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Excellence Every Day represents an MGH commitment to providing the highest quality, safest care that meets or exceeds all standards set by the hospital and external organizations.
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Patient Education and Health Literacy
Empowering patients and families to partner fully in their care

QUICK LINKS: Plain Language Consultations | New Efforts | Data Trends | MGH and External Resources

Patient Instructions Activity Tip Sheet


The Patient Experience: Focus on Education

by Stuart J. Murphy
volunteer member of the MGH General Patient and Family Advisory Council since 2014

PFACWhen I was asked to join the General Patient and Family Advisory Council (G-PFAC) four years ago, I was very excited. I was impressed by the concept of having patients and their family members serve as volunteer advisors to Mass General Hospital (MGH). I thought, “Who better to provide advice than those who have actually experienced
the services of the hospital?” Having had two recent operations,
both followed by hospital stays, I was eager to share my impressions,
most of which were very positive. I felt that perhaps this would help
the MGH staff consider additional ideas for improving the
patient experience.

However, a number of us who had joined the G-PFAC were concerned that our ideas and input might not be welcomed and appreciated by staff members. After all, we were just a group of lay volunteers with the mission of providing advice to professional employees with a great deal of expertise.

I am happy to report that this concern evaporated very quickly. Soon after the G-PFAC was established, we formed a number of sub-committees so members could focus on specific areas of interest and concern. One of those was devoted to the important topic of patient education. As my entire career has been in the field of educational publishing, I was very pleased to join that sub-committee.

It wasn’t long before Brian French, Director of The Maxwell and Eleanor Blum Patient and Family Learning Center (Blum Center) heard of the goals of the G-PFAC and realized that the Education Subcommittee could be an excellent resource for his team. The Blum team immediately saw the potential for a successful partnership and recognized the value of having direct input from patients and their family members into patient education efforts. 

PFACThe current members of the G-PFAC Education Subcommittee, in addition to myself, are Ann Galdos (chair), Robert Chen, Melissa Hoyt, Susan Keshian, Alexa Sherrill, Joyce Smith, and Carrie Stamos.
We began with a few introductory meetings to inform the members of the committee about the goals and operations of the Blum Center. We also learned about health literacy and the use of “plain language” so we could better react to materials from the point of view of patients from a wide variety of backgrounds. We provided input on a number of documents and brochures, including a resource guide for patients who are scheduled for spine surgery and an introductory letter for colonoscopy patients. We were then enlisted to review a series of health education videos. We are currently engaged in the development of a new poster for the Blum Center and the review of an important document on stroke education.

As we have continued to work together, we have grown into an effective and committed team and have developed a keen sense of mutual respect. The members of our sub-committee have seen that our input is well received and believe that we are adding value to this collaborative process. In this way, we feel that we are helping to support the ambitious MGH goal of Excellence Every Day. 

Health Literacy and Plain Language

What is health literacy?
Health literacy refers to how well a person can get the health information and services that they need, and how well they understand them. It is also about using them to make good health decisions. It involves differences that people have in areas such as:

  • Access to information that they can understand
  • Skills, such as finding that information, communicating with health care providers, living a healthy lifestyle, and managing a disease
  • Knowledge of medical words, and of how their health care system works
  • Abilities, such as physical or mental limitations
  • Personal factors, such as age, education, language abilities, and culture

More than 90 million adults in the United States have low health literacy. It affects their ability to make health decisions. This can harm their health. They may have trouble managing chronic diseases, and leading a healthy lifestyle. They may go to the hospital more often, and have poorer health overall.

Source: National Institutes of Health (NIH)

Plain language (also called plain writing or plain English) is communication your audience can understand the first time they read or hear it.

The Plain Writing Act of 2010 defines plain language as:

Writing that is clear, concise, well-organized, and follows other best practices appropriate to the subject or field and intended audience.

Language that is plain to one set of readers may not be plain to others. Written material is in plain language if your audience can:

  • Find what they need
  • Understand what they find
  • Use what they find to meet their needs

There are many techniques that can help you achieve this goal. Among the most common are:

  • Logical organization with the reader in mind
  • Using "You" pronouns to speak directly to your reader
  • Active voice
  • Short sentences
  • Common, everyday words
  • Easy-to-read design features

Source: Plain Language Action and Information Network (PLAIN)

Consultations with Blum Center to Improve Patient Education Efforts

Producing patient education materials in plain language has been established as a best practice for years, with special recognition with the Plain Writing Act of 2010. Yet, ensuring that materials comply with plain language principles can be very challenging.

There are health education experts at the Maxwell & Eleanor Blum Patient and Family Learning Center (Blum Center) at Mass General located in the White Building, 1st Floor, Room 110 (top of the staircase leading to Eat Street Café).  These experts  help identify and provide health education materials that adhere to plain language principles and are available at no cost to assist employees, patients, and visitors in finding trustworthy patient education materials. 

Upon request, Blum Center health education experts can also provide a comprehensive report to MGH professionals with suggestions for how to improve a given material’s formatting, content, and overall messaging.  All that is needed is a consultation request form be submitted along with the material to be reviewed.

Creating materials in plain language is a skill that utilizes current cognitive theory and is based in a body of empirical evidence.  Blum Center experts use standardized tools including the Suitability Assessment of Materials (SAM) and the Fry Readability Formula to assess a material for plain language, and subsequently, its likely efficacy for patient education, before and after suggested revisions.

For more information about Plain Language Consultation or other services provided by the Blum Center team, contact the Blum Center at (617) 724-7352 or through email

Efforts in Improving Patient Education

End User Testing: Engaging with Patient and Family Advisory Councils (PFACs)
In 2016, the General PFAC (G-PFAC) formed among its working committees a new Patient Education Committee to work closely with the Blum Center staff as well as the Knight Simulation Program. 
Since March of 2016, members of the committee met monthly with Blum Center staff to review select materials written for patients and families.

The partnership has been so successful that not only will their review of written materials continue, but additional ways to collaborate with the G-PFAC are being explored. .
“The work we have shared and done together so far has led to some great conversation and dialogue as well as some learning of our own.  The Blum Center can really be a valuable resource … They have certainly helped us as a group to evolve and learn about some important aspects of resources and educating...”-Melissa Hoyt, G-PFAC Member

If you have a patient or a family member who is interested in joining the MGH General PFAC or one of its committees, have them email or call (617) 726-3370.

MGH Patient and Family Education Materials & Resources Website
The Blum Center in collaboration with the Collaborative Governance Patient Education and Informatics Committees, developed an intranet website that is easier to find.  The site highlights MGH-produced patient education materials as well as preferred search engines and databases to find materials.
The intranet site can be accessed by going to:

   > Partners Applications
   > NPCS Clinical Resources
   > MGH Patient and Family Education

View the site:


The Data on Health Literacy

HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) is a patient satisfaction survey that CMS (the Centers for Medicare and Medicaid Services) requires for all US hospitals.
About HCAHPS Surveys

Tableau Patient Experience Data (Mass General login required)
Open Dashboard

US map

National Health Literacy Data




Health Literacy Data Map

Use the map to find health literacy estimates for neighborhoods throughout the United States. Select a state to get started.

Policies, Procedures & Guidelines:
(internal access only)
Patient and Family Education

Nursing Practice Guideline on Patient/Family Education



Patient Education Committee
The Collaborative Governance Patient Education Committee (PEC) is a multidisciplinary team that supports clinical staff in developing their role in patient education activities that reflect the diverse patient population served by MGH. This is achieved through stimulating, facilitating and generating knowledge of patient education materials, programs, and resources in order to improve patient care and enhance the environment in which clinicians shape their practice.
The 3 areas of the committee’s focus are patient education, health literacy, and communication, The PEC has created flyers and articles to promote effective patient education, presented seminars on health literacy, and coordinated activities for Health Literacy Awareness Month.
The Patient Education Committee meets the 2nd Wednesday of the month from 1:30-3:00pm in Sweet Conference Room GRB 432.
Collaborative Governance Patient Education Committee Champions



In the News

National and International Trends
Resources Shared by Participants During the October 31, 2013 Health Literacy Twitter Chat Hosted by This list of health literacy resources was generated by participants in a Health Literacy Twitter Chat. It includes links to government and non-government organizations.

New Federal Policy Initiatives to Boost Health Literacy Can Help the Nation Move Beyond the Cycle of Costly "Crisis Care"Health Affairs, 2012

Healthy People 2020— Health Communication and Health Information Technology

Caring for patients with limited health literacyJAMA 2011

Limited health literacy is a major barrier to heart disease prevention and treatment - American Heart Association

Health Literacy listserv
The Institute for Healthcare Advancement hosts a listserv for the health literacy community. The listserv provides a forum to share ideas, get advice, ask questions, and make announcements. There are currently over 1,500 members on this listserv.


Patient Education Resources

Patient Education in Epic: An Overview 
There are patient instruction materials loaded into Epic that can be incorporated into the patient’s health record. These materials are searchable to assist you in finding the topic you want more easily.

MGH Patient Education Libraries
MGH Patient Education Documents (internal access only) 
Library of documents created by MGH subject matter expert clinicians (updated at least biannually)

PCOI or Primary Care Office Insite is a repository of many MGH-produced patient education documents as well as care guidelines for clinicians.  Many of the patient education documents have been translated into Spanish.

MGH Patient Education Television Channel
MGH Channel 31 offers over 200 health education video titles for patients to view on-demand. To order a video, use patient’s bedside telephone and dial x4-5212.

MGH Cancer Patient Education (CaPE)
CaPE provides information on the different cancer types and cancer care; includes fact sheets on chemotherapy medications, tests and procedures, illustrations and lifestyle management.

Child & Adolescent Resource Materials (CARMA) Website (internal access only).
The CARMA website, created and maintained by MassGeneral Hospital for Children, provides primary care pediatric providers with easily accessible web-based resources to support their practice of high quality, evidence-based medicine.

MassGeneral Hospital for Children Patient Education Intranet (Internal access only)
This website provides staff with a cohesive collection of MGHfC-authored educational materials across a variety of clinical programs. Guidelines for formatting existing materials and developing new materials are available on this site. 


MGH Contacts

The Maxwell & Eleanor Blum Patient and Family Learning Center
Patient Education or Plain Language Consultation
Phone: 617-724-7352

Interpreter Services
Translation of Patient Materials
We strongly discourage the use of internet-based translation programs. The results are not reliable and can compromise patient care. Contact interpreter services for translation of Patient Materials.
Phone: 617-726-6966

Maxwell V. Blum Cancer Resource Program
The Maxwell V. Blum Cancer Resource Program offers a range of support resources around the Cancer Center. The program has an ongoing mission to make support services, as well as respite and community-building areas, more accessible to patients and families throughout the Cancer Center.

Health Decision Sciences Center
The Health Decision Sciences Center (HDSC) is a multidisciplinary research group that seeks to foster shared decision making and implement sustainable decision aid delivery. We are committed to improving the quality of decisions made by patients and health care providers from diagnosis through treatment.

Visit our website to learn more about the research, tools, and training conducted by the HDSC.



MGH Approved Patient Education Libraries
Also available in other languages:

Healthwise is an external vendor for patient educational materials now available directly in Epic. These materials are all available in multiple languages. For tips about selecting and using these materials, see the eCare Tip Sheets

The Patient Education Module provides the capability to print complete patient educational packets with information on medications, conditions, and/or procedures. The condition/procedure leaflets are available in English and Spanish, while the adult- and pediatric-specific medication leaflets are available in up to 19 languages.

Care Notes/Drug Notes
Find patient education and/or medication information by keyword search or alphabetical list; can be individualized with special instructions for the patient. 

MedlinePlus, Multiple Languages
Health information from the National Library of Medicine. Easy access to health topics, medical dictionaries, directories and publications on a variety of health topics in 48 languages


Health Literacy Resources

MGH HealthStream Offerings: (internal access only)
Improving Your Patient/Family Teaching Skills Through the Teach Back/Show Back Method

Always Use Teach-back!
The purpose of this toolkit is to help all health care providers learn to use teach-back—every time it is indicated—to support patients and families throughout the care continuum, especially during transitions between health care settings.

Talking With Your Older Patient: A Clinician's Handbook
This resource is intended for use by a range of professionals dealing directly with patients. The aim is to introduce and/or reinforce communication skills essential in caring for older patients and their families. Offers practical techniques and approaches to help with diagnosis, promote treatment adherence, make more efficient use of clinicians’ time, and increase patient and provider satisfaction.

Clear Communication: an NIH Health Literacy Initiative
This resource focuses on the various programs and resources that NIH has developed to improve communication between consumers and health professionals.

National Action Plan To Improve Health Literacy
The National Action Plan To Improve Health Literacy seeks to engage organizations, professionals, policymakers, communities, individuals, and families in a linked, multi-sector effort to improve health literacy.

Joint Commision White Paper:
‘What Did the Doctor Say?’ Improving Health Literacy to Protect Patient Safety
Recommendations from The Joint Commission on improving health literacy to ensure patient safety

CDC Health Literacy Page
This Centers for Disease Control and Prevention (CDC) resource provides information and tools to improve health literacy and public health

AHRQ Health Literacy Universal Precautions Toolkit
Resources to improve medication adherence, make action plans, understand health literacy and use written health materials effectively

National Network of Libraries of Medicine Health Literacy Initiatives
The purpose of NNLM’s strategic focus on public libraries is to develop long-term partnerships and collaborations that bring NLM’s information resources to the community. The goal of this national initiative is to promote health information literacy by equipping library staff with effective skills and high-quality resources to meet the needs of consumers.

Understanding Literacy & Numeracy
The resources on this page briefly explain literacy and numeracy and how they are measured in national education surveys. You will find a link to adult health literacy data. The page also contains links to resources that discuss literacy policies and practices and ideas about how to promote literacy and numeracy

Health Literacy Online
This site was created by Office of Disease Prevention and Health Promotion within the U.S. Department of Health and Human Services. It specifically guides how to create patient education online in a user-friendly format while adhering to plain language


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There are numerous terms and acronyms in healthcare that may be unfamiliar. Please click here to visit a Glossary of Terms that may be helpful.

This month's featured term: Health Literacy

The degree to which individuals have the capacity to obtain, communicate, process, and understand basic health information and services needed to make appropriate health decisions.”

Affordable Care Act:
The definition of Health Literacy has evolved over the years. The most recent change came from the Affordable Care Act passed in 2010; the word “communicate” was added. This makes it even clearer that a health literate individual is not a passive receiver of health information but is engaged in an exchange of information. It also underscores that health literacy is not limited to comprehending written information, but includes verbal communication as well.


Joint Commission logo

For many patients, communication may be inhibited by language differences, hearing, visual or cognitive impairments, health literacy, or other disabilities. The Joint Commission has new and revised requirements to improve patient-provider communication that will increase quality and safety through effective communication, cultural competence and patient- and family-centered care. Read more about the eight new and revised elements of here

PC.02.03.01: The hospital provides patient education and training based on each patient's needs and abilities

Magnet Recognition

Magnet_logoThe American Nurses Credentialing Center (ANCC) requires Magnet-designated organizations to track nationally-benchmarked nursing sensitive indicators (NSIs) to continually inform improvement efforts related enhance patient outcomes. Examples of NSIs include, but are not limited to: patient falls, hospital-acquired pressure ulcers, blood stream infections, ventilator-associated pneumonia, and restraint use.

Excellence Every Day represents an MGH commitment to providing the highest quality, safest care that meets or exceeds all standards set by the hospital and external organizations.

If you have questions or suggestions related to the EED portal, please contact Jess Beaham at (617) 726-3109 or via email at

updated 2/5/19


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