1. Breakout B: Health Literacy
Northeast Hospitals
Julie Holden, BSN, MA, RN

2. Cross Continuum Team
We are fortunate to exist in a healthcare system that is made up of organizations that care for the patient across the entire continuum of care: Behavioral Health, Home Care, Senior Health, Primary Care, Rehab and Skilled Nursing Facilities. They all make up our CCT.
The executive sponsor of our initiative is the Senior Vice President of Patient Care Services and the CNO.
Membership includes physicians both in primary care and the hospitalists.
We have included facilities that are not part of our system as well.

3. Key Changes Perform an Enhanced Assessment of Post-Hospital Needs
Provide Effective Teaching and Facilitate Enhanced Learning
Ensure Post-Hospital Care Follow-up
Provide Real-Time Handover Communications

4. Provide Effective Teaching and Facilitate Enhanced Learning
Involve all learners in patient education
Redesign the patient education process
Redesign patient teaching print materials
Use Teach Back regularly throughout the hospital stay to assess the patient’s and family caregivers’ understanding of discharge instructions and ability to perform self-care

5. Our Starting Point
We started with a form and education for our staff on what to do and how to do it.
Often, we would hear that the patient was “not a candidate” for the Teachback process.
We had little data, and feedback from the staff that the process was too difficult.
We went BACK TO THE DRAWING BOARD!
Newer information told us we needed to incorporate Health Literacy into our process moving forward.

6. What is Health Literacy?

7. Health Literacy Skills of US Adults

8. Readability Statistics
When we do programs, we often try to get materials from wherever we present and run them through the spelling and grammar check function of Microsoft Word. This can be eye-opening.

9. What do the experts say?

10. The Videos
Our visit to and collaboration with Saints Medical Center in Lowell provided us with several “aha” moments:
Staff WANTED an online learning opportunity for Health Literacy. To this point the videos are available to staff as optional learning through our intranet.
Health Literacy should not be directly tied to the STAAR initiative, but should be viewed as BEST PRACTICE for all patients and their families.
Health Literacy is not something new—it is putting a name to an issue that has plagued our patients and families for years.
How do issues associated with the learning styles of our elder population impact their readmissions?

11. Changes To Be Tested
Our home care nurses are embarking on a project to use the RED, YELLOW, and GREEN zones that mirror CHF teaching in their COPD teaching.
We created a form for use by our staff to use in their Teachback process that mirrors the home care format.
Incorporate Teachback information into our electronic discharge form once it meets our needs.

12. Learning
Tie tests and changes to best practice—even though you may start small on your STAAR pilot units, don’t necessarily tie the practice changes to the improvement project.
If you hear of someone in this learning session that is doing something you would be interested in applying in your organization, give them a call!

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HCAPHS Data
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14. Next Steps
Formalize learning for all nurses about Health Literacy this fall.
Continue to offer contact hour program for all staff throughout the system and continuum on Health Literacy
Continue to view Health Literacy as an important factor in patient safety and patient/family learning.

15. References and Links