Health Education: The “Education Box” of the Fondazione Policlinico Universitario Campus Bio-Medico

Abstract

Clinical education, traditionally linked to university training in health care, has found a new declination at the Fondazione Policlinico Universitario Campus Bio-Medico (FPUCBM) through a free public service aimed at patients, family members, and caregivers. This innovative approach aims to improve health self-management, promote empowerment, and foster the active involvement of patients in their own care pathway. Based on high-quality and safety certified standards (by the Joint Commission International), FPUCBM has launched structured initiatives such as “education box” events to provide clear and accessible information, addressing patients’ educational and emotional needs. The “health education service” integrates several activities, including single-topic educational events, the creation of information materials (brochures and video tutorials), and collaboration with patient associations. Since its launch in 2023, the service has reached more than 400 participants in 22 events, covering topics such as chronic disease management and prevention and the proper use of home devices. In total, 95 information brochures and 9 video tutorials have been produced to expand the available resources. Benefits include improved health awareness, increased confidence in care pathways, and a positive impact on the hospital’s reputation. In conclusion, it represents a replicable model of person-centered health care that combines human care and educational support to promote more effective and informed disease management while improving the overall patient experience.

1. Introduction

The literature definition of “Clinical Education” often refers to the field of university healthcare education. It may be used in the fields of nursing [1], veterinary medicine [2], medicine [3,4], dentistry [5], or physiotherapy [6].

Instead, at the Fondazione Policlinico Universitario Campus Bio-Medico (FPUCBM), we thought of modifying this classic form of clinical education by creating a free public service dedicated to it (for patients, family members, and caregivers).

In fact, the FPUCBM, as a Joint Commission International-accredited hospital, guarantees high standards of quality and safety in care, with a commitment to human and patient-centered care, by promoting a positive relationship with patients, family members, and caregivers.

It is known that clinical education brings economic benefits; Stenberg et al. [7], in a review of 4693 articles, highlighted an excellent return in terms of hospital admissions, emergency room visits, and outpatient visits.

In fact, living with a disease (or managing home devices) is a complex, dynamic, cyclical experience and is a multidimensional process [8,9]; moreover, to manage their disease and take responsibility for their health, people need knowledge and skills [10].

Finding the best disease management strategy is critical to effectively address the increased number of patients and rising costs related to health care [10]; therefore, more attention should be paid to support interventions for the correct self-management of one’s health [11].

Over the years, a growing number of interventions aimed at supporting self-management—through knowledge transfer, disease management, adaptation to changing conditions, and maintenance of quality of life—have emerged, commonly referred to as “patient education” or clinical self-management interventions.

“Health education” and “digital health education” offer knowledge or skills about health and health care in a timely and cost-effective manner by using all kinds of information and communication technologies (computer-assisted learning, mobile learning, and digital simulation-based learning), which are increasingly important in disease prevention and management [12,13].

Health education has always been a fundamental part of clinical activity, often implemented, in an unstructured way, by different health professionals with whom the patient (or caregiver) came into contact (doctors, nurses, physiotherapists, etc.).

A structured system of ‘‘health education” began to spread in America as early as 1969.

The United Hospitals [14] were already involved and committed to providing ‘‘health education” services to their patients, initially focusing on people with diabetes; by the 1970s, their hospital staff were offering formalized ‘‘health education” as a routine part of care for inpatients and outpatients with diabetes, various forms of heart disease, and chronic obstructive pulmonary disease.

A 1990s Loevinsohn review [15] studied the ‘‘health education” interventions in developing countries.

In 2020, a review of studies published in PubMed, CINAHL, Embase, and Cochrane between 2002 and 2017 on 416 selected articles [16] highlighted that patient education adds to health literacy, further empowering patients to use information in a positive and productive way to change some dysfunctional behaviors [17,18].

Andrews-Cooper [16] identified different forms of educational interventions:

(1)

Individual patient education: consists of sharing information, activities, and coping skills adapted to each patient’s pain experience [19];

(2)

Therapeutic education: this is a type of education provided to assist patients in learning and developing various skills to facilitate healthy behaviors [17,20,21];

(3)

Self-management education: interventions that are specifically aimed at patient education and behavior modification [17,22,23,24].

To these forms of education sometimes the following are added:

(1)

Home education: patient education in the independent use of health devices (VAC—Vacuum-Assisted Closure, the proper management of drains; the Holter pressor; home polysomnography; etc.);

(2)

Caregiver education (for geriatric patients, cancer patients, patients with disabilities, etc.);

(3)

Education in small and/or large groups (before surgery or post-surgery, e.g., for hip or bariatric surgery).

In some cases, this concept is expanded to include clinical information relating to individual informed consents for specific invasive procedures [25], for example, information notes attached to the consent form [26]; explanatory videos of the procedures [27,28]; and video tutorials and brochures for preparation for procedures [29,30], post-procedures [31,32], or outpatient [33] or pre-diagnostic procedures [34].

In the specific case history, the “education box” events (EB) were used to reach patients, family members, and caregivers (as well as other healthcare professionals interested) on the topics of ‘‘health education”.

We started from the idea that patients are overwhelmed from digital (dis)information and now like to have “in-person” information; in fact, the proliferation of digital health resources is evident [35]—a 2020 U.S. survey revealed that 80 % of adults utilize online platforms for medical inquiries [36]. However, significant variability in content quality and inadequate adaptation to diverse health literacy levels remain critical concerns [37].

This article, therefore, aims to show how a simple organizational model can contribute to promoting ‘‘health education” in a territory such as Rome (Italy) in order to make this form of ‘‘health education” easily replicable in other hospitals worldwide.

2. Materials and Methods

The Fondazione Policlinico Universitario Campus Bio-Medico is a Joint Commission International-accredited hospital with approximately 300 beds; in July 2023, the FPUCBM established the “health education service” as a strategic support to clinical care.

The Fondazione Policlinico Universitario Campus Bio-Medico implements ‘‘health education” primarily in four specific areas:

(1)

The design, creation, and distribution of informative brochures (pre/post-procedure).

(2)

The review and formatting of patients’ informative notes (to be attached to standard informed consent forms).

(3)

The development, production, and dissemination of clinical tutorial videos (e.g., the home management of drains).

(4)

“Education box” events (focused on specific healthcare topics).

In September 2023, the ’‘health education service”, according to the Top Management of FPUCBM, developed the education box events (EB) as a high-quality process improvement initiative. EB are free and open to patients as “single events” that aim to train patients, caregivers, and family members (but also healthcare workers) in healthcare dynamics.

The FPUCBM created them to offer citizens a space for training, information, and support in the field of health and care management. They are a point of reference for patients, family members, and caregivers, where can use them to find practical resources and useful insights to face their care path with awareness.

The EB objectives focus on the following areas (Figure 1):

The FPUCBM also implemented the ‘‘health education” service to achieve the following goals:

• Modify the classic form of clinical education by creating a free public service dedicated to patients, family members, and caregivers.
• Patient engagement: foster an “active patient” model within the care pathway, in alignment with the national plan for chronic diseases [38], promoting a culture of shared decision-making.
• Empowerment through education: address patients’ needs for scientific knowledge, emotional support, and social connection, reducing fear and isolation. Proactively and accessibly provide information to prevent doubts and uncertainties.
• Community and networking: establish collaborations with patient associations and disease-specific organizations to create specialized resources and expand the reach of information and support.
• The creation and distribution of informational materials: develop brochures, video tutorials, and informative notes linked to consent forms.
• The creation of a physical interrelational space: provide a welcoming physical environment (distinct from a cold medical office or a crowded inpatient ward) where healthcare professionals can meet with patients’ families or caregivers. This service acts as a space for reception and information, located on the second floor of the foundation, where patients and families can receive reliable information and support to better understand the care provided.
• The promotion of a culture of active patient involvement in therapeutic decisions: advocate for active participation by patients in their treatment decisions.
• Enhance patient education and clinical support, addressing the need for clear and accessible information that fosters awareness and confidence in the care journey.
• Engage 30 patients/family members/caregivers per event.
• Encouraging empathetic and transparent healthcare: deliver healthcare that addresses the informational and emotional needs of patients and their families with empathy and transparency.

3. Implementations

The main activities carried out by the ‘‘health education” service include:

• Educational box events: sessions led by healthcare specialists on topics such as chronic disease management, device handling, prevention strategies, and innovative treatments.
• Information hub: a physical space staffed by FPUCBM volunteers, available to address patient questions and distribute educational brochures and video tutorials.
• Digital access: QR codes linked to a dedicated section of the institutional website, where patients can access infographics and instructional videos.
• Collaboration with associations: working with patient associations to review content included in information notes or information booklets to improve communication quality and the effectiveness of ‘‘health education”.

Lastly, the “education box”:

• Aligns with the principles of Health Technology Assessment (HTA), promoting patient participation in the evaluation of healthcare technologies and ensuring that their needs and preferences are taken into account.
• Contributes to the collection of Patient-Reported Outcomes (PROs), i.e., data on patients’ experiences, which are essential for assessing the effectiveness and impact of care.
• Promotes an approach based on the assessment of the benefits and risks (efficacy and safety) of treatments.
• Promotes integrated care: integrated care models have the potential to improve quality of life, self-care, adherence to medical and mental health treatments, and both mental and physical disease outcomes [39].

The ‘‘health education” service also meets the Joint Commission International (JCI) standards outlined in chapter PCC.04.00 (patient-centered care) [40]:

• Hospital education plans are based on the care, treatments, and services provided, as well as the needs of the patient population.
• The hospital has a program for patient education in all departments, which includes:

  ○

  Supervision by one or more qualified clinical staff member.

  ○

  Access to educational resources tailored to the care, treatments, and services provided and the needs of the patient population.

• Patient and family education is developed and delivered collaboratively by interdisciplinary staff members.
• The clinical staff providing the education have the subject matter knowledge and communication skills necessary to do so effectively.

4. Outcomes

The FPUCBM is a Joint Commission International-accredited hospital; we have to guarantee high standards of quality and safety in care, with a commitment to human and patient-centered care, by promoting a positive relationship with patients, family members, and caregivers.

The ‘‘health education” service has a physical space (run by volunteers) in which patients/caregivers and families can ask about hospital services and ‘‘health education” (Figure 2).

4.1. Educational Brochures

The ‘‘health education” service currently includes 95 informative brochures covering pre-operative and post-operative instructions; the home use of medical devices; prevention guidelines; as well as information for internal staff (e.g., the proper use of outpatient clinics, compliance for sending samples to virology, available diets, and correct transfusion procedures), for a total of 9 brochures (

Table 1. Informative brochures.

Target	N°
Public	86
Internal staff	9
Tot	95

).

The health information literature [41] suggests that written education materials are used to refresh a person’s memory post dietetic consultation [42], provide additional information to increase knowledge to self-manage a patient’s condition [42,43], prevent misinformation and recall bias [44,45,46], and enable the provision of standardized information with which consumers can make health decisions [47].

All these booklets are available to patients, visitors, caregivers, and family members, free of charge, on the hospital website (https://www.policlinicocampusbiomedico.it/informazioni-utili/opuscoli-e-video-informativi, accessed on 21 May 2025).

4.2. Patient Information Notes

With the resolution issued by the Italian’s Lazio region, titled “Guidelines On Informed Consent” (G00642 dated 25 January 2022), hospitals operating within the Lazio region in Italy are mandated to standardize their system for collecting informed consent. Each informed consent form must be accompanied by a specific information note tailored to the procedure and the patient undergoing it.

Furthermore, since the Fondazione Policlinico Universitario Campus Bio-Medico (FPUCBM) is a Joint Commission International-accredited hospital [40], it must adhere to international standards (PCC 03.00—patient-centered care) for effective communication of informed consent. These standards require that the following information be communicated to the patient (presented as textual/visual sections within the information notes):

• Name of the hospital;
• Name of the test, procedure, or treatment covered by the informed consent;
• Name of the responsible practitioner(s) performing the procedures(s);
• Signature of the patient or designee if the hospital or laws and regulations require a signed consent form;
• Date and time consent is granted by the patient;
• Statement that the procedure was explained to the patient or designee, including benefits, risks, and alternatives;
• The likelihood of success, potential complications, the recovery process, and the possible results of nontreatment;
• The name, signature, and role of the person who explained the procedure to the patient or surrogate.

A non-standardized process is currently in place, whereby certain information notes are reviewed (for potential improvements) by patient associations. These associations may suggest modifications to enhance the notes’ clarity and usefulness for patients.

At present, the documentation list includes 163 codified information notes, and they are available to patients in the hospital website (https://www.policlinicocampusbiomedico.it/opuscoli-e-video-informativi/consensi-e-note-informative accessed on 21 May 2025).

4.3. Video Tutorial

With the recent experience of COVID-19, we were compelled to devise a “remote” system to educate patients and assist them at home, thereby avoiding unnecessary visits to healthcare facilities.

To achieve this goal, we collaborated with professional cameramen to produce several tutorial videos on topics such as the home management of surgical drains, VAC therapy, and more; we also discovered that some physicians use videos produced by their “scientific societies” as an effective format to deliver visual information to patients, enhancing their engagement.

The number of tutorial videos currently in use is nine, and they are available to patients on the hospital website (https://www.policlinicocampusbiomedico.it/opuscoli-e-video-informativi/gestione-dei-drenaggi accessed on 21 May 2025).

4.4. Education Box Events

From September 2023, we are piloting educational/information meetings led by our healthcare professionals to gather insights from patients and healthcare professionals. These experiences are fundamental to continuously improve the quality of our care approach.

“Education box” events allow us to listen directly to those who follow the treatment path, perfecting both the information materials and the treatment processes.

If we see this feedback through the lens of those experiencing treatment and care pathways, it is essential to provide increasingly person-centered care.

Through the “education box” initiative, we prioritize patients’ needs and concerns, supporting them at every stage of treatment. This humane, personalized approach fosters a more informed and peaceful patient experience, creating a care environment where people feel listened to and respected.

Each event focuses on a single topic and is divided into two phases:

(1)

An educational session: led by a healthcare professional (e.g., a doctor, nurse, nutritionist, or psychologist), this phase provides detailed information about the disease, treatment, or care pathway relevant to the theme of the event.

(2)

An interactive session: this phase is dedicated to listening to the questions, doubts, and concerns raised by patients, families, and healthcare professionals present.

In 2024, we conducted 22 educational events, covering a wide range of topics (

Table 2. 2024’s “education box” events.

Education Box Events in the 2024

(1) Management of complex wounds (2) Correct management of epileptic seizures (3) Regaining balance after chemotherapy (4) Know and rehabilitate the pelvic floor (5) Eye diseases (6) Obstructive sleep apnea: stopping “the silent killer” (7) Colorectal cancer awareness (8) Parkinson’s disease: practical advice for patient management (9) Healthy lifestyles to combat metabolic syndrome (10) Systemic lupus erythematosus (11) Dysphagia: prevention and management of swallowing disorders (12) Use of sunscreen and sunburn prevention (13) Life-saving maneuvers (14) Obesity and bariatric surgery (15) Diabesity: change your habits and find your health “suit” (16) The wig bank (17) Emotions and chronic diseases: taking care of the person, mind, and body (18) The elderly as a resource: day centers for Alzheimer’s patients (19) Gynecological disease prevention (20) Prevention of breast disease (21) Menopause nutrition (22) World Heart Day

).

These 22 events involved over 400 participants, including patients, visitors, caregivers, and healthcare personnel, who participated without prior registration.

Furthermore, as an unexpected result, we obtained more than 40 positive reviews on Google (related to the events), which contribute to improving the corporate reputation, but also some spontaneous thanks (Figure 3):

“I had the opportunity to say it in person that day: you are extraordinary in the way, in the location and in exposing the contents. Unfortunately, you are the only ones who organize events of this kind with the “hunger” for information that all of us users of the health service have. Congratulations, keep it up!”

5. Discussion

Although more than 400 people were involved, we have not yet implemented a system to evaluate the effectiveness of the training provided; this is an important limit of our case history because we do not have a standardized feedback process to evaluate the effectiveness of the training impact.

One of our next steps is to establish a standardized evaluation system not only to assess the quality of the event but also to measure its impact on participants.

During the events, we encountered a recurring issue: participants attempting to seek clinical advice (such as a private consultation).

To meet the needs of the Italian territory, we will move to create new events not only in the hospital headquarters but also in other locations and in collaboration with other institutions, always maintaining “free” access and the format followed up to now (a small oral presentation by health workers—about 20 min—and the rest of the time dedicated to questions/answers with patients, family members, and caregivers).

It is also important to note that we are also seeing positive effects in terms of the impact on doctors and healthcare personnel. So, we can distinguish three aspects of future improvement: (1) participants, (2) healthcare professionals, and (3) clinical research.

(1)

The improved acquisition of useful feedback from participants. The evaluation of the impact of training: the objective is to develop a digital system for assessing both the effectiveness and the quality of the training provided.

(2)

Healthcare professionals. Optimize physicians’ time: the goal is to free up valuable time for physicians, enabling them to focus more on fostering meaningful connections with patients during consultations. By offering clear guidance to informational resources, such as directing patients to a dedicated box or its digital content, physicians can ensure that patients have access to video tutorials and educational materials. These resources allow patients to deepen their understanding of their condition and revisit the explanations provided by the physician at their convenience. This approach empowers physicians to prioritize the relational aspects of care while maintaining the quality and accessibility of the information delivered.

(3)

Clinical research. Enhancing awareness of clinical trials: the objective is to improve patients’ understanding and awareness of clinical trials by ensuring they are provided with all essential information, including any details they may have overlooked or forgotten to inquire about during their consultation. By offering accessible resources that support patients in comprehending their involvement, this initiative seeks to reduce clinical trial dropout rates, fostering a sense of confidence and support throughout their therapeutic journey.

6. Conclusions

The ’‘health education service” of the Fondazione Policlinico Universitario Campus Bio-Medico represents an innovative and strategic initiative aimed not only at improving the quality of care but also at enhancing the empowerment of patients and caregivers. The results achieved so far, both in terms of participation and positive feedback, highlight the value of an integrated and personalized approach to ‘‘health education”. However, to maximize the educational impact and ensure long-term sustainability, it is crucial to implement standardized evaluation tools to measure the effectiveness of educational interventions and their long-term effects on patients’ quality of life and healthcare cost reduction. Furthermore, expanding digital content, optimizing physicians’ time, and improving support for patients involved in clinical trials are promising directions for the future. Ultimately, the ‘‘health education” service stands out as a replicable model that combines a person-centered approach with innovation, laying the foundation for healthcare that is increasingly humane, informed, and effective.