Working Together to Improve Health Literacy

• 7/26/2010
• Author: Jim Parker
• Category: Perspectives on Patient Safety Blog
• 6689 Views
• 0 Comments
• 

La mancata comunicazione sono molto frustrazinone.*

Aren’t they?

For some patients, including some well-educated patients, health care information can seem like a foreign language. The total number of people in the United States who have limited health literacy exceeds 89 million.¹ These patients have a difficult time obtaining, processing, and understanding basic health information and services and, therefore, are unable to make informed health decisions.

This deficiency can have a great effect on health outcomes, so it falls to health care workers—from the support staff to the physician—to recognize the behaviors of patients who have low health literacy skills and help them understand information relevant to their own care.

For example, when a patient says, “I left my reading glasses at home. Can you read this to me?” health care providers should dig deeper and assess the patient’s health literacy skills. Other behaviors might also indicate a literacy problem, including the following:
• The patient’s registration forms are incomplete or inaccurately completed.
• The patient frequently misses appointments.
• The patient does not comply with medication regimens.
• The patient does not follow through with laboratory tests, imaging tests,
or referrals to consultants.
• The patient says he or she is taking medication, but laboratory tests or
physiological parameters do not change in the expected fashion.
• The patient requests to bring a written document home to discuss it
with a spouse or child.
• The patient complains of a headache or other health problem too severe to
allow reading.

Education level is a poor indicator of a patient’s health literacy skills. Education level only measures the number of years an individual attended school—not how much the individual learned in school.²
 
The help health care organizations address this issue, the U.S. Department of Health and Human Services (HHS) has created a national action plan to improve health literacy. The plan is based on the “Universal Precautions” philosophy adopted by many health care providers in the area of infection prevention and control.  In a nutshell, universal precautions means that—because a provider cannot tell at first glance whether or not a patient has acquired an infectious illness—providers take precautions to prevent infection with every patient. HHS is advocating a similar strategy when it comes to health literacy. Do not assume that any patient completely understands the information you are giving him or her. Provide simple, clear, comprehensive communication to everyone.

References:
1. Kutner M., et al.: The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy. U.S. Department of Education, Sep. 2006.
2. Weiss B.D.: Health literacy and patient safety: Help Patients Understand, 2nd ed., American Medical Association, May 2007. 
  
* Translation: Communication failures are very frustrating.