health literacy - nebraska medicine
TRANSCRIPT
Health LiteracyMara McDermott RN, BSNElizabeth Blazek RN, BSN
Kathy J. Morris, DNP, APRN-NP, FNP-C, FAANP
Sue Barnason PhD, RN, APRN-CNS
Judy Jesz, DNP, MBA, RN
Jana Uryasz, MSN, RN
The Problem
In a 17 minute diabetes follow up appointment the provider addresses: 17 topics, questions, or symptoms Will write two prescriptions Will discuss nutrition & medication changes
AND
Only 12% of American adults have proficient health literacy
Bottom Line: NOW MORE THAN EVER WE NEED AN INNOVATIVE SOLUTION TO
INCREASE PATIENT UNDERSTANDING AND SELF EFFICACY WHILE ALSO DECREASING
COST AND TIME
Definition of Health Literacy
Health Literacy is defined as “The degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions”
(Jacobs, Lou, Ownby, & Caballero, 2016)
Background
Inadequate health literacy leads to inability of patients
to successfully interact with the healthcare system and
participate in self-care
Health care services continue to become more complex
Interventions recommended or prescribed are
increasingly difficult for laypersons to understand
(Mahadevan,2013)
Consequences of Low Health Literacy
Increased number and prolonged hospitalizations
Ineffective medication use
Reduced use of preventative services
Higher healthcare costs
Greater morbidity and mortality
Patients Rights
Patients have the right to understand health-care information that is necessary for them to safely care for themselves, and to choose among available alternatives.
Health-care providers have a duty to provide information in simple, clear, plain language and to check that patients have understood the information before ending the conversation.
BRIEF Health Literacy Screening Tool
Nebraska Medicine Primary Care Medical Homes (PCMH Clinics) implemented the BRIEF Health Literacy Screening Tool for all new patients that are 19 years of age and older and are English-speaking.
Written questionnaire:1. How often do you have someone help you read hospital materials?
2. How confident are you filling out medical forms by yourself?
3. How often do you have problems learning about your medical condition
because of difficulty understanding written information?
4. How often do you have a problem understanding what is told to you
about your medical condition?
BRIEF Screening Tool-Scoring
The BRIEF can be administered and scored in less than two
minutes
Applicable to all patients in all settings with all disease
processes (English speaking only)
High validity, sensitivity, and practicality
Each question scored on a Five-point Likert Scale
-Scores range from 4-20
What did the literature say?
Relatively modest interventions can help solve the problem of diminished health literacy
– Provider face-to-face counseling vs. generic brochure
– Education on increased communication skills (ex.
Motivational interviewing)
– Case manager contact-follow up
Toolkit--Nebraska Medicine
What is an innovative, cost effective approach to care that will increase
patient self efficacy, patient compliance, and patient
understanding?
History of Shared Medical Appointments
Originally created by a psychologist and adapted for the medical setting
– First SMA in medical setting in 1999.
Utilization percentage:
– In 2005: 5% of family physicians offered SMA’s
– In 2010: 10% of family physicians offered SMA’s
(Schroeder, 2015)
What are Shared Medical Appointments?
A brief one on one session directly with the clinician, followed by
an interactive group session with a cohort of peers with the same
chronic disease.
Education session provided at each appointment
Involve multidisciplinary team:– Provider (MD, NP, PA)
– Pharmacy
– Nutrition
– Behavioral Health
– Social Work
Shared Medical Appointments and Health Literacy
The benefits of shared medical appointments:
– Opportunity for peer bonding
– Reduced costs
– Increased patient
accountability
– Interprofessional focus
– Increased provider efficiency
– Expands possible patient
learnings
The benefits of increased health literacy:
– More positive patient outcomes
– Reduced healthcare costs
– Decreased hospitalizations and
reduced length of stay in the
hospital
– Increased patient compliance
– Increased patient adherence to
treatment plans
How do Shared Medical Appointments Increase Health Literacy?
“The degree to which individuals have the
capacity to obtain, process and understand basic
health information and services needed to make
appropriate health decisions”
Availability of Information– SMAs provide an environment that
facilitates learning and increased
patient engagement
Ease of Processing– SMAs utilize a variety of teaching
strategies to enhance patient
learning
Increasing Understanding – SMAs empower patients to take
control of their own treatment plan
and ask questions in a group
setting
References
Haun, J., Noland-Dodd, V., Varnes, J., Graham-Ple, J., Rienzo, B., & Donaldson, P. (2009). Testing the BRIEF literacy screening tool. Federal Practitioner, 26(12) 24-31.
Jacobs, R. J., Lou, J. Q., Ownby, R. L., & Caballero, J. (2016). A systematic review of eHealthinterventions to improve health literacy. Health informatics journal, 22(2), 81-98.
Mahadevan, R. (2013). Health literacy fact sheets - center for health care strategies. Retrieved from http://www.chcs.org/resource/health-literacy-fact-sheets/
Parchman, M. L., Romero, R. L., & Pugh, J.A. (2006). Encounters by patients with type 2 diabetes—complex and demanding: An observational study. The Annals of Family Medicine, 4(1), 40-45.
Schroeder, M. (2016). Group visit: Why shared medical appointments are gaining in popularity. Retrieved from http://health.usnews.com/health-news/patient-advice/articles/2016-07-12/group-visit- whyshared-medical-appointments-are-gaining-in-popularity
Thank you!
Further questions?
Contact Information:
Mara McDermott• [email protected]
Elizabeth Blazek• [email protected]
