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How to Write a Letter to the Editor - Institute for Healthcare

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How to Write a Letter to the Editor: Turning Passion into Action
by Jay Bhatt, DO, student in Harvard Kennedy School's MPA program
Updated July 15, 2009
These days, the media are full of discussions about health care reform. Writing letters to the editor can be an effective way of sharing your opinion and inspiring others to take action. The Institute for Healthcare Improvement (IHI) Open School has the potential to change the way the next generation of health care providers takes care of patients and improve how our healthcare system works. Letters to the editor are an important way we can spread the word about the IHI Open School and raise awareness about a particular quality improvement or patient safety issue. Politicians and policy makers look to the letters to the editor to gauge the views of their constituents. Organizations often take action on issues facing the community that were initially brought to light by a letter to the editor. Newspapers and other media receive many more letters than they have room to publish. Try submitting a letter to your local paper, where the chances that your letter will be published are better. Make sure that your letter is concise, makes one simple point or deals with one basic issue, and follows the policies set forth by the media outlet. That way, you strengthen the chances of seeing your letter in print and inspiring others to take action on your issue. This document contains the following: - general guidelines for composing a letter to the editor, - a template letter to the editor, and - sample letters for journals and newspapers. General guidelines for composing a letter to the editor
* Put your full first and last name, address, phone and/or fax numbers (day and evening), and e-mail address at the top of the letter. Most publications will want to call the writer to confirm that you are using your correct name - not a phony name - and that you did in fact write the letter. * If you are referring to a previously published letter, news story, or column, identify it by its headline and the date it was published (Re: Davenport grinds out a win, Aug. 17). This enables the editor to quickly check the original item to verify any references you have made to it (i.e. quotes, statistics, etc.). * After you have written your letter, simply cut and paste it in an email. Most newspapers will not open attachments as they may contain viruses. * Keep your letter short and to the point-one or two brief paragraphs. * Stick to only one central point; don't jump around to many different issues (unless the point of your letter is to connect the issues for the public).
* Refer to an article in a recent issue or a set of articles in previous issues. This shows that you're engaged and improves the chance of publication.
* Start with a catchy statement. * Keep your letter on an 8th grade reading level. * Conclude by briefly reiterating your argument.
* Use facts, figures, and expert testimony whenever possible. * Don't be rude or abusive, and don't personally attack anyone. * Find your issue's local connection; for example, point out your legislator's position or that local citizens are working on this issue. * If your letter targets a legislator/company/group, you may want to send a copy of your published letter to the person or agency you are writing about. * If your letter does not get printed the first time, don't give up. You can even re-send a letter you sent before, provided you make it relevant to a more recent issue.
A single letter in a newspaper with even a small circulation may be the difference between someone doing nothing and doing something, so turn your passion into action.
Most newspapers prefer letters to the editor with 250 words or less. Check your local paper for specific word-count guidelines. The more localized and personalized the letter, the more likely it is to get printed. Use the example below as a template. To the Editor:
RE: "Title of related article that appeared in paper, date it was printed"
Government Reports Criticize Health Care System, 5/6/09
Errors and quality deficits contribute to nearly 100,000 deaths in this country a year. [Use any of the statistics provided in the flyer or the presentation found on the IHI website.] According to Mr. Sack, two recent government reports showed that progress in improving quality of health care and narrowing health disparities among ethnic groups remains slow, and that patient safety may be actually declining. Mr. Sack argues that even though there has been some progress, the health care system is not closing the quality chasm that persists. According to the report, one out of every seven hospitalized adults on Medicare experienced at least one adverse event.
[Include personal experience here.] Increasing data suggests [can use reference here] that health professions students are not taught the principles of quality improvement and patient safety early in their training. The Institute for Healthcare Improvement (IHI) Open School exists to change that. Its goal is to empower the next generation of health care providers to be change agents in improving quality and patient safety. We're talking about skills like quality improvement, patient safety, teamwork, leadership, and patient-centered care. More and more students are committed to bringing innovative approaches to their institutions to engaging students in quality improvement and patient safety. A new generation of health care providers, equipped with essential skills in quality and patient safety, is the key to better care for our patients. Your Name
Organizational Affiliation (if any)
City, State, Date
Sample Letter to the Editor of a Journal
Many journals specify on their websites what sorts of opinion pieces they're seeking - it's always worthwhile to check. For the example below, the journal in question is seeking "succinct, thoughtful commentary, both concise and well-crafted; at most include one or two points about the article. The findings of the study need not be summarized; provide only a sentence or two of introduction and background to set the context."
Am J Psychiatry 166:372, March 2009
doi: 10.1176/appi.ajp.2008.08111665
Quality Improvement in Healthcare: The Six Ps of Root-Cause Analysis
Boston, Mass. To the Editor: In the October 2008 issue of the Journal, Geetha Jayaram, M.D., M.B.A. and Patrick Triplett, M.D. (1) presented a thoughtful review of a case in which the suboptimal clinical outcome had multiple underlying causes. In their Clinical Case Conference, Drs. Jayaram and Triplett highlighted the need for "a comprehensive understanding of personal and systematic factors that impact the quality of care delivered" (1, p. 1260) within the emergency psychiatric setting, particularly in the evaluation of patient safety events. To this end, I have developed a simple mnemonic, "the six Ps," to prompt a thorough assessment of the contributing factors associated with an adverse clinical outcome. This model is an adaptation of the approach to root-cause analysis described in the widely used London Protocol for the investigation and analysis of clinical incidents (2). The six Ps represent the six perspectives needed to answer the question, "Why did this event happen?" They are as follows: 1) Patient: What are the patient-related factors that may have contributed to the event? Was the patient impulsive, violent, or cognitively impaired? Was he or she intoxicated or in withdrawal? Were there language barriers that limited effective communication? The goal is not to blame the patient but rather to identify risk factors that may predispose similar future patients to the same outcome. 2) Personnel: What are the personnel or staff-related factors that may have contributed to the event? Did they have the appropriate knowledge and skills to care for the patient in this setting? What degree of supervision was present? Was an impaired clinician involved? It is important to think beyond "bad apples" or blame in order to consider the mechanisms by which good people can create less than optimal results. 3) Policies: Are there written policies for this type of event? Are they accessible and known throughout the organization? Were the policies followed? If not, why not? 4) Procedures: Are there standard procedures that should be used in handling this type of clinical scenario? Were there deviations from this standard approach in this case? If so, why? 5) Place: Were there workplace environmental factors that may have contributed to this event? Is there an appropriate degree of staffing for the clinical volume? Does the physical layout of the environment contribute to consistent and safe care or its inverse? 6) Politics: What broader institutional or outside factors may have played a role in the event? What are the interdepartmental dynamics? Are there recent regulations that have led to a shift in care? Think about recent events, both within and outside of the institution. As noted by Drs. Jayaram and Triplett, lapses and barriers to high-quality care are unfortunately common in healthcare settings. It is through the approaches that they described as well as the systematic application of tools such as the six Ps that front-line clinicians can begin to improve the care we provide in all mental healthcare settings. Footnotes
The author reports no competing interests. This letter (doi: 10.1176/appi.ajp.2008.08111665) was accepted for publication in December 2008. References
1. Jayaram G, Triplett P: Quality improvement of psychiatric care: challenges of emergency psychiatry. Am J Psychiatry 2008; 165:1256-1260[Free Full Text]
2. Vincent C, Taylor-Adams S, Chapman E, Hewett D, Prior S, Strange P, Tizzard A: How to investigate and analyze clinical incidents: clinical risk unit and association of litigation and risk management protocol. Br Med J 2000; 320:777-781[Free Full Text]
Sample Letter: Announcing an Event in the Local Newspaper
Topic: ___________ (Insert Date) _______________ (Insert Editor's Contact Information) To the Editor: By participating in the Institute for Healthcare Improvement (IHI) Open School, [ORGANIZATION NAME] is joining thousands of health care professional students across the world in renewing our commitment to continuous quality improvement in health care and improving the level of engagement of the next generation of health care providers. The IHI Open School is an inter-professional educational community giving students the skills they need to become change agents in health care.
Our organization is actively implementing Quality First with the goal of providing healthy, affordable and ethical aging services that people need, when they need them, in the place they call home. I encourage you to attend any of our public events or schedule a tour to learn more about how the IHI Open School is changing the culture of the next generation of health care professionals by engaging them in important issues of quality and safety.
Event Info
_______________ (Insert Organization Representative's Name)
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