Health Literacy

Case for Change 

 
 
 
 
 
 
 

Case for Change

Communication is the backbone of health care delivery. Patients offer their symptoms, concerns, and medical histories. In return, providers discuss ailments and illnesses while describing solutions and treatments. The success of a treatment hinges largely on the communication between the patient and the provider. Unfortunately, this can be an obstacle for many patients.

Millions of U.S. adults possess literacy skills below-high school levels. Twenty percent of U.S. adults read at or below the fifth grade level. Iowa literacy rates are also low, with 38 percent of adults reading at below-high school levels. While individuals with low literacy levels may struggle with many areas of their life, the problem is particularly germane to health care. In this context, it is referred to as "health literacy." Health literacy is "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions."

Patients with low health literacy have difficulty accessing the medical world, a world filled with jargon, acronyms, and technical language. This limited understanding can manifest itself in numerous ways. Patients may:

  • have difficulty understanding their disease, their treatment, or their medications.
  • fear asking their provider questions.
  • feel unintelligent or ignorant when it comes to their treatment.
  • misunderstand their illness or treatment and therefore endanger their health.
  • avoid seeking further medical assistance.

Health care professionals cannot increase the literacy rates of their patients. Instead, providers must acknowledge these low health literacy rates and alter their delivery of care accordingly. This step toward improving health literacy focuses on the following areas:

  • Improving interpersonal communication between providers and patients.
  • Using tools to guarantee a patient's comprehension of health information.
  • Simplifying health care situations such as check-in or health care referrals.
  • Developing simpler paperwork and educational materials.
  • Empowering the patient to ask questions.

This toolkit will:

  • Provide plain language guidelines
  • Provide health literacy planning information
  • Detail culturally effective care
  • List education materials for staff and patients

Sources:

  • Health Literacy: A Prescription to End Confusion. Nielsen-Bohlman L, et al. (eds). National Academies Press, 2004.
  • Iowa Health System Rural Health Literacy Collaborative. Learning Session Materials, June 18, 2006.
  • Office of Disease Prevention and Health Promotion. Healthy People 2010 Last viewed August 2006.
  • "Synthetic Estimates of Adult Literacy Proficiency." Stephen Reder. Portland State University. Last viewed August, 2006.
     

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Toolkit

Guidelines

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Implementation 

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Culturally Effective Care

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Educational Materials

Physician Education

Patient Education


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Success Stories

  • Allen Hospital, Waterloo
    Allen began addressing health literacy in collaboration with Iowa Health System in 2003. As a result of those efforts, the following have been implemented:
    • All associates complete a computer based learning module on health literacy and reader friendly materials
    • Nursing associates review the AMA video on Health Literacy in nursing orientation.
    • Nurses are asked to assess patients for their reading ability and to tailor patient and family education in a way that meets the needs of the patient and family.
    • Nurses are asked to use teach-back as a method of assessing patient and family understanding of their care.
    • A health literate general surgical consent has been implemented.
    • The anesthesia information sheet was revised to improve the literacy level of the document.
    • The consent for blood transfusion has been revised in a health literate format.
    • Various teaching sheets and discharge instructions have also been converted into a more health literate format.
    • Various pilots of Ask Me 3 have been done to improve patient and family understanding of their care.

The Patient Education Committee makes recommendations to improve patient and family understanding of their care, thus overseeing the implementation of projects related to health literacy. The Patient Advocacy Committee is consulted as projects are developed and implemented, allowing for consumer input into the products developed.

Future endeavors include conversion of additional consents used in the hospital to become more literate. We continue to evaluate areas where patient and family education occur, in order to assure health literate materials are available.

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Mentors

IHC would like to thank those individuals and organizations who have shared their materials and who have agreed to serve as mentors. Please contact IHC if your organization would like to contribute materials to this tool kit. The project team includes Mary Ann Abrams, MD, MPH, of Iowa Health System, as well as representatives from the Iowa Department of Public Health and Iowa health care providers.

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Resources

Other Toolkits

Articles

Websites

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