October is Health Literacy Month

1. October is Health Literacy Month What’s Happening at UNMH? What Can You Do to Move UNMH Forward? Audrey Riffenburgh Senior Health Literacy Specialist Office of Diversity, Equity, & Inclusion

2. Rising to the Challenge • National Action Plan to Improve Health Literacy (US DHHS, ODPHP) • Promote changes in the health care system that improve health information, communication, informed decision-making, and access to health services.

3. Groups at Greatest Risk of Low Health Literacy Skills • Seniors • People living in poverty • People from ethnic minority groups—Hispanic, Black, American Indian • People with physical, mental or other health problems • People with chronic or long term health problems Look familiar? Sources: National Adult Literacy Survey (1993) and Health Literacy of America’s Adults (2003).

4. How Much Does the “Person on the Street” Understand? • Health and the City

5. What is UNMH Doing to Improve Communication with Patients? • 3 Classes in 2012: “Creating Reader-friendly Print and Web Materials”— 57 people completed • Patient-Friendly Document Committee (and PFEC) • Assisting Health Literacy Specialist in designing system changes to improve patient/family documents, forms, and more • Health Literacy Task Force • Assisting with raising awareness, Health Literacy Month, and educating clinicians about health literacy • Resources Online • Diversity, Equity and Inclusion website

6. Health Literacy Month Activities • Health Literacy Fair— October 2-3, 2012 • Combined forces to celebrate national Quality, Library, and Pharmacy Week or Month • Showcased “before” and “after” documents, PDSAs, quality initiatives, “teach back” for checking patient comprehension • Bulletin boards at main • Packets to offsite clinics for staff education • This presentation

7. Health Literacy Month Activities (continued) • Coming soon: extensive plain language thesaurus on intranet • HSLIC Health Literacy LibGuide: http://libguides.health.unm.edu/ and click on Health Literacy

9. Check it Out! • Here is a recently revised document from UNM Hospitals • See if you can spot the changes!

10. Original Parent Discharge Checklist (NBICU & ICN)

12. Final Parent Discharge Checklist (NBICU & ICN)

14. Key Changes • Checklist format for easier usability • New heading and more instructions re: P-G Survey to draw attention • Phrased to speak to reader, not about reader— e.g., “your hospital stay” instead of “Mother’s Hospital stay” • More conversational language— e.g., “taking your baby home” instead of “discharge”

15. Coming Attractions at UNMH for Improving Communication with Patients • “Document clinics”/work sessions (for those who have taken the class) • Style guides/sample layouts for standardizing and improving patient documents • Intro/awareness sessions on health literacy offered for your staff meetings • More classes in 2013 • In 2013, more focus on verbal communication

16. So, you’ve heard about the exciting work on patient communication. What can you take back to your worksite that will make a difference?

17. Working Effectively with Patients Challenged by Health Literacy and Limited English Proficiency Bronwyn Wilson MD Department of Internal Medicine Sr. Associate Dean for Academic Affairs

18. How Patient-Friendly Is my Unit? • Imagine you are a new patient with limited health literacy who comes to your unit. • What happens now? Where do you go? • Whom do you ask for help? • What if you are embarrassed by what you don’t understand and don’t ask many questions? • Now imagine that you don’t speak English very well either…..

19. Behaviors that May Indicate Low Health Literacy • Trouble navigating the healthcare system • Patient registration forms incomplete or inaccurately completed • Frequently missed appointments • Anger or frustration with staff/providers • Unable to name medications or explain timing/purpose • Lack of follow-through with lab tests, imaging, referrals

20. Patient-Friendly Procedures Exhibit general attitude of helpfulness – notice when a patient is confused and suspect lower health literacy Create a shame free environment Use clear and easy-to-follow signs Insure forms are at 7th - 8thgrade level Provide assistance with completing forms Review instructions for tests, procedures using “teach back” method

21. Patient Interview Techniques Slow down Use plain, non-medical language and references to everyday life (“your heart is like a pump”) Ask simple questions, one at a time Show diagrams, pictures and models (Google images are very helpful) Limit amount of information – focus on 2-3 key points Use the “Teach Back” method to check for understanding

22. “Teach Back” Method You do not want your patients to feel this is a test. Place the responsibility on yourself : " I want to make sure I have been clear… Can you tell me how you will explain this to your family when you get home?” Can you please explain back to me what this medicine does?” Please tell me what you think the next steps are from what I’ve told you?”

23. Remember, we want our patients to feel comfortable and satisfied with their care • The majority of our patients have limited health literacy, especially if they are worried about their health or don’t speak English well. • Most of our patients do not understand how to fill out complex forms, nor the patient satisfaction surveys that we send them. • We can help them by working together at all levels to improve their experience and enhance their health outcomes.

24. To Learn More, Share Ideas, Request a Talk, or Get Help... Contact: Audrey Riffenburgh, MA Senior Health Literacy Specialist Office of Diversity, Equity, and Inclusion 272-5101 Bronwyn Wilson, MD Office of Academic Affairs 272-8268