Abstract
The Speak Up program, very simply described, encourages patients to speak up if they have questions or concerns and to ask again if they don't understand something the first time. It tells them, “It's your body and you have the right to know. Pay attention to the care you receive. Always make sure you are getting the right treatments and the right medicines from the right healthcare professionals. Don't assume anything.”
The program also encourages patients to educate themselves about any illness they have—to learn about the medical tests they receive and the plan for their treatment. It tells them to ask a trusted family member or close friend to be an advisor and supporter and to know what medicines they are given and why, because medication errors are the most common healthcare mistakes.
It also advises them to use a hospital, clinic, surgery center, or other organization that has gone through some type of review, such as that provided by The Joint Commission. It advises them to participate in all decisions about their treatment.
The Speak Up program has launched 18 campaigns, and they are all available, without cost, on our website (www.jointcommission.org/speakup.aspx). The artwork for each campaign is available on our website and ready to be printed. The back panel of the brochure for each campaign is blank. That allows organizations to include their own logos and talk about their efforts in that particular area. At a nominal fee, we provide the brochures, containing each campaign message, to those who choose not to download and print them.
The Joint Commission accredits more than 19,000 organizations, and every time we launch a new campaign we provide the materials to all of our accredited organizations. They use them at health fairs, include the information in their patient education materials, or use them when they are talking to the media or in public service announcements. There are very few restrictions on how the material can be used. We also provide the information to church groups, advocacy groups, pharmaceutical companies, and anyone else who is interested. It is available in both English and Spanish. Joint Commission International, which accredits healthcare programs around the world, also distributes the Speak Up materials.
We have done a great deal of research on the reach of the campaigns, and the results have been very positive. We also keep the material at a fifth-grade reading level. We recently sent the brochure for our breastfeeding campaign (it was launched on August 1, 2011 to coincide with World Breastfeeding Week) to one of our expert groups, and they rewrote it at the 10th-grade level. However, we kept it at the fifth-grade reading level recognizing that we will not reach the general public if we write the information at too high of a level.
The campaigns that we have launched so far include how to avoid mistakes in surgery, steps to prevent infection, avoiding mistakes with medicines, getting proper follow-up care, patient's rights, medical test mistakes, understanding doctors and caregivers, what to know about pain management, child care, managing diabetes, reducing the risk of falling, and proper care in kidney dialysis. We have many others in the works. We try to release two to three each year. We even have Speak Up buttons for healthcare professionals who want to use them, and they are great because they say to the patient, “If you have any questions, please speak up." It is a wonderful invitation.
The groups with which we are collaborating on the breastfeeding campaign include the Academy of Breastfeeding Medicine, American Academy of Pediatrics, Association of Women's Health, Obstetric and Neonatal Nurses, Baby-Friendly USA, Centers for Disease Control and Prevention, March of Dimes, and United States Breastfeeding Committee.
The campaign emphasizes that one of the most important things a mother will decide is how to feed her baby and that for most babies, breastfeeding is the best option. The campaign encourages mothers to learn about breastfeeding before their baby is born—to go online, read books, take a class, and talk with other mothers who have breastfed. It encourages them to get the support of their partners and to check with local hospitals to find out what neonatal and nursing support they offer and to speak up and ask questions about breastfeeding before giving birth, during their hospital stay after delivery, and after going home. It encourages them to ask their doctor about birthing options and how each option affects breastfeeding and to tell their nurses and doctors that they want skin-to-skin contact with their baby immediately after giving birth, want to room-in with the baby to recognize early feeding cues, want to breastfeed as soon as possible after delivery, and want any tests and procedures to be performed after the first feeding.
In my own particular case, I was fortunate to have had a cesarean section because it meant I was in the hospital for a week, and every nurse that came in had another little tip or cue about breastfeeding, which was wonderful. It is difficult for mothers, especially first-time moms, who come into the hospital to deliver and leave 24 hours later. If they don't have that support, it is often very difficult for them.
The campaign advises mothers to spend a lot of time resting and breastfeeding, stay close to the baby, call the hospital lactation consultant or a support group for advice if problems arise after leaving the hospital, and to keep breastfeeding even when the mom might get sick. They can safely breastfeed even if they are taking most medicines.
Other key messages in the breastfeeding campaign are for mothers to ask that their baby has only breastmilk—no formula— and that the baby not be given a pacifier or bottle. It also encourages new mothers to have a nurse or lactation consultant watch them breastfeed several times before leaving the hospital, and it prompts them to ask questions actively and not assume that someone will come in and answer them.
We have often been asked by accredited organizations to develop Speak Up videos. In March 2011, we released our first video. Since then, we have released five more videos: “Prevent Errors in Your Care,” “Prevent the Spread of Infection,” “Take Medication Safely,” “At the Doctor's Office,” “Kid Power,” and “Reduce the Risk of Falling.” They are animated, 60-second public service announcements. They are available on YouTube, and to date we have had more than 25,000 downloads. The videos are also available on our website so anyone can download them. Nearly 3,000 of our accredited organizations have already downloaded them for closed-circuit television. They also are available in Spanish.
We have received many comments from our accredited healthcare organizations about topics they believe are important for us to address, and these first six videos reflect that. Our plan is to produce a few more videos next year.
The characters in the videos encounter everyday situations. In our first video, a woman is at the bakery picking up a birthday cake. She opens the box and sees that the cake says "Happy Birthday Becky," she says, “That's not my son's name. It's Andrew,” and she speaks up and tells the bakery clerk, "This is not the right cake." In another video, a gentleman is at a French restaurant with his date and asks for soupe de poisson, saying “that sounds wonderful." But then he suddenly realizes, "I'd better ask what that is because I really don't know." When he finds out that it is fish head soup, he says, “That's not what I wanted so I'm really glad that I spoke up and asked."
The message is that when it comes to our well-being and healthcare, we need to ask questions. When we are talking to our doctor, we need to ask about X-rays and about our medicine and about our treatment. We have the right to ask, and that is what our Speak Up program is all about.
The Speak Up campaigns have received widespread media coverage. They have been featured in USA Today, The New York Times, and other major consumer media, and we are therefore very hopeful that the breastfeeding campaign will receive the same publicity.
The Speak Up videos are now running in 12,000 physician offices through AccentHealth, and they are also running on the GetWellNetwork, LodgeNet Healthcare, The Wellness Network, and other similar outlets. We are reaching out to these organizations to ask them to share the videos on their systems and networks with hospitals. I think that is what sets The Joint Commission a little bit apart. We work directly with healthcare organizations every day, including 80% of the hospitals in this country. Nearly 70% have used the Speak Up information we produce.
In the future, we plan to do a Speak Up video on breastfeeding because we believe it would be a great topic.
Footnotes
Disclosure Statement
No competing financial interests exist.