Effective Communication between Patients and Practitioners
Who asks this question? The patient who leaves the office feeling his concerns weren’t addressed or the practitioner who discovers her instructions on care weren’t followed? Of course the answer is at times both. And the result of either person not listening can be serious, even life threatening.
Why does this happen? More and more people are beginning to label this issue as a “health literacy” problem, and not without data to support the concern. Only 12% of American adults are considered to be proficient (advanced skill and understanding) in health literacy (National Assessment of Adult Health Literacy 2003). And, the largest study to date (Williams MV, Parker RM, Baker DW, et al. Inadequate Functional Health Literacy Among Patients at Two Public Hospitals. JAMA 1995 Dec 6; 274(21):1,677–82) found:
· 33% Americans were unable to read basic health care information
· 42% could not understand directions for taking medicine on an empty stomach
· 26% were not able to understand the information on an appointment slip
· 60% did not understand a standard consent form
So what is “health literacy” really? While there are several definitions, one most widely used is the definition from Healthy People 2010 which says, “ the ability to obtain, process, and understand health information and services to make appropriate health decisions”. Another way to say this is simply “good two-way communication”.
What is being done about it? For the last few years several local, state and national organizations have begun to address this issue. The National Action Plan to improve health literacy includes seven goals that will improve health literacy (http://www.health.gov/communication/HLActionPlan/)
1. Develop and disseminate health and safety information that is accurate, accessible, and actionable
2. Promote changes in the health care system that improve health information, communication, informed decision-making, and access to health services
3. Incorporate accurate, standards-based, and developmentally appropriate health and science information and curricula in child care and education through the university level
4. Support and expand local efforts to provide adult education, English language instruction, and culturally and linguistically appropriate health information services in the community
5. Build partnerships, develop guidance, and change policies
6. Increase basic research and the development, implementation, and evaluation of practices and interventions to improve health literacy
7. Increase the dissemination and use of evidence-based health literacy practices and interventions
Governor Parkinson has designated October as “Health Literacy Kansas Month,” noting that health literacy is a “key to the success of any reforms in our health care system.” Meanwhile, our sister state, Missouri, has a great Health Literacy resource library (http://www.healthliteracymissouri.org/library/) where you can find a wealth of helpful information.
What can I do? Becoming aware of the issue is the first step and becoming better informed about it is the second. The recently formed Kansas Health Literacy Council(http://kshealthlit.blogspot.com/) has focused on a health literacy program for parents of young children and is exploring ways to engage a variety of stakeholders in addressing health literacy. Our goal is for Kansans to have a stronger voice in addressing this important issue as a foundation for better health in our state.