health literacy
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Health literacy. Impact and action at a national level. Nicola Dunbar Director, Strategy and Development. What is health literacy?. HEALTH LITERACY. Skills / Abilities. Demands / Complexity. - PowerPoint PPT PresentationTRANSCRIPT
Health literacy
Impact and action at a national level
26 July, 2014
Nicola DunbarDirector, Strategy and Development
What is health literacy?
HEALTH LITERACY
Skills / Abilities Demands / Complexity
Parker R, Measuring health literacy: Why? So what? Now what? In: Hernandez L (ed), Measures of Health Literacy: Workshop Summary; Roundtable On Health Literacy, 2009.
What is health literacy?
• Individual health literacy:• The skills, knowledge, motivation and capacity of a person to
access, understand, appraise and apply information to make effective decision and about and health care and take appropriate action
• Health literacy environment:• The infrastructure, policies, processes, materials and
relationships that make up the health system and have an impact on the way in which people access, understand, appraise and apply health-related information and services
Individual health literacy in Australia
• 59% of Australians have a level of individual health literacy that is below the “minimum required for individuals to meet the complex demands of everyday life”
• Influences tasks such as:• reading and understanding medication instructions• completing consent forms• finding a healthcare provider and making an appointment• understanding signage
Australian Bureau of Statistics. Health Literacy, Australia, 2008.
Health literacy by state
NSW Victoria Queensland SA WA Tasmania NT ACT Total population0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Less than minimum At least minimum
Australian Bureau of Statistics. Health Literacy, Australia, 2008.
Is this a problem?
• People with low levels of individual health literacy:• more likely to have poorer outcomes• less likely to use preventive services• more likely to be hospitalised• poorer medication adherence• poorer knowledge and understanding of their own condition• less likely to attend appointments• for older people – poorer overall health status and higher risk of
death
Berkman et al. Health Literacy Interventions and Outcomes: An Updated Systematic Review, 2011
Bush et al. Advancing Health Literacy Through Primary Health Care Systems, 2010
Is this a problem?
• Complex health system:• who to see for what problem• how to navigate among many potential care providers
• Complex health services:• how to find your way in a hospital• what to do before / during / after a visit to a GP or specialist
• Complex interactions:• asking questions• sharing decision-making
• Complex information:• medicines information, informed consent, discharge instructions• many sources of information – what can be trusted?
What is happening at a national levelabout health literacy?
• 1990s – National Health Goals and Targets• 2010 – Australian Framework for Safety and Quality in
Health Care• 2012 – Australian Goals for Safety and Quality in Health
Care
What is happening at a national levelabout health literacy?
• National health literacy stock take 2011-12:• 66 submissions – over 200 separate initiatives
• Many different organisations doing work to improve health literacy
• A range of different approaches being used• Efforts fragmented with little potential for learning
Types of strategies and approaches
Health information49%
Research and knowledge sharing
21%
Building individual health literacy
14%
Workforce training7%
Health literacy envi-ronment
5%
Policy or framework4%
A national approach to addressinghealth literacy
Embedding health literacy into
systems
Integrating health literacy into education
Ensuring effective communication
People are able to access,
understand and act on health-
related information
Strategies for addressinghealth literacy
• Embedding health literacy into systems:• high level systems – standards, curricula, government policy• organisational policies and procedures
Strategies for addressinghealth literacy
• Ensuring effective communication:• appropriate health-related information• information when people need it, and in the form that they need it• effective interpersonal communication – education and recall,
shared decision-making
Strategies for addressinghealth literacy
• Integrating health literacy into education:• education and training for consumers about health and health
literacy – children and adults• education and training about health literacy for healthcare
providers – needs vary depending on role• education and training to improve communication
Everyone has a role in addressinghealth literacy
Consumers, patients and families
• Discuss with healthcare providers any difficulties in understanding information
• Ask for more information about any part of care that is unclear
Healthcare providers
• Assume most people will have difficulty understanding and applying complex health knowledge and concepts
• Use a range of communication strategies to ensure information is understood
Healthcare organisations
• Develop and implement health literacy policies and programs
Governments • Raise awareness about health literacy• Embed health literacy principles into health policy
development
Education and training organisations
• Provide education for healthcare providers about health literacy and communication
• Develop education programs for consumers
Where to next?
• Addressing health literacy in a comprehensive way requires long term strategies
• Opportunities for coordinated national action to:• raise profile of health literacy• reach agreement on where and action can be taken• integrate health literacy into policies and programs• examine how best to measure health literacy• support health care organisations and providers to improve
health literacy environment• examine how consumer organisations can support efforts to
address health literacy• promote research that addresses health literacy
Where to next for the Commission?
• Endorsement of national statement on health literacy and safety and quality by Health Ministers
• National action to raise awareness and foster a climate of action and collaboration
• Tailored resources for different groups• Linking health literacy and the National Safety and
Quality Standards
Standard 7Blood and Blood
Products
Standard 10Preventing Falls and
Harm from Falls
Standard 1Governance for Safety and
Quality in Health Service Organisations
Standard 2Partnering withConsumers
Standard 4Medication Safety
Standard 3Healthcare AssociatedInfections
Standard 8Preventing and
Managing Pressure Injuries
Standard 9Recognising and
Responding to ClinicalDeterioration in Acute
Health Care
Standard 5Patient Identificationand ProcedureMatching
Standard 6ClinicalHandover
National Safety and Quality HealthService Standards – from January 2013
The clinical workforce providing information about blood and blood product treatment options, and the
associated risks and benefits
Informing patients and carers about the risk of
falls and falls prevention strategies
Implementing processes to enable partnership with patients in decisions about their care
Consulting with consumers on patient information distributed by the organisation
Information on medicines is provided in a format that is understood and meaningful
Patient infection prevention and control information is evaluated to determine if it meets the needs of the target audience
Informing high-risk patients and their carers about the
risks, prevention strategies and management of
pressure injuries
Providing information to patients about how they
can raise concerns about potential
deterioration
National Safety and Quality HealthService Standards and health literacy
Summary
• Health literacy is a safety and quality issue• There has been a lot of work in Australia for some time,
but it is fragmented• Commission is starting to coordinate a national
approach:• embedding health literacy into systems• ensuring effective communication• integrating health literacy into education
• Everyone has a role in addressing health literacy
• [email protected]• www.safetyandquality.gov.au