Programs, Policies and Procedures

Once people learn one way to do things at work, it can be difficult to change habits. “That's the way we've always done it,” and “There's no time to do things that way,” can be the catch-phrases of complacency. Change doesn't have to be disruptive. Also, benefits that accrue days or even months after a change has been implemented are just as important as immediate payoffs.

Make Literacy Part of your Mission

Use the wording of your organization's mission statement to promote your commitment to literacy. How does literacy relate to your organization's goal of empowering people, increasing their ability to live independently or providing them with legal assistance? If literacy sensitivity is not mentioned specifically in your agency's list of goals, you may wish to expand your mission to include it. Then literacy awareness can form part of all your activities. It can be a routine part of program design, for the programs you now administer and for those you will add at some future date.

Even if literacy isn't part of your agency's mission, it can help to define the objectives of specific programs and projects and be part of the agency's overall operational objectives. Literacy concerns can be built into operating procedures at all levels of your agency's operations from client literature to volunteer promotion. Furthermore, literacy sensitivity is noticed by funding organizations who are always seeking evidence of agency impact and relevance in the community.

If your strategic plan calls for a communication plan, build in elements which will routinely screen promotional materials or monitor client intake procedures for literacy needs. If literacy is part of your program design to begin with, it will become second nature for staff and volunteers. Once agencies become sensitive to literacy needs, staff may, for example, make clients and customers aware of literacy training programs in the community. Then, if the demand for this kind of support grows, agencies might consider arranging to bring the literacy agency's services in house.

Each agency's response will depend on their clients' preferences. Some clients may want to take literacy training away from your agency because they would prefer to be “students” rather than “clients.”

The following suggestions may reflect the ways you already do business. Some of the ideas may be new. All are designed to enhance your organization's accessibility to people with low or no literacy skills.

We're Easy to Deal With

First impressions mean a lot. The procedures people face when they approach your organization for the first time can establish a relationship of trust or fear, depending on the literacy demands made on people. The attitudes of staff and volunteer personnel are very important factors in making people feel comfortable with their level of literacy and your services.

Yes, We're Interested

Like all of us, people with a literacy problem will accept assistance, if it is offered in a way that shows respect. Reception staff and counsellors who spend time explaining programs and procedures and offering assistance in the same way to all clients or customers are likely to hear honest admissions of people's limited abilities to read and write.

On the other hand, when people receive a form from someone who barely looks at them while reciting routine instructions, they are not likely to want to confide their problems. They are much more likely to disguise their inability to read or write, get help elsewhere or just leave, sometimes in sadness or anger.

The Plain Language Primer in this handbook has some suggestions on how to reduce the paperwork your agency provides to and demands of people who use your services. It also describes how you can write materials to be understood by people with low literacy skills. If you must greet people with a form, offer help with it and not only to those people you think might need help.

“Would you like me to fill that form out with you, or would you prefer to do it yourself?” can be the standard phrase you use, instead of “Do you need a pen?” If there is room, give people some privacy to complete the form on their own or to sit down with reception staff or a counsellor to do so. Put people, not paper, first.

Avoid Ten Dollar Words

Along with reducing literacy demands and showing their interest and care, reception staff can make people with low literacy skills feel comfortable by using language that is easy to understand. Hearing “There's a four- to six-day waiting period for professional staff to assess your eligibility — but they'll only do that if you've completed these forms properly and been referred by the appropriate agency,” isn't likely to make peoplc feel at ease.

The negative tone is a problem, but so is the use of ten-dollar words. If people are nervous when using your services for the first time, it may take some time for the information they hear to sink in. If it is hidden behind complicated, fancy language, your message may not get through.

The Ottawa Centretown Community Health Centre has made a commitment to letting people feel at ease when they approach the Centre, whether or not they can read and write. The Centre hired a Waiting Room Greeter who listens to patients' problems and concerns and offers information and guidance. In addition to providing literacy assistance when it is required, the Greeter offers information on social assistance including food, shelter, and clothing.

After the First Visit

Once the necessary forms are completed and a person is registered for an organization's services, the next information received from community agencies is often a letter. If your organization has been frustrated by a low rate of response on written follow-ups, it may be because many people cannot read your letters. Your follow up could include a telephone call as an alternative or supplement to a letter. However, you may find this too time-consuming to institute for everyone who uses your services. If so, you could take note of who seemed to have trouble with your forms or other literacy demands and telephone only them.

Staff who become aware of an individual's low literacy might use a discreet colour-coded sticker on the person's file to alert others to be sensitive to literacy concerns and use the telephone instead of letters for follow-ups. Also, if reception personnel complete the intake form for an individual, they could check a box on the form to indicate that the person appears to have low literacy skills. If you decide to do either of these things to identify people with low literacy skills, make sure the practice is not obvious. Staff must be especially careful to protect the privacy of the individuals involved. With this information, counsellors can be sure to offer the individuals alternative methods to written materials in individual program activities.

One organization issued business cards to people with low literacy skills, which they then handed to counsellors and others with whom they dealt in the agency, so that the personnel would avoid making excessive literacy demands. Clients appreciated the business-like, dignified approach of the cards.

Many things are literacy barriers. Every barrier removed improves your ability to work effectively with people who cannot read and write well. If you issue appointment cards to people, for example, take a look at how they are worded and how they appear to you. Are they filled with small print, advice on how to reschedule appointments if necessary, with room for a handscrawled date and time? Most of this information may be important, but can it be rewritten in plain language? Could a clock design and calendar be used to show the time and date of the person's next appointment?

The key to successfully introducing procedures and methods to identify clients with poor literacy skills and deal with their needs appropriately is personnel training. The next section of this handbook contains suggestions for sensitizing staff to people's literacy needs.

Alternatives to Writing

If your organization offers group workshops, you can accommodate participants' varying levels of reading and writing abilities by offering everyone an alternative. Instead of asking group members to write down their answers to questions, for example, people might be offered the choice of writing their responses or recording them.

When group members are to do self- directed study involving reading and some other means of information gathering, such as contacting other organizations or companies, try assigning these tasks to teams of people. One can take care of the written research, while the other does the foot work or phone work, for example. Let people in the group divide up into reporters (written task) and researchers (telephone work). Then each team member can share what he or she has learned in an oral report to the other.

If you have some leeway, try to keep reading and writing work to a minimum or offer program participants a choice of learning methods. Be sure that staff and volunteers offer these choices to all program participants. People with low or no literacy skills should not be separated out from their colleagues or placed in a designated group. Make the use of alternative methods your normal practice.

If You Know There's a Problem

If you know that someone cannot read and write at all, ensure that your staff is ready to explain things verbally and refrain from handing the person pamphlets and sending them letters. Community health agencies have realized the dangers that can arise if people don't understand health-related information. At the Lawrence Heights Community Health Centre in Toronto, for example, doctors do not give out any written instructions unless they know the patient can read and write.

When staff give important information or instructions orally, it is helpful to ask people to summarize the information they have heard. In this way, you can be sure that you have been understood.

Looking for New Ideas

Could literacy concerns be one of the subjects discussed at your agency's staff meetings? Front-line personnel are the people most likely to know about clients' literacy needs and about problems stemming from information not reaching people with low literacy skills.

At the St. John Regional Hospital, a staff member's idea was the spark that led to the development of a patient video to encourage children to read. The employee contacted literacy programs for information and assistance, checked to see if the hospital's mission might relate to the project and then approached management with a proposal.

At the employee's suggestion, a special committee was established to produce a “Child Life Reading Video” for patient education TV. The video promotes the value of reading by showing a doctor, a nurse, a caretaker and two other employees reading children's stories. The child receives a message about reading and sees these professionals as warm, caring, accessible people. Both messages help the hospital achieve its mission.

Literacy has now become a real concern at the hospital. Management decided to assess the readability of all their written materials and they developed guidelines for reading materials given to patients, for their consent form, and for any information they share with other health agencies.

The Calgary General Hospital has also used its free TV channel for patient education. A video teaches new mothers how to diaper their babies and offers information on other parenting skills. This video saves staff time and reaches people who may have low literacy skills.

Help is Out There

Changes in the way an organization does its work can be implemented gradually. A literacy audit may discover areas that need change but different aspects of an agency's work can be addressed at different times. A literacy professional may be able to help you take a critical look at how you run your programs and how you bring people into your organization. People who use your services are also good critics, as are people who are in the process of learning to read. There is help available where there is a will to change.