1. Health Literacy Summit Madison, WI
Improving Patients’ Satisfaction by Improving Physicians’ Communication Skills
Stanton Hudson, MA Associate Director Nick Butler Project Director
University of Missouri Center for Health Policy
Health Literacy Summit Madison, WI
April 14, 2015

2. Development Team Karen Edison, MD Chair of Dermatology
David Fleming, MD Chair of Internal Medicine
James Campbell, PhD Professor Family Medicine
Ioana Staiculescu, MPH Center for Health Policy
Nick Butler, Center for Health Policy
Stan Hudson, MA Center for Health Policy

3. Clinic Simulation Video

4. Learning objectives
Identity health literacy best practices for health professionals.
Understand how health literacy best practices can be used in the design and implementation of quality improvement training for health professionals.
Implement health literacy quality improvement activities using the AHRQ Universal Precaution Toolkit and the CAHPS Health Literacy Item Set.

5. Health Literacy Quality Improvement Program
The Health Literacy Quality Improvement Program begins with a day-long clinical simulation workshop followed by a year-long health literacy action plan.
Tailored action plan to integrate health literacy in the clinical setting
Data collection protocol for baseline, 6-month and 12-month assessments

6. HL Quality Improvement Module
On Track
Formative
Formative
Change
Workshop
Simulation
Training
QI Training
H.L.U.P.
Toolkit
Planning
Pre- Data
Collection
Awareness
Form Team
HL Assess
Teach Back
Clear Communication
Varies
Needs
Assessment
Phase
Intervention
Phase
3 Mos.
6 Mos.
9 Mos.
12 Mos.
PDSA Cycles

7. Why Simulate?
Provides Standardization of Clinical Training & Assessment
Allows real-life practice of skills in a low-risk environment that encourages dialogue and feedback

8. Standardized Patients
“A normal person who has been carefully coached to accurately portray a specific patient when given the history and physical examination.” - Barrows, 1993, pg.444
Actors who will:
Take on characteristics of patient
Be able to answer questions about history
Give constructive feedback

9. The Exam Rooms

10. The Observation Room

11. Clinical Simulation Workshop
A self-reflective clinic simulation exercise to focus the physician’s attention on potential health literacy gaps or challenges encountered in his/her professional practice,
A peer learning discussion of specific health literacy strategies, and
Opportunities for authentic practice to reinforce knowledge and skills gained from peer learning

12. Health Literacy Coaching
Ensuring clear communication and patient understanding
Three mandatory tools that learners must include as part of their universal precautions plan
Tool 1: Form a team.
Tool 2: Assess your practice.
Tool 3: Raise awareness.

13. In addition to the three mandatory tools, learners are given the opportunity to select one additional tool to include in their plan from a list of optional tools. These tools include:
Tool 5 The Teach-Back Method
Tool 11 Design Easy-to-Read Material
Tool 12 Use Health Education Materials Effectively
Tool 13 Welcome Patients: Helpful Attitude, Signs, & More
Tool 14 Encourage Questions
Tool 16 Improve Medication, Adherence, and Accuracy

14. Quality Improvement Plan
The physician will need to survey 25 of his/her patients prior to beginning any health literacy activities, to establish baseline data, and again at six and twelve months after the health literacy plan is implemented.
Plan-Do-Study-Act method

15. Plan-Do-Study-Act Tool: Fill in the tool name you are implementing.
Step: Fill in the smaller step within that tool you are trying to implement.
Cycle: Fill in the cycle number of this PDSA.

16. Plan-Do-Study-Act- Example 1
TOOL: Patient Feedback
STEP: Dissemination of surveys
I plan to: We are going to test a process of giving out satisfaction surveys and getting them filled out and back to us.
I hope this produces: We hope to get at least 25 completed surveys per week during this campaign.
Steps to execute:
We will display the surveys at the checkout desk.
The checkout attendant will encourage the patient to fill out a survey and put it in the box next to the surveys.
We will try this for 1 week.

18. Patient surveys Patient surveys are short and easy to implement
Include specific items from the Item Set for Addressing Health Literacy from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician & Group Survey.

19. Evaluation One day workshop: Participant physicians=44
Pre-post survey on knowledge related to health literacy;
Face-to face feedback through the session during the simulation cases review and during the coaching session
Participant physicians=44

20. Placeholder for pre-post test results

21. Evaluation One year quality improvement program:
Tailor the survey based on the health literacy tools the provider has chosen
Chose a survey methodology based on the clinic resources:
Survey Monkey
Paper format
Patients surveyed at baseline, 6 months and 12 months
Patients surveyed to date=

22. Sample Survey Items
HL9 – how often did this provider give you all the information you wanted about your health?
HL10 – how often did this provider encourage you to talk about all your health questions or concerns?
HL14 – how often did this provider ask you to describe how you were going to follow these instructions?
HL18 – how often were the results of your blood test, x-ray, or other test easy to understand?
HL21 – how often were these instructions about how to take your medicines easy to understand?

23. Place holder for patient survey results
Insert results

24. Lessons Learned Recruitment Challenges
Maintenance of Certification Challenges
Learner engagement

25. What questions do you have?
For more information please contact:
Stan Hudson
Center for Health Policy
(573)