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Presented by: Steve Smith, MBA, FACMPE, CHFP, Managing Consultant
Health literacy: how to help patients make appropriate health decisions Presented by: Steve Smith, MBA, FACMPE, CHFP, Managing Consultant
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AGENDA What is health literacy and why is it important?
Existing barriers to health literacy Strategies for improving health literacy Improving health literacy in your practice Questions
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What is health literacy?
“The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” 2003 National Assessment of Adult Literacy survey “Even for the folks who do have proficiency, all you have to do is give them a cancer diagnosis, make them sleep deprived, experiencing severe pain…anybody with those things happening is going to have trouble processing, remembering, or making decisions related to healthcare information.” Dr. Paul Smith, Professor, Department of Family Medicine and Community Health, University of Wisconsin-Madison
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What is health literacy?
Dependent on both individual and systemic factors: Communication skills/styles of patients and professionals Knowledge of patients and professionals of health topics Culture Demands of healthcare and public health systems Demands of situations and context
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Barriers to Health literacy
Access to Information Internet, personal experiences How information is obtained Trust Background differences Difficulty asking questions New Providers Lack of relationship Time Pressure to increase productivity/reporting Length of appointment Difficulty asking questions Internet No regulatory agency Complex, scientific language Lack of education
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Why is health literacy important?
Navigate healthcare system Share information with providers Behavioral changes Understand healthcare news and changes Future impacts: Outcomes Costs Quality of care
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Strategies for improving health literacy
Assess the patient’s understanding Assess the patient’s engagement Tailor language Provide instructions slowly Utilize graphics and pictures Provide additional resources
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assess the patient’s understanding
Open-ended questions May lead to concerns not expressed Teach Back communication techniques Determine if instructions are understood Repeat information in their own words Show Back communication techniques Use of devices or equipment
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assess the patient’s engagement
93% of communication is non-verbal (Professor Albert Mehrabian, UCLA, 1967) 55% body language 38% tone of voice Use of provided materials Provide upside down and see if they turn right side up Use open ended questions to increase engagement
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Tailor Language Supplement medical terminology or abbreviations with common, simplified terms “Swallow” instead of “take” “Harmful” instead of “adverse” “Fats” instead of “lipids” “Belly” instead of “abdomen” “Short duration, but may cause a serious problem” instead of “acute” Risk of offense if over-simplified or delivered in a patronizing manner Positivity important to patient success
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Provide instructions slowly
Care instructions usually delivered at the end of appointment or hospital stay Patient understanding of care instructions critical to quality of care Medication questions Readmission risk Care sought elsewhere Pay careful attention to patient understanding and engagement Open-ended questions
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Utilize graphics and pictures
Greatly enhances patient understanding Better retention than long written instructions or descriptions Supplemental if written form preferred May prompt clarifying questions Pictures on business cards
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Provide additional resources
Beyond discharge documentation or visit summary Charitable or community organizations Support groups Educational resources Books, pamphlets, articles Contact information General questions, readmission concerns
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Steps to Improving health literacy
Form Your Steering Committee Chairperson or champion All departments represented (physicians, nurses, practice management, front desk, billing, etc.) Senior leadership Regular meeting attendance required Health literacy training required for all team members
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Steps to Improving health literacy
Conduct a Practice Assessment Many tools available ( Each member of steering committee required to complete Several non-members of steering committee to complete Report results back to steering committee Results help determine prioritization of objectives and timelines Choose tools to implement (if desired)
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Steps to Improving health literacy
Raise Awareness All staff members should be aware of health literacy and strategic plan Message should come from steering committee chairperson/champion and leadership Creates a sense of importance Short video or on-site education beneficial Overview of health literacy Why health literacy is important Overview of health literacy strategic plan
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Steps to Improving health literacy
Continually Evaluate Progress This is not a short-term project Monthly or quarterly meetings beneficial to discuss progress, gains, and struggles Tasks to be broken down into categories with individual team leads Physicians Front office Patient education Training
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Steps to Improving health literacy
Additional Practice Assessments Means by which to objectively track increases in health literacy All steering committee members still required to complete Ideal if new non-steering committee members complete assessment Adjust strategic plan as necessary based on assessment results
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conclusion Quality care requires more than standardization and simplification in the office or facility settings Changing a practice’s culture related to health literacy may not be a short-term goal Ultimately, health literacy affects several aspects of high quality health care Improved communication Improved self-management Patient empowerment Improved support (at home and at practice)
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Steve Smith, MBA, FACMPE, CHFP Managing Consultant //sbsmith@bkd
Steve Smith, MBA, FACMPE, CHFP Managing Consultant //
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