Domain I Bullet Points (provided by Diane and Peggy).

Domain I – Define health literacy and its impact on patient experience

Health Literacy: The Patient Protection and Affordable Care Act of 2010, Title V, defines health literacy as - the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions. Anyone who provides health information and services to others, such as a doctor, nurse, dentist, pharmacist, or public health worker, also needs health literacy skills to Help people find information and services Communicate about health and healthcare Process what people are explicitly and implicitly asking for Understand how to provide useful information and services Decide which information and services work best for different situations and people so they can act Source: Centers for Disease Control

Impact of Limited Health Literacy Skills

Use of preventive services Persons with limited health literacy skills are more likely to skip important preventive measures such as mammograms, Pap smears, and flu shots. When compared to those with adequate health literacy skills, studies have shown that patients with limited health literacy skills enter the healthcare system when they are sicker. Knowledge about medical conditions and treatment Persons with limited health literacy skills are more likely to have chronic conditions and are less able to manage them effectively. Studies have found that patients with high blood pressure, diabetes, asthma, or HIV/AIDS who have limited health literacy skills have less knowledge of their illness and its management. Rates of hospitalization Limited health literacy skills are associated with an increase in preventable hospital visits and admissions. Studies have demonstrated a higher rate of hospitalization and use of emergency services among patients with limited literacy skills. Health status Studies demonstrate that persons with limited health literacy skills are significantly more likely than persons with adequate health literacy skills to report their health as poor. Healthcare costs Persons with limited health literacy skills make greater use of services designed to treat complications of disease and less use of services designed to prevent complications Studies demonstrate a higher rate of hospitalization and use of emergency services among patients with limited health literacy skills. This higher use is associated with higher healthcare costs. Stigma and shame Low health literacy may also have negative psychological effects. One study found that those with limited health literacy skills reported a sense of shame about their skill level. As a result, they may hide reading or vocabulary difficulties to maintain their dignity. Source: US Department of Health & Human Services

Domain I – Identify and promote health literacy strategies / technique used to ensure patient / family / resident understanding (some examples include avoiding jargon, using plain language and teach back)

Plain language is a strategy for making written and oral information easier to understand. It is one important tool for improving health literacy. Key elements of Plain Language include: Organizing information so that the most important points come first Breaking complex information into understandable chunks Using simple language and defining technical terms Using the active voice. Clear & Simple Outlines a process for developing publications for people with limited-literacy skills and features proven principles and a discussion of real life issues that individuals developing low-literacy materials face. Cultural Respect Cultural Respect is a strategy that enables organizations to work effectively in cross-cultural situations. Developing and implementing a framework of cultural competence in health systems is an extended process that ultimately serves to reduce health disparities and improve access to high-quality health care. Cultural respect benefits consumers, stakeholders, and communities. Because a number of elements can influence health communication—including behaviors, language, customs, beliefs, and perspectives—cultural respect is also critical for achieving accuracy Offer and Confirm Clear Understanding Offer a clear understanding of what to do to improve one’s health, why is it being done, and, precisely, how to do it. “This medicine will lower your blood pressure, which will help your heart. You need to take the green tablets, with food. That’s one green tablet every day when you wake up with your breakfast, and one green tablet after dinner and before you go to sleep.” Confirm the individual has a fundamental understanding of the information exchange (i.e. more than a nod of the head or an uh huh)For example, “What do you think your risk is of having the complications I mentioned? What are you going to do with that information?”Using the “teach back” method - having the patient repeat the information back to the provider, can help in ensuring there has been understanding. Source US Departments of Health & Human Services, National Institutes of Health