IOM Roundtable on Health Literacy Enhancing Health Literacy throughout a Health System April 11, 2013 Terri Ann Parnell DNP, RN Vice President, Health Literacy & Patient Education North Shore-LIJ Health System Assistant Professor Population Health North Shore-LIJ Hofstra School of Medicine
Scope of North Shore-LIJ Health System Nation s third largest, non-profit, secular healthcare system, based on number of beds. 16 Hospitals (6,000+ Beds) 5 Tertiary & 7 Community 3 Specialty & 1 Affiliate 3 Skilled Nursing Facilities Feinstein Institute 1,500 Staff (scientists, investigators and other employees) Among top 5% of institutions receiving NIH funding 1,300 Clinical Trials; 12,000 subjects Home Care, Hospice and LTC Affiliate Network Core Lab, Ambulance Transport 7 million population served 4 million patient contacts 133,400 Ambulatory Surgeries 283,700 Discharges 25,600 Births 640,000 Emergency Visits 503,700 Home Care Visits 91,500 Ambulance Transports 1,500 + Residents & Fellows; 115 programs More than 10,000 Nurses More than 9,440 Physicians More than $6.7 billion in revenue Largest provider in NY Metro 16.3% share More than 44,000 Employees Recipient of the 2010 National Quality Forum Award Hofstra North Shore-LIJ School of Medicine SM New York State s First New Allopathic Medical School in 40 years Opened August 2011 Updated 12.03.12
Attributes of a Health Literate Organization 1. Has leadership that makes health literacy integral to its mission, structure, and operations. Launching of Office of Diversity, Inclusion & Health Literacy -allocated fiscal & human resources (June 2010) Chief Diversity & Inclusion Officer reports to President /CEO President/CEO receives monthly updates System-wide patient education policies & procedures System Patient Education & Language Communication Access Committees System Diversity, Inclusion and Health Literacy Council President/CEO & Chief Diversity and Inclusion Officer Co-Chair Collaboration across the service lines and system departments
Attributes of a Health Literate Organization 2. Integrates health literacy into planning, evaluation measures, patient safety, and quality improvement. Planning: Initial assessment at several sites as baseline Ongoing assessments based on changing demographics Integrated into annual mandated topics and system orientations Evaluation Measures: Monitor PG and HCAHPS Patient Safety & Quality Incorporated into various patient safety rounds Collaboration with system Quality and CIS re: monitoring & documentation
Attributes of a Health Literate Organization 3. Prepares workforce to be health literate and monitors progress. Incorporate into new employee and inter-professional orientation Incorporate into annual mandated topics Ongoing health literacy awareness, education & curriculum training Corporate University Patient Safety Institute On-line educational resources: Office of DIHL-toolkits, resources, monthly tips, references 2012 approx.14,000 educated through various opportunities excluding general system orientation Health Literacy & Cultural Modules Cultural Resource
Attributes of a Health Literate Organization 5. Meets needs of populations with a range of health literacy skills while avoiding stigmatization. Shame-free environment-fostering humanism Launch of Dignity and Respect Campaign Educate staff regarding a universal approach: Preferred language signage, interpretation services Assess individual learning needs Use Plain Language Incorporate Teach-Back What questions do you have? Health Literacy Toolkit Health Literacy Competency Development
Attributes of a Health Literate Organization 6. Uses health literacy strategies in interpersonal communications and confirms understanding at all points of contact. Incorporate into EMR: Preferred language in top banner LEP daily report Confirm understanding by Teach-Back & document Language access audit tool Provide language assistance in response to changing demographics Health literacy toolkit for consultation Provides templates and health literacy tenets
Attributes of a Health Literate Organization 8. Designs and distributes print, audiovisual, and social media content that is easy to understand and act on. Ongoing collaboration with Marketing and PR departments New processes for material development Regular meetings and communication Development of system vetting process for home grown patient materials Development of translation process (based on English version first) Closed captioning on all in-patient and ambulatory televisions Collaboration with consultants regarding enhancement of patient, family & visitor information and education
Attributes of a Health Literate Organization 9. Addresses health literacy in high-risk situations, including care transitions and communications about medicines. Launch of DIHL Council to assist with integration across health system Vital Documents: Updated languages to reflect 2010 U.S. Census data Standardized use of interpretation services documentation Research Participants: Collaboration regarding research and informed consent Transitional Care: Collaboration regarding health literacy and education across the continuum of care Ongoing projects : Medication safety Discharge process and delivery of information
What generated interest in improving health literacy? Change in population demographics Patient safety Patient outcomes Patient satisfaction scores tied to value based purchasing Growth of Health System Launch of Hofstra North-Shore LIJ School of Medicine SM Recognized as key component in the promotion of quality patient care
General Strategies to Move Health Literacy Forward Senior leadership supportand launch of office Identify health literacy champions at sites Incorporate across many areas and vehicles across health system Screensavers Internal and external publications, monthly tips, contests, etc. Various Committees Human Resources Corporate University Move from hospital to system service line approach Pilot projects, measure and report metrics What s in it for them? Make it relatable to their scope of practice. Involve in current projects rather than always something new or extra Standardization across health system.
Facilitating Health Literacy Implementation Key stakeholders and senior leadership support Baseline assessment identifying gaps Tipping Point -2010 - national initiatives Inaugural health literacy conference Classes at corporate university Monthly tips emailed to all staff Health literacy module System patient education and language and communication access committees
Barriers to Health Literacy Improvement So many competing priorities - time-consuming Obtaining physician participation Changing landscape of health care You can t tell by looking. General assumptions not my patient demographic It belongs to all
Health Literacy Implementation Sustainability Growth to office of DIHL Ongoing awareness and education Integration into all we do Compliance with health system policies, procedures, and expectations
Essential Components for Achieving Excellent Patient Outcomes Patient Education & Health Literacy Inclusion Education Community Diversity Research Governance Excellent Patient Outcomes Humanism = Dignity &Respect Cultural Competence Patient Care Source: Modified from Dr. Marc Nivet saamc Plenary address 11/2010
Thank you! Terri Ann Parnell, DNP, RN Vice President, Health Literacy and Patient Education North Shore-LIJ Health System Assistant Professor Population Health North Shore-LIJ HofstraSchool of Medicine Office of Diversity, Inclusion and Health Literacy 516-396-6373 Tparnell@nshs.edu 0000 00000