Impact Studies in Health Literacy and Patient Activation - PART 7

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Slide 1

There is definitely an issue that is typically raised about more active patients -- namely whether they increase the length of appointments and, thus, result in excess time and cost.

Slide 2

An interesting study, which by the way confirmed findings from 4 similar studies, compared a group of patients who received activation training with a control group who did not receive any training. The training included a communication skills training booklet that was mailed to patients 3 days before their scheduled appointments. Patients were also instructed to check in 30 minutes early to participate in a face-to-face follow-up with session before seeing the doctor. This relatively simple and inexpensive intervention was very effective. Patients who received the training provided more information about their health status and concerns. They also sought out more information, namely by asking more questions. Patients in the trained group also verified information more frequently. For example, they would repeat back what they understood the doctor said to them and asked if they were correct, like a self-initiated “teach back.” During follow-up interviews, both patients and providers had higher satisfaction about communication and patients felt they had a better understanding of the doctor’s recommendations. This study also looked at the length of the appointments. Patients who were trained to be active by providing and seeking out more information, asking more questions, and verifying information did not require longer appointments. In fact, on average, appointments with trained patients were nearly four minutes shorter than appointments with patients who did not receive communication skills training.

Slide 3

Time to Talk CARDIO is a program to help patients and health care professionals make the most of their conversations by building communication skills to help better manage heart health. You start by completing a survey, rating statements on a scale of strongly agree to strongly disagree. Statements for patients include:   My health care professional sometimes used confusing medical terms.   My health care professional did not explain my medical problem in a way that I could easily understand.   I was not comfortable asking questions.   My health care professional did not help me feel that I could take care of my health and understand my treatment.   After completing the survey, you can view of list of communication skills that are most relevant to you; you can view these skills in action by watching short videos of simulated office visits; and you can print or save your list of skills. The goal is to then practice and use the skills you learned during your next medical visit.

Slide 4

Start page for patients.

Slide 5

Example of skills with links to videos. In this example, patients learn to ask for clarification by repeating what they understand the health care provider just said to them. In a way, it is a “teach back in reverse.” --- “so, you want me to take this new medication twice a day: once in the morning with breakfast, and then again in the evening with dinner?” By watching video clips of each skill in action, patients can gain the confidence to try these communication strategies at future appointments. It activates the patient to take the lead and not have to rely on the health care provider to initiate a teach back.

Slide 6

Survey questions for health care providers include:   I did not get all of the detail I wanted on the patient's current problem and symptoms. The patient has difficulty remembering my instructions. The patient was unfamiliar with medical terms. The patient does not take responsibility for his/her own health.   Communication strategies from the health care provider point of view are demonstrated in a series of short video clips. Health care providers can learn more about these strategies and practice skills that can improve communication with patients.

Slide 7

Good patient-centered resources, including free tools that other health care professionals and organizations have developed and used with success, are available at the Institute for Healthcare improvement website.

Slide 8

The U.S. Department of Health and Human Services, Health Resources and Services Administration, has good information about health literacy available on the hrsa dot gov website.

Slide 9

The resources there include a six-part series of training in health communication that addresses health literacy, cultural competency, and limited English proficiency. The training is offered free of charge.

Slide 10

Another good and free training opportunity is the CDC’s health Literacy for Public Health Professionals.

Slide 11

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.   It contains 20 evidence-based tools for improving health communications and removing literacy-related barriers to improve care for all patients. Among the tools included is the teach back method and Questions Are the Answer. The toolkit also includes a self-assessment for clinical practices and health care organizations.

Slide 12

Patient activation tools, resources and best practices are available from the New Health Partnerships community Website. New Health Partnerships is a project of the Institute for Healthcare Improvement and offers resources and tools to clinicians, patients, family members, and communities so that they can effectively collaborate in self-management support.

Slide 13

Insignia Health is committed to helping patients and health care consumers develop the behaviors that are crucial to becoming more active self-managers and engaged members of their health care team. The Patient Activation Measure is licensed through Insignia Health. Their website includes links to current research on patient activation and you can download tools and resources from the community forums section of the site.

Slide 14

And Krames has a series of Go-To-Guides multimedia self-care workbooks that offer an engaging, interactive option for patient education. You can view samples on the Krames website.

Slide 15

I had a chance to review the Go-To-Guide for Living Well with Asthma, and the content is not only well written, but the interactive format really draws you in. Each Go-To-Guide includes a combination of easy-to-understand information and supporting tools to empower patients and build self-management skills that promote healthy behaviors. The intuitive interface makes it easy for users to get the information they need in the learning style that best suits them: reading, listening, viewing or any combination of the three. There are also interactive quizzes for learning verification. The content stresses the patient’s role managing chronic disease and provides tips and suggestions on working with your health care team. These really are excellent resources.

Slide 16

That’s all I have. I believe we have some time to take a few questions. You can also contact me by email (doug@healthcommunications.org) and you can download this presentation, a list of the tools and resources a mentioned and access other information on health literacy and patient activation at my website, www.healthcommunications.org.

Slide 1

“An issue that is typically raised about more active patients is whether they increase the length of appointments and, thus, result in excess time and cost.”

Slide 2

An issue that is typically raised about more active patients is whether they increase the length of interviews and, thus, result in excess time and cost. Providing more information Asking questions Seeking more information Verifying information trained mean = 19 minutes untrained mean = 23 minutes

Slide 3

http://timetotalkcardio.com/ Time to Talk CARDIO is an educational program underwritten by Merck & Co., Inc. and developed in partnership with the American Academy of Family Physicians Foundation, Canyon Ranch Institute and RIASWorks.

Slide 4

http://timetotalkcardio.com/ Time to Talk CARDIO is an educational program underwritten by Merck & Co., Inc. and developed in partnership with the American Academy of Family Physicians Foundation, Canyon Ranch Institute and RIASWorks.

Slide 5

http://timetotalkcardio.com/ Time to Talk CARDIO is an educational program underwritten by Merck & Co., Inc. and developed in partnership with the American Academy of Family Physicians Foundation, Canyon Ranch Institute and RIASWorks.

Slide 6

http://timetotalkcardio.com/ Time to Talk CARDIO is an educational program underwritten by Merck & Co., Inc. and developed in partnership with the American Academy of Family Physicians Foundation, Canyon Ranch Institute and RIASWorks.

Slide 7

http://www.ihi.org/IHI/Topics/PatientCenteredCare/

Slide 8

http://www.hrsa.gov/healthliteracy/default.htm

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http://www.hrsa.gov/healthliteracy/training.htm

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http://www.cdc.gov/healthmarketing/healthliteracy/training/index.html

Slide 11

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

Slide 12

http://www.newhealthpartnerships.org/patientactivation.aspx

Slide 13

http://www.insigniahealth.com/

Slide 14

“The unique format and approach make these interactive tools more effective, engaging and empowering than any educational tools you’ve used in the past for disease management programs.” https://www.krames.com/OA_HTML/ibeGoToGuide_gtg.jsp

Slide 15

http://www.myvirtualpaper.com/doc/Sales/GTGAS_CHP1_01/2009111103/

Slide 16

Doug Seubert Health Communications Specialist Advantage Consulting Services PO Box 56 Marshfield, WI 54449 Websites: http://www.healthcommunications.org http://www.advantageconsultingservices.org Phone: (715) 383-0897 Email: doug@healthcommunications.org Contact Information

Summary: This presentation is an expanded version of a webinar sponsored by Krames Patient Education. Low health literacy is a barrier to care, and populations with chronic diseases are at higher risk. Research suggests activation may help compensate for lower literacy skill. This series explores effective methods to increase patient activation and to address the needs of patients with low health literacy.

Tags: doug seubert health literacy communication communications activation patient engagement empower

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