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4 Panel 3: Implementing Attributes of a Health Literate Organization
Pages 63-86

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From page 63...
... Much of the organization's health literacy efforts are focused around health educators, nutritionists, patient navigators, care coordinators, case managers, and volunteers. Most of Urban Health Plan's health literacy work occurs in the community and not during the doctor-patient visit.
From page 64...
... Izquierdo-Hernandez said that she believes that Urban Health Plan has all of the attributes of a health literate organization, although not always in a traditional manner. For example, Urban Health Plan's leader­ ship has made health literacy a priority from the beginning.
From page 65...
... Urban Health Plan has integrated health literacy into performance improvement and trains its workforce to be health literate. There is a staff learning center for professional and personal growth, with classes on how to conduct motivational interviews, how to deal with difficult patients, and how to develop a curriculum for certain chronic illnesses.
From page 66...
... Currently, Urban Health Plan is not part of a formal health system but rather is an independent FQHC. It has been able to negotiate some shared savings that help pay for health literacy, and, she believes, as health care reform and payment reform move toward prevention, health literacy work will be more sustainable.
From page 67...
... Riffenburgh's position was created in 2012 to help achieve those goals. UNM Hospitals is working most intensively on the sixth and eighth attributes of a health literate organization: interpersonal communications and printed materials.
From page 68...
... This will culminate in a template of the new style and a "gallery" of sample materials available on the system's Intranet so that people in the organization can see what plain language looks like. Riffenburgh said that she found that providers and hospital staff have often misunderstood what plain language is, and that has proven to be a barrier.
From page 69...
... Probably the most significant factor, however, was a lawsuit filed in 2005 demanding language access because the hospital was not doing enough to provide services for speakers of languages other than English. Strategies that have moved health literacy efforts forward at UNM Hospitals include gaining the support of key leaders and champions and linking health literacy to safety, quality, patient satisfaction, and cost savings.
From page 70...
... One barrier to implementing health literacy has been resistance to using plain language. Many people do not believe or do not understand that there is really a mismatch between what the system demands and what patients can navigate.
From page 71...
... Hall said Lilly's journey toward becoming a health literate organization began on the front lines, that is, in the health education department, rather than in the executive office. The health education department has a vision to provide foundational knowledge and skills to engage, educate, and empower patients to be active in the management of their own health care.
From page 72...
... Concern CME INCITE/ Addressing the Health Literacy Epidemic: Prescribing Virtual Rounds™ Toward Better Patient Outcomes Pri-Med West Health Literacy -- The Whole Patient in Primary Care Integritas Communications/ Improving Health Literacy in Primary Care: Identifying Web-based Deficiencies and Promoting Shared Decision Making Illinois Academy of Family Keep It Clear: Developing Communication Skills to Physicians/Ed Track Work with Patients with Limited Health Literacy Boston Medical Center Annual Health Literacy Research Conference (HARC)
From page 73...
... Hall said that when she heard a presentation on the findings of the assessment, it inspired her to take up health literacy work at Lilly. She realized that to be effective, any efforts to create a health literate organization had to support Lilly's business plan and build on efforts that were already under way, so that health literacy is not a separate workstream, but instead is integrated into the work that everyone is already doing.
From page 74...
... This team calls itself Health Literacy Matters. It consists of representatives from consumer marketing, clinical project management, the medical call center, labeling, and global patient safety, among others.
From page 75...
... Abrams focused her presentation on a reader-friendly consent for surgeries and procedures and described its development in the context of the attributes of a health literate organization. Although health literacy work at the Iowa Health System originates in the Department of Clinical Performance Improvement, development of the new consent materials was a crosscutting, systemwide quality initia
From page 76...
... Still, this project was not just about revising forms. The wider organizational goal was to use the project as a strategy to • educate staff and providers about health literacy concepts; • promote patient understanding through plain language and teach-back; • optimize perioperative consent communication; and • encourage adult learners, risk managers, health care providers, and the law department to work collaboratively with the health literacy team.
From page 77...
... The revised form is part of an overall health literacy–based consent process that includes surgeon-patient discussions conducted in plain language. The health literacy team began revising the old consent form with input from a number of individuals, including the New Readers of Iowa, a group of adult learners.
From page 78...
... 78 FIGURE 4-3  Consent for surgery or procedure form. SOURCE: Abrams, 2013.
From page 79...
... The Iowa Health System has achieved 9 of the 10 attributes of a health literate system, Abrams said. Interest in the consent project within the context of the health literacy effort was generated when people noticed that the original form was very hard to read.
From page 80...
... In high-risk situations, the new form helps address doubts that the patient is giving true informed consent. Abrams ended her presentation by thanking the people who have led and facilitated health literacy work at her organization.
From page 81...
... Many people and organizations say they can and do develop health literate products that can be applied anywhere, but the presenters suggested that it is difficult and time consuming to implement organizational change to improve health literacy. DeWalt then asked ­zquierdo-Hernandez to I describe what she meant when she talked about standardizing key messages and how she does it.
From page 82...
... These linkages and integration should become part of the way a health literate organization does business, Abrams said. She emphasized that a very important thing to remember when developing health literacy initiatives within an organization is the voice of the patient.
From page 83...
... She said it is very important to translate from plain-language English to plain language in the new language, because the original document needs to be a health literate document. She said they also commission two translations for each document to be sure that they are getting the best product.
From page 84...
... Hall said that once they have created patient education materials in English that follow health literate principles, they translate them into other languages, and then a separate group translates the material back into English. This is one way to check that the health literacy principles are maintained in the documents, she said.
From page 85...
... So, instead of trying to package and distribute a health literate consent form, one should package the process so that others can understand how to develop the form. Brach said she coauthored a paper several years ago that had ­ othing n to do with health literacy called "Will It Work Here?


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