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In the field of skin and wound care, a substantial effort is made to educate professionals, public policy makers, manufacturers, and researchers about the latest advances in practice. This makes sense: Our society places great value on the certification of health care professionals. We require them to have a high level of education, training, and competency to practice the art and science of wound care; we even require evidence of continuing education through the acquisition of new knowledge. This requirement is realized through attending national conferences or specialized educational programs, reading professional journals, and surfing the World Wide Web.
Most of these activities are designed to educate providers of skin and wound care. But what about the patients we serve?
The knowledge we acquire as skin and wound care professionals should be utilized for the benefit of the end user; in this case, the patient with a chronic wound. But when we focus all of our educational resources on the provider side of the equation, we run the risk of creating an information logjam.
Our task, then, is to convert the logjam into a watershed that releases information to the patient. When we transfer knowledge and educate our patients, we enable them to participate in their care, in clinically oriented research, and in best practices and outcomes related to the prevention and treatment of their specific problem or condition.
Again, this makes perfect sense: The transformation of the health care industry has included the adaptation of models from other industries, including a consumer-focused philosophy. This philosophy eliminates as many unnecessary steps as possible in the customer/supplier relationship and allows for a seamless system to provide a high-quality product at an affordable price.
Education of the customer is essential in this model. We see many examples in the pharmaceutical industry's direct marketing campaigns for various "lifestyle drugs," such as Viagra. This tactic bypasses the traditional control of patient information. Instead of relying on their health care providers, the patient-the customer-can find as much health-related educational material as he or she wants in all types of media, especially the World Wide Web. Educational brochures-once limited to distribution in the offices of health care providers and health care institutions-are now bound into major consumer magazines or available by calling a toll-free number or tapping into a Web site.
My own thinking about the issue of patient education has been challenged by observing the wound care nurse at our outpatient clinic. She does an outstanding job of educating each patient about the etiology, prevention, and treatment related to his or her specific condition. She told me that she evaluates her success through patient outcomes-whether the patient's wound heals and whether the wound recurs-and through the patient's ability to demonstrate the basic skills needed to care for and dress the wound.
This transfer of knowledge is part of nursing practice. Interestingly, however, third-party payers do not always value the educational services we provide for patients-we are not reimbursed for the patient education our wound care nurse provides, for example. Nor would we be reimbursed for the cost of doing a clinical outcomes study to assess the effectiveness of her educational efforts. Yet a physical therapist recently told me that he can accomplish the same educational objectives at a patient visit and be fully reimbursed for transferring his knowledge to the patient. This disparity in reimbursement policies is troubling and should be further evaluated to see how we can level the playing field.
It is also important for us to educate each other about what works. In that vein, I encourage all readers who are planning to attend the annual Clinical Symposium on Advances in Skin & Wound Care in Orlando, FL, to consider submitting poster abstracts showcasing effective patient-centered educational programs for patients. I also encourage you to consider submitting brief manuscripts on this topic to Advances in Skin & Wound Care.
Through this sharing of our success stories, we can work to eliminate barriers to patient education and develop the same level of rigor and enthusiasm for patient education as we do for our own professional education.
Ayello EA, Mezey M, Amella EJ. Educational assessment and teaching of older clients with pressure ulcers. Clin Geriatr Med 1997;13:483-96.
Bayne CG. Patient information systems: unbiased information is key. Nurs Manage 1997;28(3):50-3.
Sussman C. Wound Care Patient Education Resource Manual. Gaithersburg, MD: Aspen Publishers, Inc; 1999.
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