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Suggested Citation:"Front Matter." 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: 10.17226/24918.
×

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

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THE NATIONAL ACADEMIES PRESS
Washington, DC
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Suggested Citation:"Front Matter." 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: 10.17226/24918.
×

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

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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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.

Suggested Citation:"Front Matter." 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: 10.17226/24918.
×

images

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.

The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. C. D. Mote, Jr., is president.

The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president.

The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine.

Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.

Suggested Citation:"Front Matter." 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: 10.17226/24918.
×

images

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.

Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.

For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo.

Suggested Citation:"Front Matter." 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: 10.17226/24918.
×

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.

Suggested Citation:"Front Matter." 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: 10.17226/24918.
×

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Suggested Citation:"Front Matter." 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: 10.17226/24918.
×

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.

Page viii Cite
Suggested Citation:"Front Matter." 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: 10.17226/24918.
×

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

Suggested Citation:"Front Matter." 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: 10.17226/24918.
×

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.

Suggested Citation:"Front Matter." 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: 10.17226/24918.
×

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Suggested Citation:"Front Matter." 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: 10.17226/24918.
×

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.

Suggested Citation:"Front Matter." 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: 10.17226/24918.
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This page intentionally left blank.

Suggested Citation:"Front Matter." 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: 10.17226/24918.
×
Suggested Citation:"Front Matter." 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: 10.17226/24918.
×
Suggested Citation:"Front Matter." 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: 10.17226/24918.
×

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Page xvii Cite
Suggested Citation:"Front Matter." 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: 10.17226/24918.
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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
Page xviii Cite
Suggested Citation:"Front Matter." 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: 10.17226/24918.
×
PCMH patient-centered medical home
TTY teletypewriter
Suggested Citation:"Front Matter." 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: 10.17226/24918.
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Suggested Citation:"Front Matter." 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: 10.17226/24918.
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Suggested Citation:"Front Matter." 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: 10.17226/24918.
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Suggested Citation:"Front Matter." 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: 10.17226/24918.
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Suggested Citation:"Front Matter." 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: 10.17226/24918.
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Suggested Citation:"Front Matter." 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: 10.17226/24918.
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Suggested Citation:"Front Matter." 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: 10.17226/24918.
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Suggested Citation:"Front Matter." 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: 10.17226/24918.
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Suggested Citation:"Front Matter." 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: 10.17226/24918.
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Suggested Citation:"Front Matter." 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: 10.17226/24918.
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Suggested Citation:"Front Matter." 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: 10.17226/24918.
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Suggested Citation:"Front Matter." 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: 10.17226/24918.
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Page xiii Cite
Suggested Citation:"Front Matter." 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: 10.17226/24918.
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Suggested Citation:"Front Matter." 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: 10.17226/24918.
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Suggested Citation:"Front Matter." 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: 10.17226/24918.
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Suggested Citation:"Front Matter." 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: 10.17226/24918.
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Page xvii Cite
Suggested Citation:"Front Matter." 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: 10.17226/24918.
×
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Page xviii Cite
Suggested Citation:"Front Matter." 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: 10.17226/24918.
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Health literacy, cultural competence, and language access services are distinct but inextricably linked concepts for delivering equitable care to all members of the increasingly diverse population of the United States. These concepts are linked, but they developed via different paths, and each has its own unique focus with regard to enabling every individual to obtain the ability to process and understand basic health information and services needed to make appropriate health care decisions. Fragmentation of these disciplines has impeded implementation of relevant measures for quality improvement and accountability.

To foster an integrated approach to health literacy, cultural competency, and language access services, the Roundtable on Health Literacy initiated a project with three components: a commissioned paper to propose a framework for integrating measurements of health literacy, cultural competency, and language access; a workshop to review and discuss the framework; and a second commissioned paper that will provide a roadmap for integrating health literacy, cultural competency, and language access services as well as a revised measurement framework. Held on May 4, 2017, the workshop explored the quality performance measures for integration of health literacy, cultural competence, and language access services. This publication summarizes the presentations and discussions from the workshop.

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