Measures of Health Literacy Workshop Summary (2009) / Chapter Skim
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5 Measuring Health System Responses to Health Literacy
5 Measuring Health System Responses to Health Literacy
Pages 73-90
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From page 73... ...
These include chronic disease care and selfmanagement, patient-provider communication, patient safety and health care quality, access to health care and preventive services, provider time limitations, consumer-directed health care, and health care expenditures. The bottom line for all these issues is that health plan members who do not understand and cannot act on the medical information and instruc tions they are given are more likely to have poor health status that results in unnecessary costs.
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More than 200 individuals participated. These participants included individuals respon sible for health literacy efforts in health plans as well as web designers, information technology specialists, and those responsible for personal health records.
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The three components of the pharmacy assessment tool are comple mentary and designed to be completed together. The first component of the assessment tool is a pharmacy assessment tour that is designed to be completed by trained assessors who evaluate the pharmacy environment from an objective perspective.
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To minimize bias in the results, the pharmacy assessment tour should be conducted by at least two people who are trained together to promote consistent assessment techniques. The assessors should be familiar with principles of clear health communication, should not be pharmacy staff or patients, and should be able to blend in with patients who use the pharmacy.
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Health Plan Assessment The pharmacy assessment project has led to a new project that is broadening the application of the pharmacy assessment tool kit. The goal of the new project is to modify the PILL assessment tool and its applica bility to the needs of health insurance plans throughout the country.
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In terms of the focus of health literacy efforts, 50 percent of respondents said the focus was on universal health precautions, 14 percent indicated health literacy efforts were targeted at plan members with low health literacy skills, 14 percent indicated they were not sure of the focus, and 21 percent indicated the "other" category. Examples of programs for plan members with low literacy skills included specific reading levels for all materials, staff training, simplified consent forms, simplified health education materials, a plain language tool kit, a revised enrollment form, and interpreter translation of materials.
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, URAC focused on making sure its efforts addressed areas highlighted in that report. Currently, URAC is engaged in promulgating health literacy requirements for managed health care organizations.
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Health literacy is now addressed in all URAC health care accreditation programs. The core health literacy standards state the organization will implement written policies and/or document problems addressing health literacy that • Require consumer materials to be in plain language; • Assess the use of plain language in consumer documents; and • Provide relevant information and guidance to staff who interface directly with, or write content for, consumers.
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From page 81... ...
For example, there is a supplemental item set for children with chronic diseases and people with mobility impairment that can be added to the CAHPS Health Plan Survey. Two new supplemental item sets are in development -- one that assesses health literacy issues and one that is for health information technology issues.
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Stakeholders included health plan representatives, government agencies, health literacy advocates, researchers, and clinicians. In conducting the environmental scan, existing measures in the public domain were reviewed to identify items that could be included in the supplemental item set.
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(Please see Appendix C for the CAHPS® Clinician & Group Survey Health Literacy Item Set.) The developmental work for the health literacy supplement for the H-CAHPS is just beginning.
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The plan is to field test the item set in the fall or winter of 2009 with an expected release date of spring 2010. PROMOTINg EFFECTIVE COMMuNICATION: THE JOINT COMMISSION'S EFFORTS TO ADDRESS CuLTuRE, LANguAgE, AND HEALTH LITERACy Amy Wilson-Stronks, M.P.P.
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Reprinted by permission from The Joint Commission. 5-1 redrawn
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The common theme for addressing health literacy, cultural competence, and language issues is the need to address communication between the patient and the provider within the context of the health system. Support for this position can be found in examining The Joint Commission sentinel event data.
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With a grant from The Commonwealth Fund, it is now in the process of developing culturally competent patient-centered care standards. The project will explore how diversity, culture, language, and health literacy issues can be better incorporated into current Joint Commission standards or drafted into new requirements.
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You are the center of the health care team. In conclusion, Wilson-Stronks said, The Joint Commission is committed to developing standards and programs that will help health care organizations improve communication and, thereby, health literacy.
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At the organizational level, different measures may well be called for to use with health plans, hospitals, and ambulatory care orga nizations, and it is encouraging to see the development of the different CAHPS measures. There is also a need for patient-level data and data that can be used in research.
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