I am an adult literacy tutor and trainer. I am also a nurse with over  
thirty years of experience in critical care, now in supervision. I  
volunteered for our health organization's committee on health  
literacy issues two years ago.

We are presently trying to convert all our in-house patient  
information material to a "plain language" equivalent. When the print  
material is due to go back to the author for review and revision, we  
let them know our new goals for that material. The goals include  
plain language, lots of white space, etc. The material is reviewed  
for compliance before being re-released to the organization.

What I see is the clinician concerned about WHAT information needs to  
be presented. He/she presents in the most efficient (to them) format,  
which often includes the medical jargon that we are all comfortable  
with and use on a daily basis. It is when the patient gets to the  
hospital that the staff finds the gaps in understanding that are  
usually the reason for re-admission. This is when the HOW is finally  
addressed.

What I try to keep front and center in our discussions is that about  
one-third of our population is, for various reasons, not functionally  
literate. If we aim to that population with our information, then the  
stressed more-literate population can only benefit by information  
clearly presented.

In order to accomplish this, we must recognize and respect the  
knowledge and expertise on all sides. We cannot gather and  
disseminate clear, accurate information without cooperation from all.

Laurie Anson