2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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)

17. 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

18. 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

19. 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

20. 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)

22. Steve Smith, MBA, FACMPE, CHFP Managing Consultant //sbsmith@bkd
Steve Smith, MBA, FACMPE, CHFP Managing Consultant //