An Evidence-Based Quality Improvement Project to Address Organizational Health Literacy and Enhance Communication

Objective: Clinicians often overestimate a person's ability to understand, obtain, and process health information and services needed to make appropriate decisions about their care. Studies have shown that patients with limited health literacy experience more medication errors, additional emergency department visits, longer hospital stays, dissatisfaction with care, and higher rates of depression and mortality. The purpose of this quality improvement (QI) project was to address the need to become a health literate organization within a specialty practice by having all clinicians and clinical staff members utilize standardized communication tools and strategies to address low health literacy. Methods: A training program within a specialty practice was developed from evidence-based toolkits, which included raising awareness of the importance of being a health literate organization, interactive sessions focused on engaging staff in learning the teach-back method, and incorporation of visual teach-back reminders for reinforcement. Results: The outcomes measured were 1) clinician/staff conviction, 2) clinician/staff confidence, 3) frequency of use of the teach-back method, and 4) use and knowledge of the effective elements of teach-back. After project implementation, the percent of staff reporting conviction to use teach-back as a 9 or 10 on a 1-10 scale increased by 24.61%, and their report of confidence as a 9 or 10 increased by 29.23%. At the conclusion of the QI project, all (n=13) reported that they use a caring tone of voice and attitude, display comfortable body language, make eye contact, and are seated when communicating with patients more than half of the time. Nearly half of the effective elements of teach-back had an increased percent change from pre to post initiative. Conclusion: Organizational health literacy requires that organizations prioritize four key areas: 1) organizational structure, policy, and leadership; 2) communication; 3) ease of navigation; and 4) patient engagement and self-management support. QI initiatives can address the need for organizations to become health literate by focusing on improvement in communicating with patients to better meet their health and wellness needs. Practice Implications: Utilization of the teach-back method with an aim to help organizations in their journey to become health literate may lead to increased staff productivity, decreased staff turnover, and overall improved patient health and wellness outcomes. Results of this project represent the importance of the ability to be able to conduct QI projects in small, specialized practice settings.A five-year embargo was granted for this item