Often, nurse educators ask themselves how they can affect the bottom line of their organization. Education Services, within the Department of Nursing at the University of Minnesota Hospital and Clinic (UMHC), has positioned itself to be an active, visible participant in helping UMHC meet its financial challenges. We recognize that many UMHC nurses feel powerless to reduce health care costs and need more information about cost management in their practice. Education Services has taken on the task of educating staff about reducing costs at the bedside.
Newsletters are effective because of their readability and versatility (Mierzwa, Robinson, Lewis, & Saydak, 1989; Salome, 1985), and because nurses can read them on the run. In April 1989, the first issue of Dollars and Sense was distributed to patient care units throughout the hospital. Our mailing list now includes other hospital departments and has expanded to hospitals in other states as a result of presentations by UMHC nurses at the national level. Dollars and Sense serves as an effective vehicle to educate, support, and encourage staff in cost-conscious practices.
Support must come from those who have the responsibility of prioritizing and allocating resources within the department. It is also a very concrete and efficient way of promoting cooperation within and between departments. Typical cost of each newsletter is less than $300 for staff time and reproduction fees.
Creative people with a global view who are involved in broad-based hospital activities and committed to cost management are a necessity. Co-editors of Dollars and Sense share writing and editorial responsibilities. We generate most of our ideas during brainstorming sessions. Each brings individual strengths, perspective, and style to the creative process. The benefits of a team approach are mutual support and division of work.
A computer with appropriate software will help a great deal in preparing the newsletter. Word processing and desktop publishing programs are readily available and well worth the investment. Publication of a newsletter without a computer is possible if no other choice exists.
Title and Logo
The title and appearance of the newsletter deserve a great deal of consideration. Create a title that reflects the cost-awareness aspect of the publication. Try sponsoring a "Name the Newsletter" contest to involve staff, create excitement for the upcoming newsletter, and generate new ideas. We chose the title Dollars and Sense because it embodies the values we wish to promote.
Input for Articles
The most intimidating roadblock to getting started is the fear that there will not be any news fit to print. In order to minimize this problem, we do not publish on a rigid schedule. Each issue is started when enough information is collected.
Figure 1 describes the purposes of each Dollars and Sense feature.
Figure 2. December issues of Dollars and Sense present topics to the rhythm of holiday carols or poems.
Often, newsworthy information is obtained from contacts developed through involvement in hospital activities relating to supplies, equipment, and nursing practice. We also solicit our readers for their costcutting ideas and unit practices. Submitters are always recognized in the publication.
At first, Dollars and Sense related purely to quantifiable monetary savings or impact. We have expanded to other cost-related topics, without sole emphasis on dollar amounts. This shift has opened many new doors for creative educational ideas.
Features, Theme Issues, and Special Events
The establishment of regular features or use of theme issues has increased reader retention, participation, and familiarity. A "Dear Dollars and Sense" column provides a forum for reader/editor interaction on current cost-containment issues. "Money in the Bank" reveals success stories of savings realized by staff. Regular features also help to organize the newsletter. Figure 1 describes the purposes of each Dollars and Sense feature.
December issues of Dollars and Sense present topics to the rhythm of holiday carols or poems (Figure 2). Another successful theme issue coincided with the Academy Awards of 1992, when we presented costsaving ideas based on movie titles in our "Academy of Dollars and Sense." Figure 3 illustrates a portion of our awards issue.
Wording and Format
Ease of readership must be another consideration. The time nurses have to read newsletters is brief, so features must be short and easy to read. We use graphics and charts whenever possible to communicate with fewer words. We compared the reading ease level of Dollars and Sense to popular magazines designed to inform and entertain. For instance, Time Magazine is written at a lOth-grade reading level (Business & Professional Research Institute, 1986), while our first issue was written at the college level. Using shorter sentences and words brought the reading level down to the 10th to 12th-grade level.
In writing a newsletter about cost cutting, it is all too easy to point an accusing finger at wasteful practices. We make every attempt to be positive and reinforcing, rather than to shame or blame. We also try to anticipate the reaction of other departments to avoid stepping on toes. Appropriate use of humor can be an effective tool to soften the message. For example, we were having a problem with missing equipment. Instead of accusing our readers of carelessness, we asked them to solve the "Mysterious Medley of Missing Medical Merchandise."
These points are summarized in the sidebar, "Checklist for creating a newsletter."
The direction of a newsletter promoting cost awareness must be congruent with hospital philosophy. Our first issues were reviewed by the Director of Nursing and the Director of Education to guarantee consistency with departmental goals and sensitivity to other departments. Now we rely on self-censorship. The culture of an institution, as well as the "politics" of that environment, demand an editor's attention.
Figure 3. We presented cost-saving ideas based on movie titles in our "Academy of Dollars and Sense."
Checklist for Creating a Newsletter
Nursing educators have a distinct responsibility to create a learning environment that promotes judicious decision making by practitioners. We have found that a cost-containment newsletter is not only an effective and efficient educational strategy for promoting costeffective practice, but also provides an avenue for interdepartmental communication. Our initial objective of educating nursing staff has been met for less than 15 cents per person. Response from other departments and facilities indicates that the message of cost containment has been received beyond our primary target audience. Newsletters focusing on costs can help staff to be proactive about costs.
- Business & Professional Research Institute. (1986). How to write advertising copy, (pp. Ai- A3, A11). Princeton, N/; Author.
- Mierzwa, I.P., Robinson, J.A., Lewis, D.J., & Saydak, S.J. (1989). A newsletter: An innovative teaching strategy. Journal of Nursing Staff Development, 5, 238-242.
- Salome, PB. (1985). Developing a department newsletter. Journal of Nursing Administration, 15, 36-41.