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4 Why Health Literacy?
Pages 29-42

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From page 29...
... , spoke about the importance of health literacy from the perspective of a pharmaceutical company, and Bernard Rosof, chief executive officer of the Quality HealthCare Advisory Group, discussed the role of health literacy in achieving the Quadruple Aim. An open discussion with the panelists followed the two presentations.
From page 30...
... Better yet, everyone, not just those who have a health issue, need to be partners in the effort to expand health literacy to make it part of learning to live a healthy life. As a sponsor for global population health efforts, Gunther says she is interested in health creation, health promotion, and prevention; to achieve those, health literacy should start at home.
From page 31...
... The company also tests comprehension with panels of lay individuals, at least 25 percent of whom are on the lower end of the health literacy scale. "We consistently achieve about 90 percent comprehension across all levels of health literacy," said Gunther, who described this approach as a new paradigm for designing patient inserts.
From page 32...
... As the delivery of health care continues to evolve in the United States, he said, health literacy can serve as an innovative and disruptive force that creates a new value equation for health care that includes the Quadruple Aim. "Let us think about health literacy that way, as a really disruptive technology to achieve our goal," said Rosof, "one supported by science and patient experience and one designed to disrupt the old habits and existing ways of thinking that get in the way of making progress." The current design of today's health care system requires patients and families to possess and demonstrate multiple skills, including understanding and giving consent, interacting with health professionals, and applying health information to different situations in a variety of life events.
From page 33...
... He noted that the priority areas include acute care, preventive care, palliative care, and chronic care, all areas that should be familiar to the health literacy community, as well as cross-cutting systems interventions such as care coordination, self-management, and patient and family engagement that all require the presence of a health literate population. The cycle of crisis that characterizes health care delivery today (see Figure 4-2)
From page 34...
... 34 BUILDING THE CASE FOR HEALTH LITERACY Sick patient seeks Staff at doctor's medical help office give patient Patient is simple forms and discharged; no offer to help fill one follows up them out with patient Doctor explains Hospital staff patient's give patient a condition and new treatment treatment plan plan, referrals, using medical and jargon prescriptions; staff do not confirm patient's Doctor writes understanding multiple prescriptions and referrals for tests Patient's condition worsens and Doctor does not patient goes to confirm patient the emergency understanding department Staff send patient home No one follows with a complicated set of up with patient written instructions = Direct action by office or hospital staff = Direct action by doctor = Effect on patient FIGURE 4-2 A patient's experience of the cycle of crisis care in the absence of health literacy. SOURCE: Adapted from a presentation by Bernard Rosof at Building the Case for Health Literacy: A Workshop on November 15, 2017.
From page 35...
... population to become health literate as a means of improving health care and health for all, Rosof said. The National Action Plan to Improve Health Literacy (ODPHP, 2010)
From page 36...
... 36 BUILDING THE CASE FOR HEALTH LITERACY Sick patient seeks Staff at doctor's medical help office give patient Patient is simple forms and discharged; no offer to help fill one follows up them out with patient Doctor explains Hospital staff patient's give patient a condition and new treatment treatment plan plan, referrals, using medical and jargon prescriptions; staff do not confirm patient's Doctor writes understanding multiple prescriptions and referrals for tests Patient's condition worsens and Doctor does not patient goes to confirm patient the emergency understanding department Staff send patient home No one follows with a complicated set of up with patient written instructions = Direct action by office or hospital staff = Direct action by doctor = Effect on patient FIGURE 4-3  A patient's experience with health literate care. SOURCE: As presented by Bernard Rosof at Building the Case for Health Literacy: A Workshop on November 15, 2017.
From page 37...
... A learning health system to better inform health literate practices and achieve the Quadruple Aim could improve this situation. A learning health system is one in which progress in science, informatics, and care culture align to generate new knowledge as an ongoing, natural byproduct of the care experience, and seamlessly refines and delivers best practices for continuous improvement in health and health care (IOM, 2007)
From page 38...
... The 10 attributes of a health literate health care organization (Brach et al., 2012) are critical to creating a health literate health care organization, which makes it easier for people to navigate, understand, and use information to take care of their health, but it requires a charter for organizational professionalism (Egener et al., 2017)
From page 39...
... One such study, for example, estimated the effect of health literacy on selected health outcomes, controlling for education, income, race, and language, and found significant improvements in patient outcomes (see Table 4-1) , all of which should translate into greater income for a health care institution.
From page 40...
... SOURCE: Adapted from a presentation by Bernard Rosof at Building the Case for Health Literacy: A Workshop on November 15, 2017. • Efficiency in the delivery of health care, particularly in the treat ment of chronic disease, requires health literate skills.
From page 41...
... will help spread the word. Katherine Atchison from the University of California, Los Angeles, remarked that effective communication among the entire health care team, not just the physicians and nurses, is imperative for achieving a health literate health care organization.
From page 42...
... "I think there are many strange bedfellows we could tap to increase communication and education needed to improve health literacy," she said. Sochan Laltoo, a public health instructor from Trinidad and Tobago, asked Gunther to comment on how health literacy plays into the growing acceptance of so-called natural remedies as replacements for pharmaceuticals when there is little or no evidence for the efficacy of those natural remedies.


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