Improving health literacy in the healthcare setting

The Institute of Medicine defines health literacy as “the degree to which individuals can obtain, process, and understand the basic information and services they need to make appropriate health decisions.” Studies show that health literacy is a strong predictor of health status.

Inadequate health literacy can lead to numerous negative effects on an individual’s health and well-being, including poor self-care, increased utilization of health services, worse outcomes, and decreased likelihood of receiving preventive care and services. Poor communication with patients also contributes to unnecessary re-admissions and reduced patient satisfaction and engagement.

Health information can be confusing even for those with advanced literacy skills. It’s easy for those of us working in healthcare to forget that we speak our own language that patients can’t always easily understand. Most of us can recall times when we believed that we shared information with a patient and family member or caregiver and assumed they understood our instructions, only to later discover confusion or misunderstanding.

This kind of confusion is understandable, but may also be avoidable if we take some extra care with our communication with patients and family caregivers. There are a number of ways care providers can improve their communication, to help patients and families better understand health information.

Healthcare providers should ask open-ended questions to assess the patient’s understanding of written material, including prescription labels. They should use the teach back communication method to determine if a patient has understood instructions and can repeat the information in their own words. They can hand the patient written material upside down while discussing it, and observe whether they turn it right side up.

The use of simple language is very important and complicated medical terminology or jargon should be avoided.

As we continue to work on improving the safety and reliability of care, we must expand our efforts beyond the standardization and simplification we focus on in the acute care and ambulatory settings. We must consider the other defects that contribute to patient harm, including how we communicate with patients about their treatment plans and their health. Ensuring that we are communicating clearly and delivering information at the appropriate literacy level will be an important step.

Dr. Rosmond Adams, MD is a medical doctor and a public health specialist with training in bioethics and ethical issues in medicine, the life sciences and research. He is the Head of Health Information, Communicable Disease and Emergency Response at the Caribbean Public Health Agency (CARPHA). He is also a member of the World Health Organization Global Coordination Mechanism on the Prevention and Control of NCDs.

(The views expressed here are not written on behalf of CARPHA nor the WHO).

Dr Rosmond Adams is a medical doctor and a public health specialist. He may be emailed at:adamsrosmond@gmail.com