Experts Propose New “Health Literate Care Model”

Primary care providers can address their patients’ health literacy needs by using a Health Literate Care Model, according to a new study published in the February 4 online issue of Health Affairs. More than one-third of patients in the United States lack the health literacy skills to take care of their health, according to study authors, HHS Assistant Secretary for Health Howard K. Koh, M.D., AHRQ’s Cindy Brach, M.P.P., and others. The Care Model, currently used by medical providers to improve the quality of their patients’ care, has drawn attention to the importance of informed patient engagement, but it does not include specific strategies to make sure all patients understand health information and can navigate the complex health care system. The proposed Health Literate Care Model would integrate tools from AHRQ’s 2010 Health Literacy Universal Precautions Toolkit into each of the Care Model’s six elements -- health care organization, self-management support, delivery system redesign, decision support, clinical information systems, and community linkages. According to the authors, use of the Health Literate Care Model will make health literacy an organizational value while introducing health literacy universal precautions such as confirming patient understanding through “teach back” into the care system. Select to access the PubMed® abstract of the study, titled “A Proposed 'Health Literate Care Model' Would Constitute a Systems Approach to Improving Patients' Engagement in Care.” Select to access information about AHRQ’s Health Literacy Universal Precautions Kit.

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2013 Feb;32(2):357-67. doi: 10.1377/hlthaff.2012.1205.

A proposed 'health literate care model' would constitute a systems approach to improving patients' engagement in care.

Koh HK, Brach C, Harris LM, Parchman ML.

Abstract

Improving health outcomes relies on patients' full engagement in prevention, decision-making, and self-management activities. Health literacy, or people's ability to obtain, process, communicate, and understand basic health information and services, is essential to those actions. Yet relatively few Americans are proficient in understanding and acting on available health information. We propose a Health Literate Care Model that would weave health literacy strategies into the widely adopted Care Model (formerly known as the Chronic Care Model). Our model calls for first approaching all patients with the assumption that they are at risk of not understanding their health conditions or how to deal with them, and then subsequently confirming and ensuring patients' understanding. For health care organizations adopting our model, health literacy would then become an organizational value infused into all aspects of planning and operations, including self-management support, delivery system design, shared decision-making support, clinical information systems to track and plan patient care, and helping patients access community resources. We also propose a measurement framework to track the impact of the new Health Literate Care Model on patient outcomes and quality of care.

PMID:: 23381529; [PubMed - in process]; A proposed 'health literate care model... [Health Aff (Millwood). 2013] - PubMed - NCBI

Health Literacy Universal Precautions Toolkit

The Agency for Healthcare Research and Quality commissioned the University of North Carolina at Chapel Hill to develop and test this Health Literacy Universal Precautions Toolkit. The toolkit offers primary care practices a way to assess their services for health literacy considerations, raise awareness of the entire staff, and work on specific areas.

What Are Health Literacy Universal Precautions?

Health literacy is the ability to obtain, process, and understand basic health information and services needed to make appropriate decisions. Over a third of patients have limited health literacy, which results in their not understanding what they need to do to take care of their health. Limited health literacy is associated with poor management of chronic diseases, poor ability to understand and adhere to medication regimes, increased hospitalizations, and poor health outcomes.
Universal precautions refers to taking specific actions that minimize risk for everyone when it is unclear which patients may be affected. For example, health care workers take universal precautions when they minimize the risk of bloodborne disease by using gloves and proper disposal techniques. Health literacy universal precautions are needed because providers don't always know which patients have limited health literacy.

How Can This Toolkit Help?

Experts recommend assuming that everyone may have difficulty understanding and creating an environment where all patients can thrive. Research suggests that clear communication practices and removing literacy-related barriers will improve care for all patients, regardless of their level of health literacy.
This toolkit is designed to help adult and pediatric practices ensure that systems are in place to promote better understanding by all patients, not just those you think need extra assistance. The toolkit is divided into manageable chunks so that its implementation can fit into the busy day of a practice. It contains the following:

Quick Start Guide.
Path to Improvement (6 steps to take to implement the toolkit).
20 Tools (2-5 pages each).
Appendices (over 25 resources such as sample forms, PowerPoint presentations, and worksheets).

Select to download a copy of the toolkit (PDF file, 3.9 MB; Plugin Software Help).
Additional resources related to this toolkit are located at: http://www.nchealthliteracy.org/toolkit/

For information about how the toolkit was developed, see the article, "Developing and testing the health literacy universal precautions toolkit." Select to access an abstract of the article.

AHRQ Publication No. 10-0046-EF
Current as of April 2010

Internet Citation:

Health Literacy Universal Precautions Toolkit. AHRQ Publication No. 10-0046-EF, April 2010. Rockville, MD: Agency for Healthcare Research and Quality. http://www.ahrq.gov/qual/literacy/index.html