As we age and our medical needs become more complex, our ability to understand and follow a doctor’s directives becomes increasingly critical to our continued health. In an effort to improve patient-provider communication and the long-term health outcomes of patients, many hospitals are refocusing their practices to improve health literacy – the ability of a patient to obtain, process, and understand the health information and services they need in order to make healthcare decisions that reflect their goals and desires.
At Hospital for Special Surgery’s VOICES 60+ Senior Advocacy Program, an important focus of intervention is enhancing health literacy. Social workers and specially-trained volunteers help prepare older adult patients receiving arthritis or orthopedic outpatient care for their doctor’s visits, as well as through community outreach.
In an effort to better understand health literacy, we spoke with Juliette Kleinman (LCSW, ACSW), who heads this groundbreaking program.
The Benefits of Health Literacy and Warning Signs
According to Kleinman, health literacy is one of the primary indicators of positive health outcomes for a patient. “A person’s ability to understand what the doctor says, the ability to internalize that information so they can make good choices about their care is essential.”
Studies have found that higher levels of health literacy among patients can lower the frequency of emergency medical visits, lower the cost of medical care and rate of hospitalization, make it easier for patients to follow their prescribed plan of care, and ultimately give patients a greater sense of control over their own well-being.
Conversely, lower levels of health literacy can have a major impact on the efficacy of a patient’s plan of care and can make medical encounters a major source of anxiety for those struggling to manage their medical conditions. Supported by a substantial body of literature, Kleinman describes the following indicators as potential signs of low health literacy:
- Frequently missed appointments
- Incomplete registration forms
- Non-adherence with medication
- Unable to name medications, explain purpose or dosing
- Unable to identify pills without reading their label
- Asking fewer questions
- Less follow-thru on tests or referrals
Communication is Key
Because doctors only have a limited amount of time with every patient, Kleinman’s program focuses on pre-visit patient coaching, which helps patients clarify their reasons for the medical visit and build a clear set of goals to accomplish during their time in the doctor’s office.
Her staff also prepares patients to increase their comfort in sharing personal beliefs and medical practices (such as alternative therapies) which they may be reluctant to share with their doctors for fear the doctor will say it’s incorrect or wrong. This helps to open up patient-physician dialogue and builds understanding and trust.
Pre-Visit Coaching and Ask Me 3®
Kleinman’s team uses a variety of pre-medical visit coaching strategies to better prepare patients, including the National Patient Safety Foundation’s Ask Me 3®. In this form of patient coaching, social workers and volunteers encourage patients to take a more active role in their own medical encounters by having patients ask three critical questions so they can get the most benefit from their visit.
- – What is my main problem?
- – What do I need to do?
- – Why is it important for me to do this?
Through the Ask Me 3® questions, patients learn to avoid being overwhelmed with complex medical information and instead focus on individual challenges they face, tangible steps they can take to improve or preserve their health, and better understand how their plan of care will contribute to the management of their illness.
Supporting Loved Ones with Low Health Literacy
While the VOICES 60+ program focuses on a very specific patient population, Kleinman is quick to point out that the vast majority of patients can benefit from strategies that improve health literacy. If a loved one seems to be having difficulty understanding medical information, Kleinman encourages family members to explore participating in their loved one’s medical visits. Kleinman suggests the presence of a concerned family member may benefit both the patient and the medical provider. This trusted person can offer support by taking notes, seeking clarification and serve as a source of comfort.
For a comprehensive free webinar by Kleinman on health literacy in honor of Social Work Month at Hospital for Special Surgery, please visit: https://www.hss.edu/professional-conditions_assessing-addressing-health-literacy-critical-skill-to-improve-patient-outcomes.asp
At SelectCare Home Care Services, we believe our clients should be able to make well-informed decisions about their medical care. That’s why our team of RN Field Nurse Supervisors communicate regularly with our clients’ medical providers, updating plans of care and conducting free monthly visits to ensure our clients understand their treatment plans and their long-term health goals remain at the center of the decision making process. Call us today or request a free home health care guide to learn more.