Health Literacy Universal

Precautions Toolkit

Cindy Brach, MPP

Laura Noonan, MD

http://ahrq gov/qual/literacy http://ahrq.gov/qual/literacy
Overview

• Health literacy and universal precautio

• Develop g in the toolkit

• Experiences with tools• Health Literacy Collaborative Collaborative
Definition of Health Literacy Literacy

“The degree to which individuals individuals have th

capacity to obtain, process, and underst

basic health information information and services services ne

to make appropriate health decisions.”

Healthy People 2010, Institute of Medic

(2004)
Prevalence & Disparities

P t f d lt i h h lth lit

Disparities

Percentage of adults in each health literacy 

level, by race/ethnicity, 2003

53 58

41 31

52

45 59

12 14 2 4 18 7 3

60%80%

100%

ProI t 

24

41

25

22 19

34

25

18

23

28

53 58 52

20%40%60% Inte

BasBelo

14 9 24 13 25 9 0%

TotalWhiteBlackspanic APIAI/ANtiracial T W Sourc

B Hisp AMultira
Health Literacy Equation

X =

Skills/Abilities x Demand/Complexity = Healt
Health Literacy

Ui l n versal P i recautions

Structuring the delivery of care in thepractice practice as if every patient patient may have

limited health literacy
Why Health Literacy

Ui l n versal P ti recautions

• You can’t t ll e by l ki oo ng

• Even people with higher literacy skills ha

trouble und di erstanding medi l ca care

• No screening instrument can tell you if p

will und d erstand wh h d k hat they need to know

• Most interventions designed for people w

low literacy help those with higher litera
Health Literacy Universal

P i recautions T lki oo t

 Commissioned by AHRQ Developed by the University of North

Carolina and the North Carolina Netw

Consortium

 Published April 2010 Over 30 000 , downloads downloads from AHRQ s

and thousands more from UNC site
Process to

Develop Toolkit

• Identify and review tools• Identify and fill gaps

– Practice assessment– Implementation guidance– Form templates

• Advisory Group review of individual too

testing by practices

• Create “toolkit” as an organized approa• Pilot test toolkit in practices
Structure of the To

• Overview and Rationale• Path to Improvement (3 tools)

– Form a Team– Assess Practice– Raise Awareness

• 4 key changes (17 tools)

– Spoken communication– W itt r en C i ti ommunication

– Self Management and Empowerment

– Supportive Services

Quick Start Guide
Tool Structure

• Overview• Purpose• Action• T k rac your progress

P ti l ractical E i xper ence U is ng

the Assessment

Practical Experience Using

the Teach Back Tool

Practical Experience Using

the Encourage Questions Too


Practical Experience Using

the Action Plan Tool
Carolinas Healthcare System He

Literacy C ll b ti Collaborative

• Executive Sponsor : Executive VP/CMO

• Participants: Health System Facilities

• Goals and Measures

– Team measures– Collaborative measures

• Meetings and Conference Conference Calls
Monthly Data

Collection Form

CHS Health Literacy CollaborativeMonthly Data Collection Sheet Month: 
Reflections on

Et i n erprise‐wide S d prea

• How to measure (e.g., who does the te

back observation?)

• The power of their own data

• Centralized expertise ( g, e. . creation of 

to‐understand materials)

• Takes time!