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?

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Using health literacy basics to improve interpretations translations and patient outcomes

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

Melissa Reyna, MPH, RN, ICCE

Texas Health Resources

9-7-2012


Agenda

Agenda

  • What 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 document’s reading level

  • Patient education councils

  • Resources


Do i look like an idiot

Do I Look Like An Idiot?

  • http://www.youtube.com/watch?v=dMAS2S51bM8


What is health literacy

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 and follow instructions for treatment.” (Healthy People 2020)

  • Not only an individual’s traits/abilities, but a system’s/organization’s ability to create a functional environment (IOM, 2012)


Why is health literacy important

Why 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)


Why is health literacy important1

Why 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


Why is health literacy important2

Why is Health Literacy Important?

  • http://www.youtube.com/watch?v=BgTuD7l7LG8

    (AMA Foundation, 2007)


How does health literacy affect interpretations and translations

How Does Health Literacy Affect Interpretations and Translations?


How does health literacy affect interpretations and translations1

How Does Health Literacy Affect Interpretations and Translations?

  • Advocacy

  • Accuracy

  • Cultural Awareness

  • Professional Development

  • Business Case


Solutions for improving patient outcomes interpretations

Solutions for Improving Patient Outcomes - Interpretations

  • Slow 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)


Solutions for improving patient outcomes translations

Solutions for Improving Patient Outcomes - Translations

  • General Content

    • Limit to one or two objectives

    • Limit to what patients really need to know

    • Use non-medical words

    • Appropriate content for age & culture

  • Text Construction

    • At or below 6th-grade level

    • One- or two-syllable words

    • Short paragraphs

    • Active voice

    • Simple tables & graphs

      (Weiss, 2007)


Solutions for improving patient outcomes translations1

Solutions for Improving Patient Outcomes - Translations

  • Fonts and Typestyle

    • Large font (12 minimum) & serifs

    • No more than two or three fonts styles

    • Upper- and lower-case text

  • Layout

    • Empty space

    • Headings & subheadings

    • Bulleted lists

    • Useful illustrations

      (Weiss, 2007)


How to assess a document s reading level

How to Assess a Document’s Reading Level

  • Many different Readability Formulas

  • Provide grade reading level for documents

  • Examples:

    • Flesch-Kincaid (Microsoft Word)

    • Fry Readability Graph

    • McLaughlin's SMOG Formula

    • Gunning Fog Formula

    • Suitability Assessment of Materials (SAM)

    • Non-English available


Patient education councils

Patient Education Councils

  • Provide linguistically- and culturally-appropriate tools, experiences, policy, procedure, etc.

  • Multidisciplinary

  • Administrators & direct-care specialists

  • Place at table for Interpreters and Translators


Using health literacy basics to improve interpretations translations and patient outcomes

Please contact me:

Melissa Reyna, MPH,RN, ICCE

Coordinator of Patient Education

Texas Health Resources

[email protected]

(682)236-6931


Resources

Resources

  • http://www.youtube.com/watch?v=dMAS2S51bM8

  • http://www.youtube.com/watch?v=BgTuD7l7LG8

  • www.amafoundation.org/go/healthliteracy

  • 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.


Resources1

Resources

  • Brach, 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.


Resources2

Resources

  • McGee, 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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