Quality Improvement Specialist & Patient Engagement Lead University of Ottawa Heart Institute Ottawa, Ontario, Canada
Background: Patient educational guides are essential tools used by the University of Ottawa Heart Institute (UOHI) to support patients, caregivers, and families in understanding heart conditions and procedures. By 2018, UOHI had 22 educational guides in circulation. One of these guides had been reviewed in partnership with patients and none had been co-written with patients or caregivers. A 2016 report showed that 47% of Ontarians have low health literacy, emphasizing the need for clear and accessible materials at a grade 6-8 reading level. Three guides underwent a Flesch-Kinkaid reading level assessment in 2018. The guides scored Grade 8, 9 and 10 reading levels (Table 1.0). In response, the UOHI Quality Department (QD) initiated a project to create plain language guides by integrating patient engagement, evidence-based review processes and conducting a reading grade level assessment of the final text.
METHODS AND RESULTS: The QD integrated the Patient Educational Materials Assessment Tool (PEMAT) and the Harvard School of Public Health’s guidelines for creating and revising educational materials into a collaborative review process with patient partners.
Patient and caregiver feedback was systematically gathered on existing and new guides to ensure that they were both understandable and reflective of patient needs and experience. Reviewers contributed to the specific content of the guides and recommended areas for improvement. The Cardiac Rehabilitation Health Living Guide was revised in 2021 using this new approach, resulting in readability at a Grade 6 level.
Building on this success, UOHI formalized its process with the Educational Materials for Patients, Caregivers, and Family Policy No. 2.156, which mandated collaboration between staff and patient partners in all phases of educational material development. The policy emphasizes the use of plain language, active voice, and the definition of medical terminology. The Patient Educational Materials (PEM) Task Force of staff and patient partners was formed to review each guide prior to publication. Six (6) revised and new patient and caregiver education guides have been published using this approach (Table 2.0).
Conclusion: UOHI’s integration of patient engagement and health literacy principles into the development, review and approval of patient educational materials has improved the clarity and accessibility of its guides and other educational resources. By formalizing patient collaboration and employing validated review tools, UOHI is creating resources that our patients and their families can better understand, thereby empowering them in shared decision making about managing their heart health.
