Addressing Health Literacy in Care Coordination Emily Fisher Access to Care Coordinator - Columbus Public Health
Objectives • Care coordination, patient engagement and health literacy • What are we working on? • What lessons have we learned? • How do we continue this work? • Shared Learning – Q&A – Group Discussion
City of Columbus • Columbus Public Health
Question‌
Plain Language Policy?
Teach Back Training?
Do you or your organization take steps currently to promote or improve health literacy?
Universal Precautions?
Ask Me 3?
City of Columbus • Columbus Public Health
Health Literacy and Care Coordination Care coordination: Organizing of patient care activities and sharing information to achieve safer and more effective care. Patient engagement: A patient's knowledge, skills, ability and willingness to manage their own health and care with interventions designed to increase activation and promote positive patient behavior. 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.(1)
City of Columbus • Columbus Public Health
Health Literacy Low health literacy is more prevalent among: – Older adults – Minority populations – Those with low socioeconomic status – Medically underserved Patients with low health literacy have difficulty: – Finding doctors and seeking preventive health care – Filling out health forms – Sharing their health history – Knowing the connection between risky behaviors and health – Managing chronic health issues – Understanding directions on medicine(2)
City of Columbus • Columbus Public Health
What Gets In The Way of Care? What affects the ability to grasp and remember information? – Fear – Pain – Language – Culture – Stress – Medications City of Columbus • Columbus Public Health
Engagement and Literacy Enhancing patient-centered communication: – Plain language (verbal and written) – Confirming understanding (Teach Back) – Interpretation and translation
Results Greater patient satisfaction
Enabling shared decision-making: – Working together to make decisions – Selecting tests, treatments and care plans that balances risks/expected outcomes with patient preferences and values. – Clinicians and patients sharing the best available evidence when making decisions.(3)
Adherence to treatment plan Increased health literacy Improved health outcomes
City of Columbus • Columbus Public Health
Why Do We Focus on Health Literacy?
City of Columbus • Columbus Public Health
What have we learned?
The Cycle… Care Coordination
I understand the information and can act on it.
Health Literacy
My needs are being met and I’m connected.
Patient Engagement
I have a say and I’m being heard.
City of Columbus • Columbus Public Health
The Layers‌
Patients and Consumers
Providers
Organizations
City of Columbus • Columbus Public Health
Patients and Consumers Health Health Literacy Literacy Cultural & Conceptual Knowledge
Listening
Oral Literacy
Speaking
Reading
Writing
Numeracy
Print Literacy
4: Health Literacy – Cliff Coleman, MD - Evidence Based Best Practices, Oregon Health & Science University
City of Columbus • Columbus Public Health
Providers
City of Columbus • Columbus Public Health
Clear Communication
---5 IOM Crossing the Quality Chasm, 2001
City of Columbus • Columbus Public Health
Organizations
City of Columbus • Columbus Public Health
Local Improvements
The Landscape
Statewide collaborative of caregivers and health professionals working together to improve health communication between those seeking health care and those providing it.
City of Columbus • Columbus Public Health
Local Coalition Work
City of Columbus • Columbus Public Health
Local Assessments
City of Columbus • Columbus Public Health
Internal Improvements • • • • • • • •
Phone systems Signage Paperwork Policies Staff Training QI Projects Cross-Departmental Collaboration Streamline referrals City of Columbus • Columbus Public Health
Recent Outreach Initiatives
City of Columbus • Columbus Public Health
What Barriers Exist? • Limited funding, capacity • Competing demand • Lack of awareness for Universal Precautions • Federal and state changes to health coverage/care • Leadership and staff buy-in City of Columbus • Columbus Public Health
Future Efforts • Health literacy in ESL • Education: – Transportation – ACA and Medicaid – Coverage to Care – Prescription 101 – Local Health Issues
• Staff Training City of Columbus • Columbus Public Health
Shared Learning and Discussion
Shared Discussion • What role do you think health literacy plays in care coordination? • What challenges do you think exist for health literacy in care coordination? • How can you incorporate health literacy into your work to improve care coordination? City of Columbus • Columbus Public Health
Thank you!
Emily Fisher – Access to Care eefisher@columbus.gov 614-645-1244
References 1. 2. 3. 4. 5.
6.
https://health.gov/communication/literacy/ https://www.hrsa.gov/about/organization/bureaus/ohe/health-literacy/index.html https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5006571/ https://www.legacyhealth.org/~/ media/Files/PDF/Conference%20materials/Health%20Literacy%202016/Coleman.pdf http://www.nationalacademies.org/hmd/~/ media/Files/Report%20Files/2001/Crossing-the-Quality-Chasm/Quality%20Chasm%2 02001%20%20report%20brief.pdf www.ohiohealthliteracy.org
City of Columbus • Columbus Public Health