Is your information for patients hard to understand?

Recently I’ve had the chance to review some letters to patients about steps to follow for upcoming procedures. I’m afraid to say they left me with multiple questions, even though they were in my mother tongue and my educational background is in science. I was confused and was also a bit embarrassed that I was confused. For the letters where I was the patient, this confusion increased my worries about the procedure.Some of the letters required the patient to put on an analytical hat. For example, instructions were out of order for a colonoscopy preparation, with nighttime instructions coming before earlier that day. The preparation was different than what the pharmacy provided: the instructions spoke of sachets of PegLyte when the pharmacy provided it as a big jug. It had measurements in cups at one point and in millilitres in another, forcing the patient to make the conversion.Other letters left out information. For example, one told the patient to do bloodwork before a surgery, but not where to do bloodwork or if fasting was required. Another patient handout used complex sentence structures that I had to read twice. Sentences like: "Your health is such that a same day discharge is expected and with improved anaesthesia and surgical techniques, this is now possible." Please note this sentence was squished into a long paragraph. It was in a tiny font.I understand why these patient handouts are messy. They were probably developed over time, with information added and taken out over the years. Some letters may clunky because they're a combination of set paragraphs that the doctor puts together depending on the patient's needs. There’s also little time to comb over something that seems to have done the trick for years. But could letters to patients be better? By reviewing these letters, could you cut down on questions, calls to the office and the number of poorly prepared patients? Could clearly written letters help patients feel calmer about a procedure or operation? I think so.As a professional communicator for several decades now, I thought I'd share some best practices for communicating in written formats with patients. Using plain languageWriters communicating with the public often employ what we call “plain language principles.” The goal is to make everything clear and simple. Plain language includes:Using words the patient will knowUsing short, clear sentences Using short paragraphsOrganizing information logicallyUsing plain language makes it easier for patients to absorb the information. It’s amazing how you can write accurately about complex subjects using simple words and sentences. Instead of: “A discussion will take place with respect to postoperative pain control.”Try: “Your anesthesiologist will talk with you before your surgery. They will talk about the medications you’ll take after surgery to control your pain.” Accessibility is another concern. Don’t assume patients can read the same way you can. Avoid italics, because it's hard for people with learning disabilities to understand. Have your letter in a clear font and avoid using underline and all-caps. Keep punctuation simple so those using text-to-voice software can understand it.Start by explaining the procedureWhat exactly is it? Good online resources can help with this, and save patients running to Dr. Google or their neighbourhood know-it-all. My favourites online resources include:Canadian Cancer Society. The patient education material on their website is a masterclass of perfect tone and clarity.HealthLinkBCSick Kids’ About Kids' HealthUniversity Health Network’s My Surgery pageGo over the basic things patients need to know Patients must know what they need to do and what the doctor’s office will do for them. They need to know all the steps they must take, like the following:Before the procedure:What do they need to get from the pharmacy? When will they need it?Will they need special equipment in their recovery? Where do they get it? How long do they need it if they’re renting? How much will it cost?Do they need to set up appointments with other healthcare professionals?Preparation before the procedure:When do they need to start taking medication?When do they stop taking certain medication?When do they stop eating?The procedure:What should they bring? What should they leave at home? What should they wear? What should they not wear?Can someone come with them?Does someone need to take them home?How long is the procedure?When can they eat after the procedure?Recovery:When will they have a follow-up appointments?Do they need to book follow-up appointments?How long is recovery expected to take?When can they drive?Review your patient letterTry to get a non-healthcare person to review it for you. They’ll point out things you missed. I’d recommend a teenager or a senior, someone not afraid to tell you what is unclear. Here's a little checklist to help with the review.Do patients know the order that things will happen?Do patients know specifics in terms of time, place and what to bring?Do patients know how long the procedure and recovery will take?Are all the units the same?Are the costs involved explained? (i.e., patient parking, renting equipment)Is the information up to date?How much time will they need to take off work?Would someone who doesn’t have English or French as a first language understand this?Could someone with learning difficulties understand this?It takes time to review the information that you're giving your patients, but it could be worth it to have patients fully understand what to expect and come prepared.What are your tips on how to write a clear letter to patients?Kylie Taggart is a long-time journalist for the Medical Post.

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