Health professionals: how to write patient information at local level

health professionals,patient information,how to write,write as people speak

Patient information written inhouse
can be hard to understand

For reasons I won’t bore you with, I have quite a lot of experience of medical writing and the quality of written information for patients – in my experience in the UK and North America at least – is, er, variable to put it mildly.

In many countries, generic information about various diseases and conditions is created at a national level either by government departments or by approved charities. Usually (but not always) this is written by professional writers, based on information given to them by health professionals, so it’s of a good standard that’s easy for patients to understand.

Where problems can crop up, however, is with patient information created at local level

After all, each hospital’s procedures and processes are unique and often can’t be accommodated by generalized information, either in concept or in detail. Normally, such information at local level has to be written by health professionals, usually senior nurses. This opens up two issues to start with…

1) Nurses tend to be “doers” rather than “writers,” not surprisingly. And equally without surprise, nurses don’t have a lot of time to spend dreaming up beautiful words in ivory towers.

2) Despite nurses being at the coalface of patient relationships, it’s easy – and often convenient – for them to lapse into hospital-speak when describing processes and procedures … especially in writing.

Where does this leave patients?

Some patients, especially those suffering from long-term conditions like diabetes, cardiac issues and even cancer, become very aware of the jargon associated with their conditions and probably know more about it than some of the less senior nurses do. But there are many more patients who find the whole medical and hospital culture frighteningly beyond them.

Given that written patient information has to accommodate the lowest common denominators (in the nicest possible ways), written patient information has to be dragged out of hospital jargon and made understandable to your ageing aunt, over a cup of tea at the kitchen table. But because health professionals are usually too close to the coal face, this is harder than it seems.

What about clinical governance and other official censors?

Most hospitals and health systems around the world will have some sort of filtration device in place to ensure that anything that gets published in the hospital’s name or “brand” has to pass through some hoops to make sure it’s compliant with certain standards. In the UK, we have our clinical governance people who perform this role across all our National Health Service (NHS) hospitals.

Many health professionals, when writing patient information, assume that the censorship people concerned will insist on formal, stuffy language and the use of proper terminology. However in my experience (and I help write quite a lot of patient information in the UK) that’s not true. The governance overseers aren’t stupid; they understand that patient information has to be written in a way that patients can understand otherwise it won’t work. In the main they are concerned with accuracy of information rather than writing style – within reason, of course.

So how should nurses and other health professionals write patient information properly?

When I run workshops for nurses and other health professionals one thing strikes me as particularly interesting. It’s after we have a discussion and a live (verbalized) role play about explaining a simple procedure like inserting a cannula, to their Auntie Meg. When they all sit down to write it two things happen:

1.They start off really well

2.By the time they get about halfway through, they have reverted to hospital-speak, but only realize this when I point it out to them

What can we learn from that?

I think it’s that although nurses and other health professionals can fully understand the concept of writing as they’d speak to their Auntie Meg over the kitchen table in social terms, because their medical training is so deeply ingrained that has a way of overwhelming their writing. And it’s not surprising. After years of study, essay writing, dissertation writing et al  it’s very hard to break out of the academic/professional model. It keeps coming back and biting them on the ankles, whatever they’re doing.

If you’re a health professional who has to write patient information, what’s the answer?

Give yourself frequent reality checks. Reality checks with every single sentence. Preferably, too, get an Auntie Meg character or other typical patient to review your text and make sure s/he can understand it.

It may seem hard at first, and if you find yourself floundering, keep remembering Auntie Meg. Visualize her; think how she talks. Think hard about what she would understand. Ask yourself if each sentence would make sense to her. Get yourself into an “Auntie Meg” mindset (I know this sounds a bit woo-woo, but it works!) and keep her image and culture in the front of your mind when you’re writing.

And when you’re done, give your text another reality check. Yes, I know … another one, but it’s worth it!

Further reading that will help you

blog,writing,news,blogging,business,Suzan St Maur,howtowritebetter.net,how to write betterHere are two other articles of mine that go into more detail..

How to write as people speak

Why professionals need to get naked to write simply

What experience do you have of reading (or writing) patient information produced at local level? How would you rate the way the text was written? How easy was it to understand? Please share!

photo credit: lydia_shiningbrightly via photopin cc

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  1. A lot of what you say can equally well be applied in the computer industry . When I worked in that, there were several different groups that each needed a different approach.
    There was the end user where the KISS principle was needed as they were mostly computer illiterate.
    Then there was computer management who had next to no computer literacy for the most part.
    Next came the Systems Analysts who had variable levels depending on if they had come up through the programming ranks or had come in straight from a non computer related. The latter had a language all of their own
    Finally the programmers, of which I was one, who knew all the technospeak.
    Each needed a different style of writing. I kept away from writing for end users as much as possible. No way to avoid the others so I varied the tone according to which of the groups it was for.
    Well normally I did but the analysts would frequently annoy me because they though they were superior. The result when they did was that the next thing I wrote for them would be laced with technospeak. They had to pretend they understood because they were in the computer department. I’m bad 🙂

  2. LOL Ian … I used to write quite a lot of scripts and speeches for the IT industry to deliver to sales forces and IT retailers, and I remember just how hard it was to adjust the jargon levels appropriately!

    With professionals (e.g. doctors, nurses, lawyers, accountants) they’re lucky because they don’t have to work on a number of different levels. Assuming they deal directly with patients, they only have two levels to worry about: either professional-speak for text amongst themselves, or normal human-speak for their “clients.”

    The computer industry is far more complex in that regard, don’t you think? With all these different levels of technical literacy – and an inherent snobbishness running around in all those levels – it’s an utter nightmare.

    We ought, perhaps, to look to good professors and teachers who manage to communicate complex information in ways their students can understand. But not all professors/teachers know how to do that well, and I suspect it’s largely to do with their inability to phrase their information in a way that not only can be understood easily by their audiences, but also that brings the subject matter alive.

    A tough call. Great to hear from you Ian – come back soon!

    • I couldn’t agree more Suzan (excellent write up by the way). The issue isn’t communication, so much as CLEAR communication, i.e. minimizing the risk of anything getting ‘lost in translation’. Sadly, this is a skill set that is not getting nearly as much emphasis as it should in the teaching and training environment…

      • Hello Thom – good to see you here. I hear what you say about this skillset not being addressed; it’s not even touched upon in nursing courses here in the UK and yet writing patient information at local level nearly always falls to senior nurses and nurse practitioners.

        I lecture on cancer survivorship at a UK university and have mentioned this to the course leader. The university is now considering putting on workshops on writing patient information (designed and delivered by me) for final year nursing students. I hope it comes off, as it would help both the health professionals and patients.

        And as you say, CLEAR communication is critical. However the tendency is that people will add words and phrases to simple English in order to “clarify” the points they’re making … so making the text even harder for the average person to understand! The trick is to show these people how to write clearly AND simply … and that’s a bit harder than it sounds.

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