Mayden Health Literacy Workshop

Friday, March 29, 2013

Roundtable Call to Action

Topic:Clinical Care and Health Literacy

Facilitator:Robert C. Pendleton

Recorder: Erica Lake

Reporter:Emily Eresuma

Table Group:

RorieDuPrey, VA

Hailey Nielson, UU

Mary McFarland, EHSL

Amy Honisett, EHSL

Camille Salmond, EHSL

Sue Chase Canterini, UU

Amanda Flanders, IHC

Bryan Smith Gibson, UU

Emily Eresuma, PCMC

Characterize Health Literacy in the clinical environment

We all come from different institutions and backgrounds, but what are our health literacy commonalities? What are our differences?

Hurdles we share:

  • Ask Me Three doesn’t address psychological aspects. Motivational interviewing recommended because many times patients don’t know what questions to ask.
  • Patients and providers need to establish overall goals and expectations – if they are mismatched, won’t have patient or provider satisfaction. What are patients’ goals? What are providers able to do for that particular patient?Need to have the two parties making the best possible decision together. Could create a standard template for communication that can be a medium for engagement – both patientsand providers could fill them out.
  • Empowering the patient is a huge piece of health literacy. How do we have patients feel most empowered when they come into the health care arena?
  • Need to find physician champions in our fields who can serve as health literacy L mentors and experts.
  • WHAT even IShealth literacy?? Most practitioners don’t have a clue - there is a total misperception about what it is and who provides it. Need marketing campaign aimed at providers and administrators to demonstrate it is all about patient-centered care, outcomes, et al.

How do we measure success?

Patient experience measures are robust now, and some domains are specific to provider, to communication, and to outcomes. How can we leverage the data that is publically reported?

We could survey every patient who comes to the clinic – produce something like Trip Advisor - and leverage this to get providers to think twice about how they care for patients.

Need to increase transparency of care so providers know what kind of education patients have already had while in the hospital – how can this knowledge be documented? We could integrate the care processes and education going on within a department, and coordinate it – document it - make everything transparent. Oncology and cardiology at UUHC have well-established practices of doing this, and could be the role models for others.

Payment penalties will grow with health care reform – we could also take advantage of these to leverage improved health literacy practices from providers.

Identify 3 specific initiatives related to the topic

  1. Current assessment of best practices for standard processes – look at high performers in this area.
  1. Modify best practices and initiate small tests of change by doingtests at single clinic sites – use resource sharing to institutionalize practices.
  1. Build up providers’ competencies/knock down misperceptions of what health literacy is. What can we do to improve providers’ health literacy competency? We need a campaign on health literacy tools, and how they affect outcomes for physician empowerment.

Action Steps: what do we need to do to make these initiatives happen?

  1. Create a template: research templates that already exist; pilot at a clinic; focus group w/providers and patients and support staff; line up physician champions
  1. Engage leadership: go to the top – must be valued by leadership or else won’t get traction; marketing campaign to reduce misconception of health literacy by providers; only academic center that has unedited patient surveys posted online - these stories are VERY impactful, more so than statistics - take advantage of them, and of their internal pressure.
  1. Partner with local health literacy research experts to define and refine way of measure: can’t improve what you don’t measure; HCAP measures; devise efficient ways to measure current levels and tie to satisfaction based on specific questions tied to clinical outcomes; measure providers’health literacy competencies to see if they are rated better by patients (find who are the highest level providers on patient satisfaction surveys, and see if they rank high on health literacy); Health literacy is intervention related to patient outcomes – could focus on pain management - belief that robust HL intervention could improve patient’s reported pain management scores

How will these initiatives be delivered? Createdirectives for research? Create directives for clinical care?

Not addressed.

Who will make theseinitiatives happen? (Identify specific individuals)

Not addressed.

Identify resources needed to make the above initiatives happen:

Not addressed.

3/26/2013/jml/aw