Title: Health Literacy: A Crisis In Health Care
1Health LiteracyA Crisis In Health Care
- Developed by Stratis Health with the Permission
of - the American Medical Association Foundation and
the American Medical Association
2Definitions
- General Literacy
- An individuals ability to read, write, and
speak in English, and compute and solve problems
at levels of proficiency necessary to function on
the job and in society, to achieve ones goals,
and develop ones knowledge and potential. - National Literacy Act of 1991Health
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. - Healthy People 2010
3Self-Assessment
4Implications of low health literacy on patient
care
- 33 Were unable to read basic health care
materials - 42 Could not comprehend directions for taking
medication on an empty stomach - 26 We unable to understand information on an
appointment slip - 43 Do not understand the rights and
responsibilities section of Medicaid
application - 60 Did not understand a standard informed
consent - Williams et.al., JAMA 12/6/95
5Cost of poor health literacy Estimate gt50
billion annually
- We all pay!
- 39 paid by Medicare (FICA taxes on workers)
- 17 paid by employers
- 16 paid by patients, out-of-pocket
- 14 paid by Medicaid
- 14 from other public and private sources
Estimated by National Academy on an Aging
Society using 1998 figures
6National Adult Literacy Survey (NALS)
- Conducted in 1992
- N26,000
- Most accurate portrait of literacy in the US
- Scored on 5 levels
- Not accounted for
- Patients who have adequate language skills, but
do not have adequate health literacy
7Results National Adult Literacy Survey (NALS)
Level
(Kirsh I, Jungeblut A, 1993)
8Why are patients at risk?
- Reliance on the written word for patient
instruction - Increasingly complex healthcare system
- More medications
- More tests and procedures
- Growing self-care requirements
- Esoteric language
- An aging population
- A more culturally diverse patient population
9Understanding the problem
- What is it like?
- The following passage simulates what a reader
with low general literacy sees on the printed
page - Read the entire passage out loud
- You have 1 minute to read
- (Hint The words are written backwards and the
first word is cleaning)
10- GNINAELC Ot erussa hgih ecnamrofrep,
- yllacidoirep naelc eht epat sdaeh dna natspac
- revenehw uoy eciton na noitalumucca fo tsud
- dna nworb-der edixo selcitrap. Esu a nottoc
- baws denetsiom htiw lyporposi lohocla. Eb erus
- on lohocla sehcuot eht rebbur strap, sa ti sdnet
- ot yrd dna yllautneve kcarc eht rebbur. Esu a
- pmad tholc ro egnops ot naelc eht tenibac. A
- dlim paos, ekil gnihsawhsid tnegreted, lliw pleh
- evomer esaerg ro lio.
11What was it like?
- How did you feel while reading this passage?
- How did you feel when you finished reading the
passage? - How do you clean the capstan?
- How do you think patients with low health
literacy feel?
12Understanding the problem
- View As Patients See It
- Video made by the AMA in 2003
- Real patients and real physicians talking about
literacy issues - Task Note
- Barriers to access
- Barriers to diagnosis
- Barriers to treatment/care
13Video The Patients Voice
- Discussion
- What ideas hit home with you?
- Did any of the situations seem familiar?
- Did anything surprise you?
14What do we know?
- Low Health Literacy (LHL) is prevalent
- LHL leads to
- Lower health knowledge and less healthy behaviors
- Greater health costs
- Poorer health outcomes
- Techniques and approaches may be used to address
health literacy
15Strategy Create a shame-free environment
- Recognize red flags
- I forgot my glasses
- Incomplete forms
- Seeking help only when illness is advanced
- Convey an attitude of helpfulness, caring and
respect (by all staff) - What is it like being a patient in your setting?
- Are there forms or instructions that could be
confusing?
16Strategy improve interpersonal communication
- Slow down
- Use plain or living room language
- Focus on key messages (www.askme3.org)
- What is my main problem?
- What do I need to do?
- Why is it important for me to do this?
- Use teach back techniques
17Strategy Develop patient-friendly materials and
forms
- Keep content concise and focused
- Focus only on key points
- Emphasize what the patient should do
- Minimize anatomy and physiology to the basics
- Tips for easy-to-read materials
- Simple words (1-2 syllables)
- Short sentences (4-6 words)
- Short paragraphs (2-3 sentences)
- Limit medical jargon
- Headings, bullets and lots of white space
18Self-Assessment answers
19What can you do right away?
- Do a walk through at your facility and identify
barriers - Review registration forms and consider if they
could be simplified - Develop a plan to educate all staff about low
health literacy
20What can you do in the future?
- Form a team to determine a long-term strategy
- Discuss methods for improving communication
skills with providers and staff - Incorporate Ask Me 3 components into patient
information
21- Understanding
- is a two-way street.
- Eleanor Roosevelt
22For More Information
- Other resources
- www.amafoundation.org
- www.askme3.org
23- Brought to you by Stratis Health
- Minnesotas Medicare Quality Improvement
Organization - Stratis Health is a non-profit independent
quality improvement organization - that collaborates with providers and consumers to
improve health care. - This presentation was created by Stratis Health
under a contract with - the Centers for Medicare Medicaid Services
(CMS). - The contents do not necessarily reflect CMS
policy.