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<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>At my old institution there was discussion
at the Nursing Research council about a confusing “consent” form to
be used in a study. The Nursing Research council wanted it changed
because it was written at too high a level. The IRB board said no.
They use one consent and that was the legalize that was required. The
nurses were all in an uproar and I gave them information on how informed
consent must be understood or it doesn’t matter. Since it was
nursing that wanted to do the research the implication was “use what we
say you can use or don’t do research.” It was a bad shot for
Magnet but there wasn’t anything anyone could do. IRB especially at
a small not academically associated hospital doesn’t have the time to
review a hundred different consent forms. It was very sad.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>On the note of filling out the forms at 5
different places or even the same place multiple times. The head of
registration at my old hospital was a friend of mine. We were working on
Six Sigma (quality improvement program see <a href="http://www.isixsigma.com/">www.isixsigma.com</a>
for info) and wanted to reduce wait times in registration. I talked about
my father having to reregister each time he came to the hospital for an Epogen
shot. Said can’t we just give him a card so that all he has to do
is go to the place he is to get the shot and swipe it. Found out that
Medicare/Medicaid rules require registration (signatures) each time services
are rendered. Can’t get around it. It can be shortened
somewhat but most of the time it isn’t. Often the forms fill out
have nothing to do with our health but how the hospitals/physicians will get
paid. <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Julie<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
<div>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Julie Esparza<br>
Clinical Medical Librarian<br>
Department of Medical Library Science<br>
<st1:place w:st="on"><st1:PlaceName w:st="on">LSU</st1:PlaceName> <st1:PlaceName
w:st="on">Health</st1:PlaceName> <st1:PlaceName w:st="on">Sciences</st1:PlaceName>
<st1:PlaceType w:st="on">Center</st1:PlaceType></st1:place><br>
<st1:address w:st="on"><st1:Street w:st="on">P.O. Box</st1:Street> 33932</st1:address></span></font><font
color=navy><span style='color:navy'><o:p></o:p></span></font></p>
<p class=MsoNormal><st1:Street w:st="on"><st1:address w:st="on"><font size=2
color=navy face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:navy'>1501 Kings Highway</span></font></st1:address></st1:Street><br>
<st1:place w:st="on"><st1:City w:st="on"><font size=2 color=navy face=Arial><span
style='font-size:10.0pt;font-family:Arial;color:navy'>Shreveport</span></font></st1:City><font
size=2 color=navy face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:navy'>, <st1:State w:st="on">Louisiana</st1:State> <st1:PostalCode
w:st="on">71130</st1:PostalCode></span></font></st1:place><br>
<font size=2 color=navy face=Arial><span style='font-size:10.0pt;font-family:
Arial;color:navy'>318-675-4179<br>
318-675-5442 Fax</span></font><font color=navy><span style='color:navy'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><a href="mailto:jespar@lsuhsc.edu">jespar@lsuhsc.edu</a></span></font><font
color=navy><span style='color:navy'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><br>
</span></font><font color=navy><span style='color:navy'> </span></font><o:p></o:p></p>
</div>
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<p class=MsoNormal><b><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'>
healthliteracy-bounces@nifl.gov [mailto:healthliteracy-bounces@nifl.gov] <b><span
style='font-weight:bold'>On Behalf Of </span></b>Lisa Bernstein<br>
<b><span style='font-weight:bold'>Sent:</span></b> Wednesday, March 26, 2008
11:53 AM<br>
<b><span style='font-weight:bold'>To:</span></b> The Health and Literacy
Discussion List<br>
<b><span style='font-weight:bold'>Subject:</span></b> [HealthLiteracy 1868] Re:
help</span></font><o:p></o:p></p>
</div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='margin-bottom:12.0pt'><font size=3
face="Times New Roman"><span style='font-size:12.0pt'>And thus, Janet, your
story effectively illustrates that WE ALL have low health literacy -- and NO
ONE teaches healthcare professionals how to effectively communicate with
patients - no matter their education or socio-economic standing. So while
those in the literacy field need to help adult learners access health
information their will not be real change until we can work with in the
healthcare system and medical schools -- which I'm happy to tell you there
are plenty of doctors, nurses and writers (Including many on this
listserve) working on right now.<o:p></o:p></span></font></p>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>On Wed, Mar 26, 2008 at 11:42 AM, Janet Sorensen <<a
href="mailto:Jsorensen@afmc.org">Jsorensen@afmc.org</a>> wrote:<o:p></o:p></span></font></p>
<div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>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><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> <o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>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><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> <o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>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 <st1:place w:st="on">OB</st1:place> 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><b><font
face=Arial><span style='font-family:Arial'>four paragraphs</span></font></b></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><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> <o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>When I mentioned this experience to my own personal <st1:place
w:st="on">OB</st1:place> (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><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> <o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>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><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> <o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>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><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> <o:p></o:p></span></font></p>
</div>
<p class=MsoNormal><font size=2 color=teal face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:teal'>Janet Sorensen</span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color=teal face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:teal'>Web Writer</span></font><o:p></o:p></p>
<p class=MsoNormal><st1:State w:st="on"><st1:place w:st="on"><font size=2
color=teal face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:teal'>Arkansas</span></font></st1:place></st1:State><font size=2
color=teal face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:teal'> Foundation for Medical Care</span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color=teal face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:teal'>501-212-8644</span></font><o:p></o:p></p>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> <o:p></o:p></span></font></p>
</div>
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<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><br>
----------------------------------------------------<br>
National Institute for Literacy<br>
Health and Literacy mailing list<br>
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To unsubscribe or change your subscription settings, please go to <a
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Email delivered to <a href="mailto:lisab@whattoexpect.org">lisab@whattoexpect.org</a><o:p></o:p></span></font></p>
</div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><br>
<br clear=all>
<br>
-- <br>
Lisa Bernstein<br>
Executive Director<br>
The What To Expect Foundation<br>
144 <st1:Street w:st="on"><st1:address w:st="on">W. 80th Street</st1:address></st1:Street><br>
<st1:place w:st="on"><st1:City w:st="on">New York</st1:City>, <st1:State w:st="on">NY</st1:State>
<st1:PostalCode w:st="on">10024</st1:PostalCode></st1:place><br>
212-712-9764<br>
<a href="http://www.whattoexpect.org">www.whattoexpect.org</a><br>
<br>
Providing prenatal health and literacy support so that women in need know what
to expect when expecting. <o:p></o:p></span></font></p>
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