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Low Health Literacy Puts Patients at Risk

Far too often, ordinary citizens are placed at risk for unsafe care because important health care information is communicated using medical jargon and unclear language that exceed their literacy skills, according to a call to action released in February 2007 by The Joint Commission in its newest public policy white paper, “What Did the Doctor Say? Improving Health Literacy to Protect Patient Safety.” The paper frames the existing communications gap between patients and caregivers as a series of challenges involving literacy, language, and culture, and suggests multiple steps that need to be taken to narrow or even close this gap.

“Effective communication is a cornerstone of patient safety,” says Dennis S. O’Leary, M.D., president, The Joint Commission. “If patients lack basic understanding of their conditions and the whats and whys of the treatments prescribed, therapeutic goals can never be realized, and patients may instead be placed in harm’s way.”

The Joint Commission already promotes the involvement of patients in their care through its ongoing Speak Up™ educational campaigns. In addition, expectations regarding patient engagement and involvement in care decisions are stipulated in Joint Commission accreditation standards and its National Patient Safety Goals. But health literacy problems, which often go unrecognized and unaddressed by health care practitioners, undermine the ability of health care organizations to comply with the intents of the accreditation standards and safety goals that seek to protect the safety of patients.

The Joint Commission report on strategies for addressing health literacy and protecting patient safety contains 35 specific recommendations that cover a wide range of important improvement opportunities including, among others:

The sensitization, education and training of clinicians and health care organization leaders and staff regarding health literacy issues and patient-centered communications.
The development of patient-friendly navigational aids in health care facilities.
The enhanced training and use of interpreters for patients.
The re-design of informed consent forms and the informed consent process.
The development of insurance enrollment forms and benefits explanations that are “client-centered.”
The use of established patient communication methods such as “teach back.”
The expanded adaptation and use of adult learning centers to meet patient health literacy needs.
The development of patient self-management skills.
Health care organization assessment of the literacy levels and language needs of the communities they serve.
The design of public health interventions that are audience-centered and can be communicated in the context of the lives of the target population.
The integration of the patient communication priority into emerging physician pay-for-performance programs.
The provision of medical liability insurance discounts for physicians who apply patient-centered communication techniques.

The report is part of a continuing series of white papers on key public policy issues that impact patient safety and health care quality.

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