Improving out-patient care through participation: the Newark experiment in staff and patient involvement

Several studies have confirmed that well-organized health services and vital health information are critical in insuring that consumers utilize health services and practice preventive health habits adequately. Inaccessibility actively discourages the consumer while the lack of on-going health education activities limits his ability to practice life-promoting health habits. Recent work of the Health Education Project (HEP) at the College of Medicine and Dentistry of New Jersey in Newark, has demonstrated tangible ways of eliminating some of the barriers that limit consumers in receiving health services in an out-patient setting. Redesigning the health services in ways that reflect consumer and provider needs and involving the staff and consumers in this process has been a dominant aim of the project which has resulted in the elimination of unnecessary laboratory work, improved coordination of human resources, and increased staff and patient morale. Health education activities are now integrated into the clinic routines as a result of structural changes in outpatient procedures. The work of HEP has been focused on multi-racial, inner-city health problems. Nonetheless, its findings in terms of how to deal with organizational aspects of delivering health services and ways to develop comprehensive health education activities should be of use to health providers and consumers in many other settings. The second part of the paper deals with special aspect of the project, namely, the development of low-cost, community oriented videotapes which are used regularly both in the outpatient department and in various community settings as a teaching tool for providing consumers with critical health information. Tailored to specific teaching objectives and interwoven into health education discussion groups, the videotapes use recognizable local settings and residents to stress the relevance and importance of controlling and taking charge of one's health care. Among the outcomes of the use of these videotapes have been increased demands by consumers for physician continuity, information concerning medication and laboratory tests, and, in general, more information about how to stay healthy.