A PROPOSED FRAMEWORK
FOR INTEGRATION OF QUALITY
PERFORMANCE MEASURES FOR HEALTH
LITERACY, CULTURAL COMPETENCE,
AND LANGUAGE ACCESS SERVICES
PROCEEDINGS OF A WORKSHOP
Joe Alper, Rapporteur
Roundtable on Health Literacy
Board on Population Health and Public Health Practice
Health and Medicine Division
THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu
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This project was supported by contracts between the National Academy of Sciences and AbbVie Inc.; Aetna Foundation; Agency for Healthcare Research and Quality (HHSP23337024); American Dental Association; Bristol-Meyers Squibb; East Bay Community Foundation (Kaiser Permanente); Eli Lilly and Company; Health Literacy Media; Health Literacy Partners; Health Resources and Services Administration (HHSH25034011T); Humana; Institute for Healthcare Advancement; Merck Sharpe & Dohme Corp.; National Institutes of Health (HHSN26300054); National Library of Medicine; Northwell Health; New York University Langone Medical Center; Office of Disease Prevention and Health Promotion (HHSP23337043); and UnitedHealth Group. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-46672-1
International Standard Book Number-10: 0-309-46672-5
Digital Object Identifier: https://doi.org/10.17226/24918
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Copyright 2018 by the National Academy of Sciences. All rights reserved.
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. A proposed framework for integration of quality performance measures for health literacy, cultural competence, and language access services: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/24918.
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PLANNING COMMITTEE ON QUALITY MEASURES FOR INTEGRATING HEALTH LITERACY, CULTURAL COMPETENCE, AND LANGUAGE ACCESS SERVICES1
IGNATIUS BAU (Chair), Consultant, Health Policy Consultation Services
HELEN BURSTIN, Chief Scientific Officer, National Quality Forum
JAMES M. CRALL, Professor, Chair of the Division of Public Health and Community Dentistry, University of California, Los Angeles
DARREN A. DEWALT, Chief of the Division of General Medicine and Clinical Epidemiology, University of North Carolina at Chapel Hill
CHRISTOPHER DEZII, Director, Healthcare Quality and Performance Measures, Bristol-Myers Squibb
MICHAEL PAASCHE-ORLOW, Professor of Medicine, Boston University School of Medicine
BERNARD M. ROSOF, Chief Executive Officer, Quality in Healthcare Advisory Group, LLC
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.
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ROUNDTABLE ON HEALTH LITERACY1
BERNARD M. ROSOF (Chair), Chief Executive Officer, Quality in Healthcare Advisory Group, LLC
WILMA ALVARADO-LITTLE, Principal and Founder, Alvarado-Little Consulting, LLC
SUZANNE BAKKEN, Alumni Professor of Nursing and Professor of Biomedical Informatics, Columbia University
CINDY BRACH, Senior Health Care Researcher, Agency for Healthcare Research and Quality
GEM DAUS, Public Health Analyst, Office of Health Equity, Office of Special Health Affairs, Health Resources and Services Administration
TERRY C. DAVIS, Professor of Medicine and Pediatrics, Louisiana State University Health Sciences Center
CHRISTOPHER DEZII, Director, Healthcare Quality and Performance Measures, Bristol-Myers Squibb
JENNIFER DILLAHA, Medical Director for Immunizations, Medical Advisor, Health Literacy and Communication, Arkansas Department of Health
JAMES DUHIG, Head, Risk Communication and Behavioral Systems, Office of Patient Safety, AbbVie Inc.
WILLIAM ELWOOD, OppNet/HealthScientist Administrator, National Institutes of Health
ALICIA FERNANDEZ, Professor of Clinical Medicine, Department of Medicine, Division of General Internal Medicine, University of California, San Francisco
LAURIE FRANCIS, Senior Director of Clinic Operations and Quality, Oregon Primary Care Association
LORI HALL, Director, Health Literacy, Eli Lilly and Company
LINDA HARRIS, Director, Division of Health Communication and eHealth Team, U.S. Department of Health and Human Services
JOAN KELLY, Chief Patient Experience Officer, New York University Langone Health System
LAURIE MYERS, Global Health Literacy Director, Merck Sharp & Dohme Corp.
CATINA O’LEARY, President and Chief Executive Officer, Health Literacy Media
MARYLYNN OSTROWSKI, Executive Director, Aetna Foundation
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.
MICHAEL K. PAASCHE-ORLOW, Professor of Medicine, Boston University School of Medicine
TERRI ANN PARNELL, Principal and Founder, Health Literacy Partners
KIM PARSON, Strategic Consultant, Proactive Care Strategies, Humana
ANDREW PLEASANT, Director of Canyon Ranch Institute and Global Health Literacy Research, Health Literacy Media
LINDSEY A. ROBINSON, Thirteenth District Trustee, American Dental Association
STACEY ROSEN, Associate Professor of Cardiology, Hofstra Northwell Health School of Medicine, and Vice President, Women’s Health, The Katz Institute for Women’s Health
RIMA RUDD, Senior Lecturer on Health Literacy, Education, and Policy, Harvard School of Public Health
STEVEN RUSH, Director, Health Literacy Innovations, UnitedHealth Group
MICHAEL VILLAIRE, Chief Executive Officer, Institute for Healthcare Advancement
EARNESTINE WILLIS, Kellner Professor in Pediatrics, Medical College of Wisconsin
AMANDA WILSON, Head, National Network Coordinating Office, National Library of Medicine
MICHAEL S. WOLF, Professor, Medicine and Learning Sciences, Associate Division Chief, Research Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University
WINSTON F. WONG, Medical Director, Disparities Improvement, and Quality Initiatives, Kaiser Permanente
Consultant
RUTH PARKER, Professor of Medicine, Pediatrics, and Public Health, Emory University School of Medicine
Health and Medicine Division Staff
LYLA M. HERNANDEZ, Senior Program Officer
MELISSA G. FRENCH, Program Officer
ALEXIS WOJTOWICZ, Senior Program Assistant
ROSE MARIE MARTINEZ, Senior Board Director, Board on Population Health and Public Health Practice
Reviewers
This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We thank the following individuals for their review of this proceedings:
MARIN ALLEN, University of Pennsylvania; National Institutes of Health
PAMELA SCARROW, American College of Obstetrics and Gynecology
STEVE SPARKS, Health Literacy Wisconsin
ANTONIA M. VILLARRUEL, University of Pennsylvania
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by Ned Calonge, The Colorado Trust; University of Colorado. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteur and the National Academies.
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Acknowledgments
The sponsors of the National Academies of Sciences, Engineering, and Medicine’s Roundtable on Health Literacy made it possible to plan and conduct the workshop on quality performance measures for integrating health literacy, cultural competence, and language access services, which this Proceedings of a Workshop summarizes. Federal sponsors included the Agency for Healthcare Research and Quality; Health Resources and Services Administration; National Institutes of Health; National Library of Medicine; and Office of Disease Prevention and Health Promotion at the U.S. Department of Health and Human Services. Non-federal sponsorship was provided by AbbVie Inc.; Aetna Foundation; American Dental Association; Bristol-Myers Squibb; East Bay Community Foundation (Kaiser Permanente); Eli Lilly and Company; Health Literacy Media; Health Literacy Partners; Humana; Institute for Healthcare Advancement; Merck Sharp & Dohme Corp.; New York University Langone Medical Center; Northwell Health; and UnitedHealth Group.
The roundtable would like to thank each of the speakers, reactors, and panel moderators for their time and effort. Speakers, reactors, and moderators were, in alphabetical order, Suzanne Bakken, Ignatius Bau, Cindy Brach, Marshall Chin, James Crall, U. Michael Currie, Jessica Briefer French, Foster Gesten, George Isham, Cara James, Yolanda Robles, Bernard Rosof, Andrew Sanderson, Margaret VanAmringe, Knitasha Washington, Alicia Wilson, and Michael Wright.
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Contents
Organization of the Proceedings
National Committee for Quality Assurance Commissioned Paper
3 REACTION PANEL OF DEVELOPERS AND USERS
Questions Regarding an Integrated Approach to Measurement
Helping Health Care Organizations Improve Services to Diverse Populations
Equity Performance Measures Within Payment and Delivery System Reform
Leadership Development, Talent Management, Organizational Development, and Change
How Would You or Your Organization Use This Approach?
What Would You Need to Implement This Approach?
5 MODERATED DISCUSSION WITH IMPLEMENTER PANEL 2
What Would the Chief Executive Officer of a Hospital Need to Implement This Framework?
Is Patient-Centeredness Enough of a Focus to Get Disruptive Change?
Would the Concepts in This Framework Apply to a Patient-Centered Dental Home?
What Are Some of the Issues You Foresee with Implementation of the Framework?
B Biographical Sketches of Moderators, Speakers, and Panelists
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Acronyms and Abbreviations
AHRQ | Agency for Healthcare Research and Quality |
CAHPS | Consumer Assessment of Healthcare Providers and Systems |
C-CAT | Communication Climate Assessment Toolkit |
CDC | Centers for Disease Control and Prevention |
CHW | community health worker |
CLAS | Culturally and Linguistically Appropriate Services |
CMS | Centers for Medicare & Medicaid Services |
HHS | U.S. Department of Health and Human Services |
HIPAA | Health Insurance Portability and Accountability Act |
ICSI | Institute for Clinical Systems Improvement |
IOM | Institute of Medicine |
MIPS | Merit-Based Incentive Payment System |
NCQA | National Committee for Quality Assurance |
NIH | National Institutes of Health |
NQF | National Quality Forum |
OMH | Office of Minority Health at the U.S. Department of Health and Human Services |
PCMH | patient-centered medical home |
TTY | teletypewriter |