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NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
This activity was supported by contracts between the National Academy of Sciences and the Agency for Healthcare Research and Quality (HHSP233200900537P); the American College of Physicians Foundation; America’s Health Insurance Plans; the California Dental Association; the East Bay Community Foundation (Kaiser Permanente); Eli Lilly and Company; the Health Resources and Services Administration (HHSH25034004T); Humana; Johnson & Johnson; Merck and Co., Inc.; the Missouri Foundation for Health (09-0290-HL-09); the North Shore–Long Island Jewish Health System; the Office of Disease Prevention and Health Promotion; and the UnitedHealth Group. The views presented in this publication are those of the rapporteurs and do not necessarily reflect the view of the organizations or agencies that provided support for this project.
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Suggested citation: IOM (Institute of Medicine). 2013. Organizational change to improve health literacy: Workshop summary. Washington, DC: The National Academies Press.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
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PLANNING COMMITTEE ON ORGANIZATIONAL CHANGE TO IMPROVE HEALTH LITERACY1
MARY ANN ABRAMS, Health Literacy Medical Advisor, Iowa Health System
CINDY BRACH, Senior Health Policy Researcher; Center for Delivery, Organization, and Markets, Agency for Healthcare Research and Quality
BENARD P. DREYER, Professor of Pediatrics, New York University School of Medicine, and Chair, American Academy of Pediatrics Health Literacy Program Advisory Committee
PAUL M. SCHYVE, Senior Advisor, Healthcare Improvement, The Joint Commission
RICARDO WRAY, Associate Dean for Graduate Education and Research and Associate Professor of Behavioral Science and Health Education, Saint Louis University College for Public Health and Social Justice
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1 The planning committee’s role was limited to planning the workshop, and the workshop summary has been prepared by the workshop rapporteurs as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants, and are not necessarily endorsed or verified by the Institute of Medicine, and they should not be construed as reflecting any group consensus.
ROUNDTABLE ON HEALTH LITERACY1
GEORGE ISHAM (Chair), Senior Advisor, HealthPartners
WILMA ALVARADO-LITTLE, Director, Community Engagement/Outreach, Center for the Elimination of Minority Health Disparities, University of Albany
CINDY BRACH, Senior Health Policy Researcher, Center for Delivery, Organization, and Markets, Agency for Healthcare Research and Quality
GEMIRALD DAUS, Public Health Analyst, Health Resources and Services Administration Office of Health Equity, Department of Health and Human Services
DARREN DEWALT, Associate Professor of Medicine, University of North Carolina at Chapel Hill
BENARD P. DREYER, Professor of Pediatrics, New York University School of Medicine, and Chair, American Academy of Pediatrics Health Literacy Program Advisory Committee
LAURIE FRANCIS, Senior Director of Clinic Operations and Quality, Oregon Primary Care Association
MARTHA GRAGG, Board Member, Health Literacy Missouri
LORI HALL, Consultant, Health Education, Eli Lilly and Company
LINDA HARRIS, Team Leader, Health Communication and eHealth Team, Office of Disease Prevention and Health Promotion, Department of Health and Human Services
BETSY L. HUMPHREYS, Deputy Director, National Library of Medicine, National Institutes of Health
MARGARET LOVELAND, Global Medical Affairs, Merck & Co., Inc.
PATRICK McGARRY, Assistant Division Director, Scientific Activities, American Acadamy of Family Physicians
RUTH PARKER, Professor of Medicine, Emory University School of Medicine
TERRI ANN PARNELL, Vice President, Health Literacy and Patient Education, North Shore–Long Island Jewish Health System
KIM PARSON, Consumer Experience Center for Excellence, Humana, Inc.
KAVITA PATEL, Managing Director for Clinical Transformation and Delivery, The Brookings Institution
CLARENCE PEARSON, Consultant, Global Health Leadership and Management
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1 Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
SUSAN PISANO, Vice President of Communications, America’s Health Insurance Plans
ANDREW PLEASANT, Health Literacy and Research Director, Canyon Ranch Institute
SCOTT C. RATZAN, Vice President, Global Health, Johnson & Johnson
LINDSEY ROBINSON, President, California Dental Association
WILL ROSS, Associate Dean for Diversity, Associate Professor of Medicine, Washington University School of Medicine
RIMA RUDD, Senior Lecturer on Health Literacy, Education, and Policy, Harvard School of Public Health
STEVEN RUSH, Director, Health Literacy Innovations Program, United Health Group
PAUL M. SCHYVE, Senior Advisor, Healthcare Improvement, The Joint Commission
PATRICK WAYTE, Vice President, Marketing and Health Education, American Heart Association
WINSTON F. WONG, Medical Director, Community Benefit Director, Disparities Improvement and Quality Initiatives, Kaiser Permanente
IOM Staff
LYLA M. HERNANDEZ, Roundtable Director
MELISSA FRENCH, Associate Program Officer
ANDREW LEMERISE, Research Associate
ANGELA MARTIN, Senior Program Assistant
ROSE MARIE MARTINEZ, Director, Board on Population Health and Public Health Practice
Reviewers
This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:
WILMA ALVARADO-LITTLE, Director, Community Engagement/ Outreach, Center for the Elimination of Minority Health Disparities, University of Albany
SHARON E. BARRETT, Principal, SEB and Associates
DEBRA KELLER, San Francisco Department of Public Health
DEBRA ROTER, Professor, Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health
Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by Harold J. Fallon, Medical University of South
Carolina. Appointed by the Institute of Medicine, he was responsible for making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this workshop summary rests entirely with the rapporteurs and the institution.
Acknowledgments
The sponsors of the Institute of Medicine Roundtable on Health Literacy made it possible to plan and conduct the workshop Organizational Change to Improve Health Literacy. Sponsors from the U.S. Department of Health and Human Services are the Agency for Healthcare Research and Quality, the Health Resources and Services Administration, and the Office of Disease Prevention and Health Promotion. Nonfederal sponsorship was provided by the American College of Physicians Foundation; America’s Health Insurance Plans; the California Dental Association; the East Bay Community Foundation (Kaiser Permanente); Eli Lilly and Company; Humana; Johnson & Johnson; Merck and Co., Inc.; the Missouri Foundation for Health; the North Shore–Long Island Jewish Health System; and the UnitedHealth Group.
The Roundtable wishes to express its gratitude to the following speakers for their interesting and thoughtful presentations: Mary Ann Abrams, Thomas Bauer, Lori Hall, Paloma Izquierdo-Hernandez, Karen Komondor, Sabrina Kurtz-Rossi, Bridget McCandless, Laura Noonan, Terri Ann Parnell, Audrey Riffenburgh, Karen Rogers, Ricardo Wray, and Shonna Yin. The roundtable also wishes to extend its appreciation to the planning committee members: Mary Ann Abrams, Cindy Brach, Benard Dreyer, Paul Schyve, and Ricardo Wray.
Contents
2 PANEL 1: IMPLEMENTING ATTRIBUTES OF A HEALTH LITERATE ORGANIZATION
Karen Rogers, M.S.N., R.N.-B.C.
3 PANEL 2: IMPLEMENTING ATTRIBUTES OF A HEALTH LITERATE ORGANIZATION
Terri Ann Parnell, D.N.P., M.H.A., R.N.
4 PANEL 3: IMPLEMENTING ATTRIBUTES OF A HEALTH LITERATE ORGANIZATION
Boxes, Figures, and Table
BOXES
Ten Attributes of a Health Literate Health Care Organization |
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FIGURES
Health literacy 101: Your role as a health care provider to better health literacy |
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