Health literacy affects a patient's ability to access health care services, understand health-related information, and partner with clinicians in making health care decisions. Implementing health literacy universal precautions in your practice requires that all of your staff members—from front office staff to the medical director—know how health literacy affects your patients and consistently work to make health care clearer and easier.
Educate all staff.
- Show a video: These videos include interviews in which patients talk candidly about their experience in the health care system and their understanding of health-related information.
- Conduct a presentation: Health Literacy: Barriers and Strategies. This PowerPoint presentation includes 30 slides, with speaker's notes, that can be delivered in 30-45 minutes to a group or as a self-study program. Include time for group discussion.
"We had lunch to discuss health literacy and introduce this topic to the staff... I showed the 6-minute health literacy video, and as soon as it ended, I was amazed at the reaction. The staff started talking about similar experiences they have had with our patients… This video created such momentum. It was very easy to get the staff to work on these tools after watching it."
–Rural family practice
When planning your education session, allow time for group discussion.
Some ideas on how to lead the session include:
- Refer to the Questions for Discussion and Moderator's Guide, which can be used in conjunction with health literacy videos.
- Ask attendees to provide examples of health literacy barriers they have encountered in working with patients. Discussion of such experiences can both raise awareness and engage your staff.
- Play a plain language game (use a plain language thesaurus as reference). Ask teams of staff members to come up with plain language names and descriptions for common medical terms.
- Have staff and clinicians role play good and bad health literacy practices. Go to Tool 4: Communicate Clearly for tips on communicating effectively.
- Use other tools in this Toolkit, like Tool 5: Use the Teach-Back Method and Tool 11: Assess, Select, and Create Easy-to-Understand Materials, to show how you can apply health literacy best practices.
- Consider using the Health Literacy Brief Assessment Quiz to gauge the knowledge of your staff. Ask staff to complete the quiz before and after your staff training. Feel free to add items that capture the key points you plan to cover.
Pursue continuing education credits in health literacy.
- Health Literacy and Public Health: Communicate to Make a Difference Series from the New York/New Jersey Public Health Training Center has 2 modules, each 1-2 hours long.
- Two health literacy Maintenance of Certificate (MOC) modules (the Part 2—Knowledge Self-Assessment and Part 4-Performance Improvement Modules) are available through the American Board of Pediatrics. MOC credit for other primary care physicians is expected to be available in 2015. If your organization issues continuing education credit and you would like to offer these modules, write to: HealthLiteracy@ahrq.hhs.gov.
Maintain health literacy awareness.
- Make sure to have a plan for revisiting the topic of health literacy periodically and training new staff. If you have fellows or residents, be sure to emphasize during their training that they're learning communication skills that will be valuable regardless of their chosen specialty.
- Use existing opportunities (e.g., staff meetings, huddles, or "Lunch & Learns") to provide training.
- Follow up your initial training with sessions covering key recommendations for improving communication provided in other tools (e.g., Tool 4: Communicate Clearly; Tool 5: Use the Teach-Back Method).
- Consider sending out "Health Literacy Weekly Reminders" to staff and clinicians with communication tips and plain language reminders to maintain interest in health literacy.
- Post Ask Me 3 posters in the practice to encourage patients and staff to ask questions (Go to Tool 14: Encourage Questions). Post the Key Communications Strategies posters (Tool 4: Communicate Clearly) posters in the practice to help staff remember the key tips for communicating effectively with patients.
- Provide a plain language thesaurus to staff and clinicians to help them avoid medical jargon when talking to patients.
Track Your Progress
- Document the proportion of staff completing health literacy training, on-site, off-site, and virtual.
- Calculate the percent of new hires and new residents that get health literacy training in their first month.
- Confirm that health literacy education is offered to staff on an ongoing basis, including regular updates as well as training for new employees and residents rotating into the practice.
- Compare Health Literacy Brief Assessment Quiz answers before and after staff training to assess understanding.