How Can Health Care Organizations Become More Health Literate? Workshop Summary (2012) / Chapter Skim
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2 Attributes of a Health Literate Health Care Organization
2 Attributes of a Health Literate Health Care Organization
Pages 5-20
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University of California, San Francisco Most health literacy research, Schillinger said, has focused on characterizing patients' deficits, on how best to measure a patient's health literacy, and on clarifying the relationships between limited health literacy and health outcomes. There is now a growing appreciation that health literacy represents a balance between an individual's health literacy and the health literacy demands and attributes of the health care system.
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The attributes identified in this paper are not intended to describe a specific type of organization; rather it is the case that organizations aspiring to these attributes are those that are committed to implementing improvements. They are organizations committed to reengineering systems in order to better accommodate the communication needs of populations with limited health literacy, that is, to become health literate health care organizations.
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ATTRIBUTE 2: Health literate health care organizations develop a culture of active inquiry, partner in innovation, and invest in evaluations of operations improvements. Because the science of health literacy is not yet fully developed, health literate organizations need to partner with health literacy researchers from a number of fields to develop and implement interventions, to pilot successful interventions in real-world
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They perform institutional assessments focused on the health literacy environment and the variety of communication and support systems in place. At both patient and organization levels, health literate health care organizations identify, track, and monitor health literacy metrics relevant to their organization.
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a Following the workshop, members of the Workgroup on Attributes of a Health Literate Organization of the Roundtable on Health Literacy, using feedback provided on the paper, collapsed the number of attributes to 10 and published a discussion paper that articulates a rationale for these attributes and identifies the organizations that should use them. There is also a list of resources for organizations interested in taking action.
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at the Boston City Hospital,3 which developed interactive, computer-based teaching tools based on health literacy principles. Health literate health care organizations have an instrumental role in influencing the marketplace of patient communication products by demanding rigorous testing with and adaptation for populations with limited health literacy, and in supporting the development of national certification standards for print and digital material that is accessible to these populations.
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ensure that information and education available on the personal health record can be accessed through interpersonal or alternative means for those who do not access the PEHR. ATTRIBUTE 8: Health literate health care organizations foster an augmented and prepared workforce to promote health literacy.
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ATTRIBUTE 11: Health literate health care organizations prioritize medication safety and medication communication. They recognize that patients with limited health literacy have great difficulty with medication management and are more likely to misunderstand prescription labels and warning labels (Davis et al., 2006; Wolf et al., 2007)
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ATTRIBUTE 14: Health literate health care organizations recognize social needs as medical concerns and connect people to community resources. They might partner with community resources, develop a clearinghouse of local resources, appoint a team member to be the expert in local resources, or partner with case managers and social workers to embed social services into health care delivery.
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ATTRIBUTE 18: Health literate health care organizations recognize and accommodate additional barriers to communication. Patients with limited health literacy often face additional communication challenges.
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and, as such, provides only a superficial overview. The paper offers a set of attributes and foci for institutional investment by organizations striving to become more health literate.
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. That report lists six aims for care provided by health care organizations: Care should be safe, timely, effective, efficient, equitable, and patient-centered.
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These need to be emphasized more, Epstein said. Roundtable member Winston Wong said that the attributes presented resonated with what Kaiser has been exploring, particularly in terms of using the electronic health record to capture utilization information and track demographic profiles of users.
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Schillinger said that he believes developing such checklists would indeed be complicated and would require significant work to define the crucial pieces that need to be included, but that such checklists would be a major contribution. Linda Harris, another roundtable member, suggested that in thinking about attributes of a health literate organization it might be useful to use such language and concepts as productive interactions in the Chronic Care Model,9 patient-centered care, the medical home, and accountable 8 The checklist can be viewed at http://www.who.int/patientsafety/safesurgery/en/ (accessed December 13, 2011)
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It would be useful to create a conceptual map that shows how these concepts correlate with the attributes. Roundtable member Ruth Parker said there is an opportunity to frame the discussion more broadly in order to help those who provide health care see that a health literate organization is one that values health and values sharing that with populations and individuals.
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2011. The Other Side of the Coin: Attributes of a Health Literate Health Care Organization.
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