How can patients make the best decision possible when a situation arises? Health literacy, or having the right information top-of mind is the place to start. According to a NAAL study 35 percent of all patients have basic or below basic health literacy, which equates to about 77 million U.S. adults.
To help address patient literacy problems over time, here are nine effective techniques that you can implement:
1. Make information more readily accessible
Gaining access to important information can be difficult for some patients, depending on where your healthcare organization makes this information available. Many health systems place this information online, but can be difficult to find. For instructions related to surgery prep or labor and delivery, for example, many times pamphlets or brochures are handed out to patients and not read or understood.
An alternative we are finding to be the best option is mobile apps. Healthcare organizations are slowly making the shift to offering them for just about any circumstance, instead of just providing a single app. The benefit of this approach is that the information is where patients need it, when they need it.
2. Simplify the delivery of information
For patients with poor health literacy, making sure information is easily digestible and user-centered is one tip recommended by the Centers for Disease Control and Prevention (CDC) to help with improving literacy. Again, an effective way to do this for many patients is by providing a mobile app. According to Pew Research, 95 percent of Americans use a smartphone, and have the expectation of convenience whenever they launch an app.
For me personally, having instructions on how to use any new app I am unfamiliar with simplifies the experience. Apps are great for delivering important information one item at a time, and making an experience interactive. Imagine how much more effective this strategy is versus pointing users to a webpage filled with text, or handing out a multi-paragraph document.
3. Listen and interact with patients
Being available goes a long way in making sure that patients with low health literacy understand that you care. Many cultural factors can contribute to whether or not patients will easily understand important information such as where to park, what to do before arrival, etc. Sometimes simply speaking with patients beforehand and asking questions goes a long way in making sure they know what to expect.
Repeating instructions and asking open ended questions can be a good way to help patients absorb information that otherwise may be forgotten in written form.
4. Focus on user-centered design
One way to help improve health literacy according to a National Action Plan to Improve Health Literacy released by the U.S. Department of Health and Human Services is to adopt a user-centered design. Incorporating pictures to help patients fully understand how to take medication is one of several strategies laid out in the plan. The benefit of this approach is the ability to decrease medical errors by make instructions more clear as opposed to bullets or checklists.
For some patients, graphs and charts can also be effective in communicating the significance of certain statistics patients should know.
5. Target specific patient groups with your messaging
Patients respond differently to how information is presented, and this depends on several factors. For some patients with lower literacy skills this is key because information presented to these groups may need to be delivered much differently than other more literate patients. Factors like socioeconomic status and even language barriers can help determine how simplified language needs to be.
Visuals that can be interpreted universally is a good place to start. Knowing the demographic makeup of the audience you are targeting is essential in determining what content will resonate best, and can vary from state to state.
6. Simplify forms
Simplifying a standard process, such as requiring certain forms be filled out by a patient, is a simple way to make important information easier to understand and collect. In addition to updating existing forms that may be confusing for some patients, having a process to explain or assist patients with the data entry process may also be a good strategy to implement.
7. Ask open-ended questions to reiterate important information
Questions like “How would you do XYZ before coming into the lab?” or “Tell me your plan for XYZ” are the types of open-ended questions that can help patients better understand and memorize important next steps in the care process. The Institute for Healthcare Improvement (IHI) suggests using this method (called the Teach-back method) as a way to help patients explain what they need to do and re-explain if necessary.
8. Speak slowly
One thing to keep in mind when interacting with patients is the importance of speaking slowly. Fast speech is like fine print – it’s easy to ignore and not the best practice for driving home an important point. A Brown University study found that word-for-word, fast talkers tend to convey less information than slow talkers due to factors like sentence structure.
9. Create a gameplan for improvement
There are many different techniques you can implement to begin to address the problem of health literacy, but creating a plan is probably the most important technique to see real change. What policies will you look to put in place and communicate to members of your organization? How will you measure success? These questions are critical to being able to asses what’s working for patients and what isn’t.
To help with putting this process in place, the CDC created a National Action Plan to Improve Health Literacy which outlines the following seven goals:
1. Develop and disseminate health and safety information that is accurate, accessible, and actionable
2. Promote changes in the health care system that improve health information, communication, informed decision-making, and access to health services
3. Incorporate accurate, standards-based, and developmentally appropriate health and science information and curricula in child care and education through the university level
4. Support and expand local efforts to provide adult education, English language instruction, and culturally and linguistically appropriate health information services in the community
5. Build partnerships, develop guidance, and change policies
6. Increase basic research and the development, implementation, and evaluation of practices and interventions to improve health literacy
7. Increase the dissemination and use of evidence-based health literacy practices and interventions
To obtain, process, and retain information, some patient groups respond better to certain strategies outlined versus others. One of the things we’ve found helpful is to modernize the patient education materials using technology like mobile apps.
What has worked for your hospital or health system when it comes to improving health literacy?