Health Literacy Mara McDermott RN, BSN Elizabeth Blazek RN, BSN

Transcription

1 Health Literacy Mara McDermott RN, BSN Elizabeth Blazek RN, BSN Kathy J. Morris, DNP, APRN-NP, FNP-C, FAANP Sue Barnason PhD, RN, APRN-CNS Judy Jesz, DNP, MBA, RN Jana Uryasz, MSN, RN

2 The Problem In a 17 minute diabetes follow up appointment the provider addresses: 17 topics, questions, or symptoms Will write two prescriptions Will discuss nutrition & medication changes AND Only 12% of American adults have proficient health literacy Bottom Line: NOW MORE THAN EVER WE NEED AN INNOVATIVE SOLUTION TO INCREASE PATIENT UNDERSTANDING AND SELF EFFICACY WHILE ALSO DECREASING COST AND TIME

3 Definition of Health Literacy Health Literacy is defined as The degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions (Jacobs, Lou, Ownby, & Caballero, 2016)

4 Background Inadequate health literacy leads to inability of patients to successfully interact with the healthcare system and participate in self-care Health care services continue to become more complex Interventions recommended or prescribed are increasingly difficult for laypersons to understand (Mahadevan,2013)

5 Consequences of Low Health Literacy Increased number and prolonged hospitalizations Ineffective medication use Reduced use of preventative services Higher healthcare costs Greater morbidity and mortality

6 Patients Rights Patients have the right to understand health-care information that is necessary for them to safely care for themselves, and to choose among available alternatives. Health-care providers have a duty to provide information in simple, clear, plain language and to check that patients have understood the information before ending the conversation.

7 BRIEF Health Literacy Screening Tool Nebraska Medicine Primary Care Medical Homes (PCMH Clinics) implemented the BRIEF Health Literacy Screening Tool for all new patients that are 19 years of age and older and are Englishspeaking. Written questionnaire: 1. How often do you have someone help you read hospital materials? 2. How confident are you filling out medical forms by yourself? 3. How often do you have problems learning about your medical condition because of difficulty understanding written information? 4. How often do you have a problem understanding what is told to you about your medical condition?

8 BRIEF Screening Tool-Scoring The BRIEF can be administered and scored in less than two minutes Applicable to all patients in all settings with all disease processes (English speaking only) High validity, sensitivity, and practicality Each question scored on a Five-point Likert Scale -Scores range from 4-20

9 What did the literature say? Relatively modest interventions can help solve the problem of diminished health literacy Provider face-to-face counseling vs. generic brochure Education on increased communication skills (ex. Motivational interviewing) Case manager contact-follow up

10 Toolkit--Nebraska Medicine

11 What is an innovative, cost effective approach to care that will increase patient self efficacy, patient compliance, and patient understanding?

12 History of Shared Medical Appointments Originally created by a psychologist and adapted for the medical setting First SMA in medical setting in Utilization percentage: In 2005: 5% of family physicians offered SMA s In 2010: 10% of family physicians offered SMA s (Schroeder, 2015)

13 What are Shared Medical Appointments? A brief one on one session directly with the clinician, followed by an interactive group session with a cohort of peers with the same chronic disease. Education session provided at each appointment Involve multidisciplinary team: Provider (MD, NP, PA) Pharmacy Nutrition Behavioral Health Social Work

14 Shared Medical Appointments and Health Literacy The benefits of shared medical appointments: Opportunity for peer bonding Reduced costs Increased patient accountability Interprofessional focus Increased provider efficiency Expands possible patient learnings The benefits of increased health literacy: More positive patient outcomes Reduced healthcare costs Decreased hospitalizations and reduced length of stay in the hospital Increased patient compliance Increased patient adherence to treatment plans

15 How do Shared Medical Appointments Increase 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 Availability of Information SMAs provide an environment that facilitates learning and increased patient engagement Ease of Processing SMAs utilize a variety of teaching strategies to enhance patient learning Increasing Understanding SMAs empower patients to take control of their own treatment plan and ask questions in a group setting

16 References Haun, J., Noland-Dodd, V., Varnes, J., Graham-Ple, J., Rienzo, B., & Donaldson, P. (2009). Testing the BRIEF literacy screening tool. Federal Practitioner, 26(12) Jacobs, R. J., Lou, J. Q., Ownby, R. L., & Caballero, J. (2016). A systematic review of ehealth interventions to improve health literacy. Health informatics journal, 22(2), Mahadevan, R. (2013). Health literacy fact sheets - center for health care strategies. Retrieved from Parchman, M. L., Romero, R. L., & Pugh, J.A. (2006). Encounters by patients with type 2 diabetes complex and demanding: An observational study. The Annals of Family Medicine, 4(1), Schroeder, M. (2016). Group visit: Why shared medical appointments are gaining in popularity. Retrieved from whyshared-medical-appointmentsare-gaining-in-popularity

17 Thank you! Further questions? Contact Information: Mara McDermott Elizabeth Blazek

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