard.edu.

Web Resources

• Healthfinder is at www.healthfinder.gov.
• Massachusetts Department of Public Health’s Web site is at www.state.ma.us/dph.