Using Health Literacy Basics to Improve Interpretations, Translations, and Patient Outcomes

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Using Health Literacy Basics to Improve Interpretations, Translations, and Patient Outcomes. Melissa Reyna, MPH, RN, ICCE Texas Health Resources 9-7-2012. Agenda. What is health literacy? Why is health literacy important? How does health literacy affect interpretations and translations? - PowerPoint PPT Presentation


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Using Health Literacy Basics to Improve Interpretations, Translations, and Patient Outcomes

Melissa Reyna, MPH, RN, ICCETexas Health Resources9-7-2012

1AgendaWhat is health literacy?

Why is health literacy important?

How does health literacy affect interpretations and translations?

Solutions for improving patient outcomes

How to assess a documents reading level

Patient education councilsResources 22Do I Look Like An Idiot?

33What 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 and follow instructions for treatment. (Healthy People 2020)

Not only an individuals traits/abilities, but a systems/organizations ability to create a functional environment (IOM, 2012)

44Why is Health Literacy Important? 50% American adults have functional literacy issues (TJC, 2007)

12% American adults have proficient health literacy (National Assessment of Adult Literacy, 2006)

Healthcare workers overestimate their ability to communicate information (Schillinger, et al., 2003)

National Tipping Point for health literacy (Koh, et al., 2012)55Why is Health Literacy Important?Sudore, et al. (2009) Health literacy = Quality of care received Health literacy = Chronic disease management Health literacy = Likelihood of readmission

Schillinger, et al. (2003) Communication = Patient satisfaction Communication = Patient outcomes

Levinson, et al. (1997) Communication = Litigation

Boulding, et al. (2011) HCAHPS = 30-day readmissions

66Why is Health Literacy Important?

(AMA Foundation, 2007)

77How Does Health Literacy Affect Interpretations and Translations?88How Does Health Literacy Affect Interpretations and Translations?Advocacy


Cultural Awareness

Professional Development

Business Case99Solutions for Improving Patient Outcomes - InterpretationsSlow down

Use plain, non-medical language

Show or draw pictures

Limit the amount of information provided-and repeat it

Use the teach-back technique

Create a shame-free environment-encourage questions(Weiss, 2007)1010Solutions for Improving Patient Outcomes - TranslationsGeneral ContentLimit to one or two objectivesLimit to what patients really need to knowUse non-medical wordsAppropriate content for age & culture

Text ConstructionAt or below 6th-grade levelOne- or two-syllable wordsShort paragraphsActive voiceSimple tables & graphs(Weiss, 2007)1111Solutions for Improving Patient Outcomes - TranslationsFonts and TypestyleLarge font (12 minimum) & serifsNo more than two or three fonts stylesUpper- and lower-case text

LayoutEmpty spaceHeadings & subheadings Bulleted listsUseful illustrations

(Weiss, 2007)1212How to Assess a Documents Reading LevelMany different Readability Formulas

Provide grade reading level for documents

Examples:Flesch-Kincaid (Microsoft Word)Fry Readability GraphMcLaughlin's SMOG FormulaGunning Fog FormulaSuitability Assessment of Materials (SAM)Non-English available1313Patient Education CouncilsProvide linguistically- and culturally-appropriate tools, experiences, policy, procedure, etc.


Administrators & direct-care specialists

Place at table for Interpreters and Translators

141415Please contact me:

Melissa Reyna, MPH,RN, ICCECoordinator of Patient EducationTexas Health

Boulding, et al. (2011). Relationship Between Patient Satisfaction with Inpatient Care and Hospital Readmission within 30 Days. American Journal of Managed Care, 17(1): 41-48.

Brach and Noonan (2010). Health Literacy Universal Precautions Toolkit. US Department of Health and Human Services, Agency for Healthcare Research and Quality. AHRQ Publication No. 10-0046-EF.

1616ResourcesBrach, et al. (2012). Ten Attributes of a Health Literate Organization. Institute of Medicine.

Doak, Doak, and Root (1996). Teaching Patients with Low Literacy Skills, Second Edition. JB Lippincott Company.

Kanack, Susan (2009). Effectively Managing Patient Education: Going Beyond Joint Commission Requirements. HCPro, Inc.

Koh, et al. (2012). New Federal Policy Initiatives to Boost Health Literacy Can Help Nation Move Beyond the Cycle of Costly Crisis Care. Health Affairs, 31(2): 434-443.

Levinson, et al. (1997). Physician-Patient Communication: The Relationship with Malpractice Claims Among Primary Care Physicians and Surgeons. Journal of the American Medical Association, 227: 553-559.

1717ResourcesMcGee, Jeanne and McGee & Evers Consulting, Inc. (2010). Toolkit for Making Written Material Clear and Effective. US Department of Health and Human Services, Centers for Medicare and Medicaid. CMS Product No. 11476.

Schillinger, et al. (2003). Closing the Loop: Physician Communication with Diabetic Patients Who Have Low Health Literacy. Archives of Internal Medicine, 163: 83-90.

Sudore and Schillinger. (2009). Interventions to Improve Care for Patients with Limited Health Literacy. Journal of Clinical Outcomes Management, 16(1): 20-29.

Weiss, Barry (2007). Health Literacy and Patient Safety: Help Patients Understand, Second Edition. American Medical Association Foundation and American Medical Association.



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