<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN">
<HTML><HEAD>
<META HTTP-EQUIV="Content-Type" CONTENT="text/html; charset=iso-8859-1">
<META content="MSHTML 6.00.2900.2995" name=GENERATOR></HEAD>
<BODY>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN class=044075416-26032008>First
of all Janet, please let me sympathise with your experience. Unfortunately, you
are not alone.</SPAN></FONT></DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN
class=044075416-26032008></SPAN></FONT> </DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN
class=044075416-26032008>Regarding your question about strategies to get
clinical people to rewrite letters and forms, I have the following concepts and
experiences of my own to offer.</SPAN></FONT></DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN
class=044075416-26032008></SPAN></FONT> </DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN
class=044075416-26032008>Firstly, think about the administration of health
education materials. The different names applied to these materials is
enough to drive anyone crazy, and it highlights the complicated ins and outs of
health info administration that is "disturbed" when someone offers to 'change'
it. Some health regions, trusts and authorities only have
communications experts look at health information. Forms are written by legal
eagles to check for legality first, and communication second (if at
all). Before offering to change materials, think about the systems in
place...sometimes offering to help a nurse rewrite a health info
document. Some of the attitudes I have encountered are: "it's not my job";
"it's fine as it is"; "but I can understand it"; "the patient
will understand it once they have read through it a few more
times". My advice, start at the top! Go to the director, owner of the
clinic, managers, etc.</SPAN></FONT></DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN
class=044075416-26032008></SPAN></FONT> </DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN class=044075416-26032008>Also,
some people take their writing very personally. For some of my clients, I really
have to tip-toe around their feelings when I take my "red pen" to their
writing. Imagine this scenario - you arrive to meet your friend at a gathering,
and she has just introduced herself to the entire room. She has talked
to hundreds of people and is quite proud of herself
for putting her inhibitions aside, and then you notice that she
has a huge chunk of spinach in her teeth. How do you tell her? It's
the same for some 'unpracticed' writers. Remember that for most people "writing"
starts and ends at a quick text message, writing a shopping
list or a sticky reminding someone to pick up the dry
cleaning. Some people who write health information do so with the
best of intentions, but somewhere along the line they trip up, through no fault
of their own. The same feeling your friend would have at having spinach in her
teeth is the same feeling I often see reflected in the faces of my clients when
they see how much their materials have to be modified in order to meet the
standards set out by my department. </SPAN></FONT></DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN
class=044075416-26032008></SPAN></FONT> </DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN class=044075416-26032008>For
some departments, checking for readability is a "nice to have" rather than a
"need to have". I have encountered that a few times in my career. Hurt feelings
aside, my response is "you spend hours writing it, hundreds of dollars printing
and distributing it, thousands of copies have gone out, and only ten percent of
the people who pick it up and read it will actually understand it. How can a
system that allows you to reach more than ten percent of your audience be a
'nice to have'?" This always makes the policy makers (and people who control
budget purse-strings) sit up and listen to what you are
saying.</SPAN></FONT></DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN
class=044075416-26032008></SPAN></FONT> </DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN class=044075416-26032008>I hope
this helps you.</SPAN></FONT></DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN
class=044075416-26032008>Nicola</SPAN></FONT></DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN class=044075416-26032008><A
href="mailto:ndavies@dthr.ab.ca">ndavies@dthr.ab.ca</A></SPAN></FONT></DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN
class=044075416-26032008></SPAN></FONT> </DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN
class=044075416-26032008></SPAN></FONT> </DIV>
<DIV class=OutlookMessageHeader dir=ltr align=left><FONT face=Tahoma
size=2>-----Original Message-----<BR><B>From:</B>
healthliteracy-bounces@nifl.gov [mailto:healthliteracy-bounces@nifl.gov]<B>On
Behalf Of </B>Janet Sorensen<BR><B>Sent:</B> Wednesday, March 26, 2008 9:43
AM<BR><B>To:</B> healthliteracy@nifl.gov<BR><B>Subject:</B> [HealthLiteracy
1867] help<BR><BR></FONT></DIV>
<DIV><FONT face=Arial size=2><SPAN class=645082914-26032008>Since I'm not quite
as formally educated or experienced on this subject as the rest of you, I have a
question from a personal as well as professional
perspective.</SPAN></FONT></DIV>
<DIV><FONT face=Arial size=2><SPAN
class=645082914-26032008></SPAN></FONT> </DIV>
<DIV><FONT face=Arial size=2><SPAN class=645082914-26032008>As I'm sure many of
you have experienced, I'm often handed printed materials in the course of my own
health care (or a loved one's), or asked to fill out forms that I am tempted to
rewrite, redesign and hand back to the health care provider or staff member. As
a writer, I've seriously considered doing this (but waiting until my or my
relative's health care crisis or issue has been resolved). Is there a graceful,
persuasive and nonoffensive way to make suggestions to health care providers
regarding, say, written materials, preop and postop materials and processes, and
so forth? Anything that has worked or specifically NOT worked for you in winning
support from health care providers or others who are in a position to make
seemingly simple changes? I don't want to come across as a know-it-all because,
for one thing, I don't know it all, and also because such an approach or
attitude would not serve our purpose.</SPAN></FONT></DIV>
<DIV><FONT face=Arial size=2><SPAN
class=645082914-26032008></SPAN></FONT> </DIV>
<DIV><FONT face=Arial size=2><SPAN class=645082914-26032008>An example -- during
my pregnancy, I was referred for a diagnostic ultrasound because of my "advanced
maternal age" and because I had decided against amniocentesis. After the
ultrasound, the high-risk OB again tried to talk me into amnio and again I
politely refused. He said the ultrasound looked ok but would be read in more
detail later. A few days later, I got a form letter. The first <STRONG>four
paragraphs</STRONG> talked about Down syndrome, what it is, risk factors,
"markers," and so forth, and how women with "advanced maternal age" are at
greater risk. In the fifth paragraph, it explained that my ultrasound was (fill
in the blank) negative for all of the Down syndrome markers. But by then I had
already assumed my unborn child had Down syndrome and was freaking completely
out. I ran the Gunning-Fog on it out of curiosity, and it was higher than 12th
grade, besides just being badly written and badly organized.</SPAN></FONT></DIV>
<DIV><FONT face=Arial size=2><SPAN
class=645082914-26032008></SPAN></FONT> </DIV>
<DIV><FONT face=Arial size=2><SPAN class=645082914-26032008>When I mentioned
this experience to my own personal OB (not the high-risk guy) and said that
I thought the letter could have been written more effectively for the audience,
he said it's too bad these uneducated people can't read nowadays. I agreed and
said it's also too bad some educated people can't write nowadays. It occurs
to me now, that probably wasn't the best response for building collaboration and
support...I'm blaming hormones.</SPAN></FONT></DIV>
<DIV><FONT face=Arial size=2><SPAN
class=645082914-26032008></SPAN></FONT> </DIV>
<DIV><FONT face=Arial size=2><SPAN class=645082914-26032008>I'm asking now
because I just went through a grueling pre-op process at an academic
medical center with my 76-year-old mom, and we had to fill out the exact same
detailed form at five different clinics, although they have electronic
records there. I had to help an old man in one of the various waiting
rooms, who could not bend his arm and had no one to help him write. And that's
just the beginning. But I will stop now.</SPAN></FONT></DIV>
<DIV><FONT face=Arial size=2><SPAN
class=645082914-26032008></SPAN></FONT> </DIV>
<DIV><FONT face=Arial size=2><SPAN class=645082914-26032008>Any words of advice
on how I could effectively offer my own, for the sake of my blood pressure if
nothing else? I realize health literacy and health communication are huge
and evolving fields of study, and we need scholarly papers and more research,
but we also need front-line fighters. Or maybe guerilla is a better term. Polite
and respectful, of course. Any response will be appreciated. thx
jps</SPAN></FONT></DIV>
<DIV><FONT face=Arial size=2></FONT> </DIV>
<DIV align=left><FONT face=Arial color=#008080 size=2>Janet
Sorensen</FONT></DIV>
<DIV align=left><FONT face=Arial color=#008080 size=2>Web Writer</FONT></DIV>
<DIV align=left><FONT face=Arial color=#008080 size=2>Arkansas Foundation for
Medical Care</FONT></DIV>
<DIV align=left><FONT face=Arial color=#008080 size=2>501-212-8644</FONT></DIV>
<DIV> </DIV><PRE>***************************************************************************
CONFIDENTIALITY NOTICE: The information in this E-mail is
confidential and may be privileged. This E-mail is intended solely
for the named recipient or recipients. If you are not the intended
recipient, any use, disclosure, copying or distribution of this
E-mail is prohibited. If you are not the intended recipient, please
inform us by replying with the subject line marked
"Wrong Address" and then deleting this E-mail and any
attachments. Arkansas Foundation for Medical Care, Inc.
(AFMC) uses regularly updated anti-virus software in an attempt
to reduce the possibility of transmitting computer viruses. We do
not guarantee, however, that any attachments to this E-mail are
virus-free.
***************************************************************************
</PRE></BODY></HTML>