April 17, 2020
Steven A. Smith, M.D., still remembers the day he noticed inconsistencies in the Patient Appointment Guide for patients with diabetes. He discussed it with his colleagues in Endocrinology. It didn't take long for consensus to emerge that the Patient Appointment Guide should be standardized across Mayo Clinic.
The inconsistencies compromised patient safety and pointed to the need for regularly scheduled clinical review of instructions. "When someone realized that it needed to be an institutional effort to develop consistent instructions, who did they call on?" Dr. Smith asks. "Patient Education." The results speak for themselves. Since 2009, when Patient Education was enlisted to oversee the Patient Appointment Guide, there have been no sentinel events related to patients with diabetes.
Bridging the gap
Clinicians sometimes overestimate patients' understanding of their health conditions and the actions necessary to adhere to their treatment plans, says Kristin S. Vickers, Ph.D., L.P., research director of Patient Education. Patient education helps bridge that gap between provider assumptions and patient understanding.
"Education is more than information delivery. It's about clarifying the needs of the learner and the best method for delivering information so that the patient can quickly understand and act on medical expert recommendations," Dr. Vickers says. "Patient education must be sensitive to numerous learning and behavior change barriers, such as stress and pain. Dr. Smith models for us evidence-based patient education, such that patient health literacy, motivation, understanding of technology, culture and preferences are valued."
For the last 15 years, Dr. Smith has served as Patient Education's medical director, advancing its function from Mayo Clinic in Rochester, Minnesota, to all Mayo Clinic locations.
Endowing the future
To ensure Patient Education's commitment to the science of evidence-based patient education, Dr. Smith has established the Steven A. Smith and Lynda D. Smith Family Fund in Diabetes Care and Education, an endowment to support diabetes research and education. "Diabetes is an up-and-coming, if not already established, epidemic," Dr. Smith says. "There's lots of opportunity to help serve individuals in the self-management issue."
The American Diabetes Association says 9.4% of Americans have diabetes. Of the 30 million adults with diabetes, 23 million are diagnosed and 7 million are undiagnosed. Diabetes remains the seventh-leading cause of death in the U.S.
"I'm impressed with the exponential growth in patient education science," Dr. Smith says. "Despite all that is known, challenges remain in getting expert information to the patient at the right time and place. There is promise in the future of the art and science of patient education in the digital age, including the use of technology delivered with a human touch."
Milestones in patient education
Patient Education dates back to 1976 when the Mayo Clinic Health Learning Center was established in Rochester to instruct patients in self-management of disease and healthy-living habits. In 2009, when it was known as the Section of Patient Education, it began overseeing the Patient Appointment Guide. But standardizing the Patient Appointment Guide is just one of Patient Education's many milestones.
In 2010, when Patient Education developed the "Big 4 Safety Language," instructions for patients with diabetes were the priority. The section name was changed to the Office of Patient Education in 2016 to connect efforts in creating patient education across all Mayo Clinic locations. The Content Convergence Project in 2018 launched delivery of education materials and the Patient Appointment Guide through Epic.
Another milestone, albeit a bittersweet one, is the departure of its longest-tenured medical director. Dr. Smith retired Jan. 20, 2020, after 31 years as a Mayo Clinic endocrinologist. As he enters retirement, Dr. Smith says he knows Patient Education is in good hands. "They make my day every day when I come to work," Dr. Smith says of staff members in the Office of Patient Education. "They're very dedicated to the mission of Mayo Clinic. I can't say enough good things about them."
Those who have worked with Dr. Smith feel the same way about him. "Because so much of Patient Education work is behind the scenes with the clinical practice to plan, produce and implement patient education, he inspires me in his continual recognition of the expertise of our staff," Dr. Vickers says. "He has empathy for patients as they struggle to understand complex conditions and work to manage them. Though the phrase 'patient-centered care' gets thrown around a lot, he epitomizes this view."