Collaborative Development of a Clinic-based Health Literacy Initiative

Background: Limited patient health literacy and ineffective patient-provider communication can result in high hospital readmission rates, distrust in the healthcare system, and poor treatment outcomes. Improving the patient-provider experience to proactively engage patients in dialogue that transcends health literacy levels can lead to increased health literacy and improved medical outcomes.

Program background: A collaborative partnership between university researchers, clinical providers, and a statewide hospital advisory council helped determine the need for this health literacy initiative. Together this team developed a clinic readiness assessment which a pilot clinic completed prior to being selected to implement the health literacy intervention. The intervention protocol and data collection instruments were developed collaboratively by the clinical and academic partners. The intervention included administration of a validated patient literacy assessment followed by the administration of AskMe3 questions from the Institute for Healthcare Improvement / National Patient Safety Foundation designed to help patients understand in plain language what their main problem is, what they need to do, and why it is important for them to do it.

Evaluation Methods and Results:

The results from the clinic readiness assessment survey demonstrated the pilot intervention site’s strong dedication to improvement of patient care and capacity for successful implementation of a health literacy initiative. Currently, pilot program data from 53 patients has been collected. Throughout the data collection process, updates have been made to the interview guide when discussing implementation processes with the administering staff. Of those interviewed to date, the sample was mostly male, had a high school diploma or GED, and were African American. Twenty eight percent had no insurance and were diagnosed with hypertension as the primary reason for the visit. Thirty-nine percent indicated ‘Never’ needing help with written materials from doctors or pharmacists. All patients reported learning about the AskMe3 questions. Forty-three percent responded that their doctor did not use pictures, charts or drawings to explain information during their last appointment.

Conclusions: The strong dedication to improvement of patient care and staff capacity has been a major factor in the successful pilot implementation of the AskMe3 intervention. Results thus far indicate an opportunity for information to be provided in other formats.

Implications for research and/or practice:

Results from the pilot study will help guide planned efforts to scale-up this initiative statewide. The pilot site has helped to create streamlined surveys lessening the burden on staff while educating patients about AskMe3. Given that 100% of respondents have been shown the AskMe3 materials thus far, it is promising for future clinics to add AskMe3 into their standard operating procedures to help patients better understand their health needs and participate in their medical decision making.