Health Literacy

While the original meaning of literacy referred to whether someone could read or write, the meaning has since expanded to encompass whether someone has enough knowledge about something to understand it and use it. This is critical when making decisions that affect your health, which is why ambiguous and misleading information frustrates me.

To improve patients' health literacy, the health literacy (the ability to read and write) of those creating content for patients, must also improve. They must read the content they need to share from the perspective of a patient and then write in a way that is easy for patients to read and understand.

People creating documentation must be part of the solution and not part of the problem.

Retirement activities

When I said I was retiring, I was repeatedly asked if I had any trips planned. I told them there was nothing big planned for the first year, so I might be taking some small trips that would include some trips to see my grandson. Most people could appreciate and understand wanting to do these activities.

Now, if I had told everyone that I wanted to do more advocacy work and save the world through wording and format changes, the reaction would have been different depending on how well a person knew me. Anyone who had never seen me in action to advocate for change, would have responded with polite nodding and the use of their inside voice to ask, “What the heck? Is she crazy?” 

Those people who have seen me in action were not surprised by what I planned to do. They already understood and accepted that my mind doesn't rest when there is an improvement for me to trigger.

It's therefore no surprise that while I retired as a Senior Business Systems Consultant in June, my attention to detail and analytical skills continue to work. And so, retirement has given me more time to find areas for improvement wherever I go. Sometimes I struggle to turn off this ability/disability. And, although I haven't managed to turn it off yet, it's a dream that I hope to achieve within my lifetime. 

Who would have thought that bloodwork and a colonoscopy form could bring me so much joy? Yes, joy! Welcome to my unconventional world. Enjoy the ride.

Bloodwork

I had to get some bloodwork done and, while I was waiting for the technician, I read this sign. I couldn’t help myself. It was right there at nearly eye level. My quick analysis started and, once it started, I couldn’t stop.

Here were the results:

• While the sign started with plain language, it finished with medical terminology in the “Please note:” section. Hematoma? Phlebotomy? Venipuncture? Dictionary?

• “Why” you might bruise was described before “what” to do for bruising when what to do is more important to know.

• The general wording of the whole note is awkward.

A possible solution

In most cases, people wouldn’t read the sign and, if they did, they wouldn’t read past the first part. However, I did and I came up with a potential solution. It was either put together a rewrite or live with the ongoing urge to make the correction...even if just mentally.

To minimize bruising

• Keep your arm straight.

• Apply firm pressure on the bruise for at least 3 to 5 minutes.

• Avoid exercise or heavy lifting for 2 to 4 hours.

To manage bruising if it occurs

In most cases, no action is required; however, if the bruising is substantial or concerning, do the following:

• Apply a cold compress or ice pack to the bruised area for 10 to 20 minutes.

• Remove the compress or ice pack for 10 to 20 minutes.

• Repeat the process for 3 hours.

If the note is kept (and I don't recommend it), it could be written something like this:

Note

While some bruising is common when having bloodwork done, it is more likely to occur in the following cases:

• The process of drawing blood was difficult.

• You are on blood thinners.

• You have a history of bruising.

Colonoscopy

Even a referral (form) for a colonoscopy was not safe from me with my prying eyes and critical mind. When I received my referral, my first thought was not, "Great, something new to critique." However, sometimes things just work out.

Doctor's phone number

I called he phone number that was on the form and it was answered with a recording. The problem was that the recording listed a lot of doctors, but I didn't hear my doctor’s name listed in the recording. I hung up and decided to look the doctor up online. And, there it was, an entirely different number. I knew I had struck gold when I tried the new number and I reached the correct doctor's office. Where there was one mistake, there was probably more.

I was not disappointed.

Addresses

Even worse than providing a wrong phone number, I was presented with two possible locations to go to on July 22, which was the date of my colonoscopy.

Although no one truly likes to be told where to go, in this case, I wanted to know exactly where to go. I had two different addresses in two different cities.

While the date and time on the form matched what I was told during a phone call, the presence of two addresses confused me and made me question if I had heard correctly.

Health care provider

The fact that I was being told to "contact the health care provider directly" if I couldn't attend the appointment wasn't specific enough. I didn't even know which health care provider I would contact. Was it the doctor with the wrong phone number (the person doing the procedure) or my family doctor? Since the original call for an appointment had come from someone associated with the Co-ordinated Colonoscopy Access Program, I would have thought I should be contacting them. That option might have seemed logical, but nothing about this form was logical.

Important information

By labelling something as "Important Information", but not until halfway down the page, did it mean that everything above it was unimportant? It couldn't be, because the date and time were in the top section. The extra heading didn't help. In fact, it added confusion. The important information was scattered above and below the heading. Luckily, I read the whole page and finally got my answer about where to go for my colonoscopy (Address 2).

I guess Address 1 was just a decoy in a scavenger hunt.

A possible solution

Since many people do not read documents from start to finish, a better structure and wording could be the following:

A referral for colonoscopy was sent for you by (doctor's name) on (date).

Your appointment for a colonoscopy has been scheduled for (day and date).

While the procedure itself will occur at (time), you must report to Day Surgery Registration at (time).

Registration and the subsequent procedure will occur at (location - previously Address 2)

Address 1 should not be included anywhere on the form.

If you cannot have your colonoscopy on the date indicated, contact the doctor who will be performing the procedure. I don't really know if this is the health care provider being referred to, but it would be better for the patient if the name of the doctor and the correct phone number were included here.

Next Steps

While I won’t take any action about the bloodwork sign, I am going to contact the place that provided details about my colonoscopy. The documentation stinks and should be cleaned up because, in the end, no one needs all this ambiguity when the preparation and colonoscopy is challenging enough.

Think of the time savings if the information was easy to find and understand and phone calls weren't required. Now that I'm retired, it's a dream I hope to make a reality.