Chapter 06: The Patient Education Office in the Eighties; Services Provided and Funding Challenges
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Description
Ms. Villejo notes in this Chapter that, at MD Anderson, “everyone is a patient educator.” She covers the process of integrating educational content from different sources. She also explains a major challenge: the Patient Education Office must secure its own funding for educational materials.
Identifier
VillejoL_01_20150507_C06
Publication Date
5-7-2015
City
Houston, Texas
Interview Session
Louise Villejo, MPH, MCHES, Oral History Interview, May 07, 2015
Topics Covered
The University of Texas MD Anderson Cancer Center - An Institutional Unit; Joining MD Anderson; MD Anderson History; Institutional Mission and Values; MD Anderson Culture; Education; Information for Patients and the Public
Transcript
Tacey Ann Rosolowski, PhD:
So tell me more about what your role looked like in patient education when you arrived.
Louise Villejo, MPH, MCHES:
So I mentioned that they had started to develop these patient education committees in every disease site. So Thoracic, Head and Neck, Breast, Pediatrics. We all had several committees. It’s the same way now. Now we don’t have these huge monthly meetings with everybody on the team. Because everybody’s just so busy. We try to make sure that all the people that need to be involved in that particular program or project weigh in. But we definitely—I mean we have a lot of meetings here as you know, but we don’t have like we did at the beginning. So we had a monthly meeting, which we gathered everybody, and we did the needs assessment. And then we started working through what projects, what programs needed to be developed.
Tacey Ann Rosolowski, PhD:
So what was your role in all of this?
Louise Villejo, MPH, MCHES:
So facilitator. So you would go into an area and I’ll give you an example of one that we started. So went into the protective environment. They wanted to develop patient education. And protective environment was very different at that time. And they wanted to develop a program. So what I would do was I’d just have—because we had the whole interdisciplinary team there, each person would talk about what their role was in educating the patient. And I remember the head of the protective environment at that time, he just looked at me, and he goes, “Are you going to come in here and tell us what we need?” I said, “No, you’re going to tell me what you need.” And so it was good to get that straight right away. But so one of the first projects was to develop a brochure on what is the protective environment, what do you need to know, what the process is. I mean it just was very very detailed. And we also developed along with that a teaching plan. So each discipline was listed on the plan and what their part of the education was. So it was very well organized and everybody knew what their part was. Because I think one of the great things about MD Anderson is that it’s always been everybody is a patient educator, every discipline. And a lot of them obviously have that within their regulatory guidelines as far as what they need to do regarding patient education. So that’s how we would work. And we would do needs assessments with patients. We would do focus groups with patients. We would talk to all the different disciplines that worked in the area. We would get all that information together and then develop the teaching plans and the printed materials, videotapes, whatever was needed for the program. And then we had a plan of action as far as how it would roll out, because a lot of times we still have to talk to staff about this. Oh, we want this booklet, we want this video, we want this print piece. Well, how is that going to fit within the educational program, the clinical process? Because if you just develop this one piece out here with this one person, and it’s not integrated and valued by the rest of the team, if that person moves on, then how is it going to be used? It has to benefit in the patients’ experience. So we really try to help staff look at the big picture as far as the educational program and not just give everybody a piece of paper so you don’t have to talk about it. I know one time when I went to one of the funding groups here in the institution, and there were a number of community members and volunteers, and we were asking for funds for a video. And it was interesting to get their feedback. They said, “We really want to make sure that this is used and the clinical staff are talking to the patients, because we don’t want them just to put them in a room and have them watch the video and then that’s their teaching. We want it to be very interactive.” So they were very hesitant about giving funding for that video, because they were afraid that they were just going to get tossed that video and not have the interaction. What we really try to reinforce is that it’s a tool for the teaching, it’s not the teaching.
Tacey Ann Rosolowski, PhD:
Itself.
Louise Villejo, MPH, MCHES:
Yeah. It has to be a dynamic process. And that’s a reinforcement. Like when people come to learn about anything, wound catheter drainage, central venous catheter, whatever, they’re so overwhelmed. How much do they really hear when they’re in the class? Now central venous catheter, they have to do the mandatory return demonstration. But I can tell you, working here for thirty something years and then going through it with my mom, you don’t know what side is up and what side is down and what questions to ask. And I’m like oh, I know I read this, or I wrote this thirty years ago. But now I need it. Now I’m looking at it with different eyes.
Tacey Ann Rosolowski, PhD:
Absolutely.
Louise Villejo, MPH, MCHES:
So that’s the one thing that I know staff understand is that people don’t really hear everything that you’re telling them. So the materials that we develop are reinforcing when they get home to have available.
Tacey Ann Rosolowski, PhD:
Very interesting. What other dimensions of your role were present in that early job?
Louise Villejo, MPH, MCHES:
In the early job the other part of it was we had a corps of volunteers from the Junior League. So my job was to orient them to the institution and to their job. See if I remember. One was they were like nutrition aides, so they helped getting basic information from the nutritionist. I know we also had one volunteer that wrote our newsletter. Oh my God, if you would see that now, you would die, it was just really bad. (laughter) It was really bad. I mean because there was no computers or—I mean maybe at that time we had a computer, I don’t know. I mean I had to buy a computer for the office, and I didn’t know anything about computers. They didn’t have all the standardization and all this. So we had one computer sitting at the back of the room. And we had a sign-up sheet so that we could go and use the computer.
Tacey Ann Rosolowski, PhD:
Different days.
Louise Villejo, MPH, MCHES:
Yes. And we were all in one room. So we didn’t really have to have staff meetings because we could hear everything that everybody else was working on.
Tacey Ann Rosolowski, PhD:
How many staff members were there?
Louise Villejo, MPH, MCHES:
Well, there were three of us and then we were able to hire another health educator a few years after I started. So it was a very small group. The volunteers also helped us. So we had bulletin boards like you did in grade school. And we would go and change out the bulletin boards. Can’t even imagine that now. (laughter) We had literature racks throughout the institution. Back then NCI would send us huge boxes of anything that we needed. Now we can desperately even get fifty pieces, we’re just happy. It’s a whole different world. I think they’re going to stop printing actually.
Tacey Ann Rosolowski, PhD:
Wow.
Louise Villejo, MPH, MCHES:
But we had I mean tons and tons of boxes. And we’d have volunteers go and stock the literature racks around the organization. Trying to remember what else they did, but anyway so that was one of my—and then the Junior League also provided us funding for developing materials. So chemo guide, or immunotherapy guide, or videotape or whatever.
Tacey Ann Rosolowski, PhD:
What’s interesting to me, and I noticed as I was doing my background research that this continues to be the case—that a lot of your funding you have to seek out. I mean the burning question is why. I mean if this is such an essential function within the institution. So what’s your view of that?
Louise Villejo, MPH, MCHES:
Well, I think that back then we would charge the clinic for every card. So every card was five cents. Booklets were $1. I don’t remember exactly the amount. And then we would put it back into this account. And that was our revolving fund. So then we would put the money back in there and then we would print. But it was always a struggle because they did not want to pay out of their budget, and we didn’t have a budget. And so why is a good reason, we’ve made a couple of runs at getting additional funding, especially for videos. And we haven’t been successful yet but we have another idea we’re still trying. Because we’re asked to do at least four videos a year. And then the maintenance is a whole other issue. I mean we have videos online right now where people with mullets are talking. (laughter)
Tacey Ann Rosolowski, PhD:
Oh, right. Need to update.
Louise Villejo, MPH, MCHES:
As long as the clinical content is still good we’re going to keep it up there. Yeah, it looks old, but we just don’t have funds, because we have to do new. And so the management of it, we have over 200 videos now, and then we have over 3,000 documents. So as we’re developing more we still have to manage what is already developed. So we have been lucky to have some funding within the institution, but I think that really the clinical areas think that we have a pot of funds, which we don’t. So we do try to submit applications to places like holiday giving, VEPS. But they have a lot of requests so they have to weigh. Volunteers Endowment Program. We used to get more funding from the Children’s Art Project, but now they’re really focusing more on just the pediatric area.
Tacey Ann Rosolowski, PhD:
Really money is always a challenge and an unfunded mandate status is a tough one.
Louise Villejo, MPH, MCHES:
It is. Now it’s a lot easier with just printed sheets, because now that’s all free. We just put it up on the patient education online, and then they print it themselves when they need it. Now when Steve [Stuyck] was here, when he was our boss, there were some things, because we were very concerned about here we have these clinical trial booklets and these chemotherapy booklets, and they’re $5, $10 each, people don’t want to be purchasing them. And he said, “Just go ahead and take it out of your budget.” So we did. So probably seventy-five percent of our budget goes for printing materials for patients.
Tacey Ann Rosolowski, PhD:
I’m sorry. You said seventy-five percent?
Louise Villejo, MPH, MCHES:
Mm-hmm. Say seventy, yeah.
Tacey Ann Rosolowski, PhD:
Wow. Seventy percent. Wow. That’s incredible. Should we shift subjects just a little bit?
Louise Villejo, MPH, MCHES:
OK.
Recommended Citation
Villejo, Louise and Rosolowski, Tacey A. PhD, "Chapter 06: The Patient Education Office in the Eighties; Services Provided and Funding Challenges" (2015). Interview Chapters. 1521.
https://openworks.mdanderson.org/mchv_interviewchapters/1521
Conditions Governing Access
Open
