Hi all -

Nancy commented - ³What now is becoming a barrier is that many institutions
do have their own "health literacy experts" on staff. These individuals are
now turning out improved readability documents...but it's not enough.²

There are ongoing efforts ­ in particular I am thinking of the Joint
Commission ­ to develop accreditation standards for hospitals in this regard
... Or we hope in this regard.

However, prompted by Nancy¹s comment I just did a quick search for ³health
literacy² in the proposed accreditation changes currently available online
at their site. As far as I could tell (and it was I emphasize a quick
search) those proposed changes only add health literacy in the following:

Standard PC.02.03.01 The hospital provides patient education and training
based on each patient¹s needs and abilities.
EP 1. The hospital performs a learning needs assessment for each patient,
which includes the patient¹s
cultural and religious beliefs, emotional barriers, desire and motivation to
learn, physical or cognitive
limitations, health literacy needs, and barriers to communication.

I found no mention of evaluating the health literacy environment of the
hospital ­ something that many of us have done in our own work. Nor any
mention of health literacy training for health professionals ­ again
something that is offered by a number of people on this list. Given the
growing strength and size of people working in health literacy around the
world ­ I would suggest those two are very Œdoable¹ now.

One caveat ­ this quick search only looked at what was easily accessible
online at the Joint Commission¹s web site ­ I would be delighted to learn
there is something more in the works there that is either unavailable to the
public or that I missed.

So, I hope the folks doing the good work at the Joint Commission take
Nancy¹s observation to heart and boost the presence of health literacy in
those proposed accreditation guidelines. Evaluating the patient¹s needs is a
good start but, in Nancy¹s words, ³it¹s not enough.²

Best,

Andrew Pleasant
Health Literacy and Communication Director, Canyon Ranch Institute
Assistant Professor, Rutgers University



On 11/5/09 8:52 AM, "nancy meyers" <njmeyers at gmail.com> wrote:


> On my more frustrating days, I agree, somewhat. However, you can put the

> responsibility on the institutions etc and challenge them all you want but

> this does NOT mean they have the skills or understanding to develop the

> products that people will understand. I currently am working with the health

> education staff at a large healthcare system. They can run the readability

> scales through the tests but they still do not understand at a deeper level

> the difference between "reading" and "comprehension." Only the people who have

> worked with the more "vulnerable at risk populations" can understand what this

> really looks like. We need to continue to push for partnerships between the

> people working with the more vulnerable populations and the institutions to

> learn together. What now is becoming a barrier is that many institutions do

> have their own "health literacy experts" on staff. These individuals are now

> turning out improved readability documents...but it's not enough. We need to

> explore ways to make the information "contextual." What's the background for

> this document (ex. Patient Bill of Right?) What does a person need to have in

> terms of background knowledge to make this piece of paper "memorable" in the

> context of their life experience. But this opens another can of worms because

> of the many different sub-populations. 

> 

> On Tue, Nov 3, 2009 at 11:26 AM, Audrey Riffenburgh

> <ar at plainlanguageworks.com> wrote:

>> Greetings, all, 

>> 

>>  

>> 

>> Fran, I DO say ³this makes sense for everyone² and it's true. If you look at

>> the NAAL health literacy data, you¹ll see that ³only 12% of the population is

>> proficient" in the tasks required for health literacy. But I think we need to

>> turn that on its head and say ³the health, medical, and insurance industries

>> have built systems that do not work for 88% of their intended audiences.² I

>> think we ought to start using that kind of labeling.

>> 

>>  

>> 

>> As we make the case, we don¹t have to point out any specific ³at risk²

>> populations because 88% of us are at risk of not being able to handle the

>> systems that we¹re forced to use to get our health care, learn about healthy

>> choices, etc. We need to make the case for change from that perspective and

>> challenge the institutions, corporations, agencies, etc. to recreate systems

>> and processes that work for everyone, no matter their educational, literacy,

>> or language skills. That is their responsibility, I believe! In

>> communication, whether patient education, technical writing, social

>> marketing, or advertising, the writers¹/speakers¹ first task is to know their

>> audience and customize to the audience¹s needs and interests. That means one

>> does not use methods that reach only 12% of your audience! Let¹s put the

>> responsibility where it should be.    

>> 

>>  

>> 

>> Audrey  Riffenburgh, M.A., President

>> Plain Language Works, LLC

>> 

>> Specialists in Plain Language & Health Literacy since 1994

>> 

>> Based Albuquerque, New Mexico,  USA

>> Phone: (505) 345-1107   E-mail: ar at plainlanguageworks.com

>> <mailto:ar at plainlanguageworks.com>

>> 

>> ========================================

>> Principal and Founding Member, www.clearlanguagegroup.com

>> <http://www.clearlanguagegroup.com/>

>> Co-founder and former Faculty, www.healthliteracyinstitute.net

>> <http://www.healthliteracyinstitute.net/>

>> Ph.D. Student in Health Communication, Univ. of New Mexico

>> 

>>  

>>  

>> 

>>> > -----Original Message-----

>> 

>>> > From: healthliteracy-bounces at nifl.gov

>>> [mailto:healthliteracy-bounces at nifl.gov]

>> 

>>> > On Behalf Of Frances E. Robinson

>> 

>>> > Sent: Tuesday, November 03, 2009 8:20 AM

>> 

>>> > To: The Health and  Literacy Discussion List

>> 

>>> > Subject: [HealthLiteracy 3673] Re: Simulated Hospital Patients

>> 

>>> > 

>> 

>>> > I agree completely that labeling seems inappropriate and often unkind.

>> 

>>> > Unfortunately, as long as we still need to constantly "make the case" to

>> 

>>> > disbelievers of the need for health literacy advocacy, we will still need

>>> to identify

>> 

>>> > the "at-risk" populations.  Evidence and statistics help to convince the

>>> skeptics,

>> 

>>> > but data needs to be "labeled."  If only we could just say, "This makes

>>> sense for

>> 

>>> > everyone..."

>> 

>>> > 

>> 

>>> > Fran Robinson

>> 

>>> > Patient Education Coordinator

>> 

>>> > Patient Education Services

>> 

>>> > Dartmouth-Hitchcock  Medical Center

>> 

>>> > One  Medical Center Drive

>> 

>>> > Lebanon,  New Hampshire 03756

>> 

>>> > (603) 650-6439

>> 

>>> > 

>> 

>>> > --- You wrote:

>> 

>>> > I am missing why the patient needs to be labelled at all--everyone of us

>>> in some

>> 

>>> > situation has problems understanding because of our capacity (variable

>>> over time

>> 

>>> > and situation) and the demands placed on us.  These situations are too

>>> common

>> 

>>> > to even need to label the person.

>> 

>>> > 

>> 

>>> > Connie  Davis, MN, RN

>> 

>>> > Co-director, Health Literacy in Communities Prototype Collaborative

>> 

>>> > Senior Faculty

>> 

>>> > Impact BC

>> 

>>> > 

>> 

>>> > 450 - 1385 West 8th Avenue

>> 

>>> > Vancouver,  BC V6H 3V9

>> 

>>> > 

>> 

>>> > cell: 604 991-4563

>> 

>>> > Tel: 604 742-1772

>> 

>>> > Toll Free: 1 888 742-1772

>> 

>>> > Fax: 604 742-1773

>> 

>>> > 

>> 

>>> > Email: cdavis at impactbc.ca

>> 

>>> > Web: www.impactbc.ca <http://www.impactbc.ca>

>> 

>>> > ________________________________________

>> 

>>> > From: healthliteracy-bounces at nifl.gov [healthliteracy-bounces at nifl.gov] On

>> 

>>> > Behalf Of IHABRAMSON at aol.com [IHABRAMSON at aol.com]

>> 

>>> > Sent: Monday, November 02, 2009 2:29 PM

>> 

>>> > To: healthliteracy at nifl.gov

>> 

>>> > Subject: [HealthLiteracy 3666] Re: Simulated Hospital Patients

>> 

>>> > 

>> 

>>> > Rima,

>> 

>>> > 

>> 

>>> > Depending on the situation, I have used other terms such as 

>>> "undereducated

>> 

>>> > adults."  By the way, we once had a governor here in Michigan who shared

>>> the

>> 

>>> > sentiment you refer to [you had your chance] - and he promptly made cuts

>>> to

>> 

>>> > many adult education programs.

>> 

>>> > 

>> 

>>> > Ilene

>> 

>>> > 

>> 

>>> > 

>> 

>>> > 

>> 

>>> > 

>> 

>>> > In a message dated 11/2/2009 1:58:44 PM Eastern Standard Time,

>> 

>>> > rrudd at hsph.harvard.edu writes:

>> 

>>> > Ilene,

>> 

>>> > Yes, that is true but illiteracy is such a loaded word -- it has become a

>>> label

>> 

>>> > shaded by blame [you had your chance] and filled with shame and a sense of

>> 

>>> > disgrace.  I would not use it as a metaphor.

>> 

>>> > Rima....

>> 

>>> > 

>> 

>>> > Rima E. Rudd, ScD, MSPH

>> 

>>> > Department of Society, Human Development & Health

>> 

>>> > Harvard  School of Public Health

>> 

>>> > 677  Huntington Avenue

>> 

>>> > Boston  MA 02115

>> 

>>> > Phone: 617 432 1135

>> 

>>> > fax:     617 432 3123

>> 

>>> > web:

>> 

>>> > www.hsph.harvard.edu/healthliteracy

>>> <http://www.hsph.harvard.edu/healthliteracy>

>>> <http://www.hsph.harvard.edu/healthliterac

>> 

>>> > y>

>> 

>>> > www.hsph.harvard.edu/sisterstogether

>>> <http://www.hsph.harvard.edu/sisterstogether>

>>> <http://www.hsph.harvard.edu/sisterstoget

>> 

>>> > her>

>> 

>>> > 

>> 

>>>>>> > >>> <IHABRAMSON at aol.com> 11/1/2009 11:45 AM >>>

>> 

>>> > Thank you for your response, Rima.  A lot depends on how one defines

>>> illiteracy.

>> 

>>> > 

>> 

>>> > Ilene

>> 

>>> > 

>> 

>>> >  In a message dated 11/1/2009 11:40:32 AM Eastern Standard Time,

>> 

>>> > rrudd at hsph.harvard.edu writes:

>> 

>>> > Please keep in mind that while many people may struggle with the written

>>> word,

>> 

>>> > very few people in the US are illiterate.

>> 

>>> > Rima

>> 

>>> > 

>> 

>>> > Rima E. Rudd, ScD, MSPH

>> 

>>> > Department of Society, Human Development & Health

>> 

>>> > Harvard  School of Public Health

>> 

>>> > 677  Huntington Avenue

>> 

>>> > Boston  MA 02115

>> 

>>> > Phone: 617 432 1135

>> 

>>> > fax:     617 432 3123

>> 

>>> > web:

>> 

>>> > www.hsph.harvard.edu/healthliteracy

>>> <http://www.hsph.harvard.edu/healthliteracy>

>>> <http://www.hsph.harvard.edu/healthliterac

>> 

>>> > y>

>> 

>>> > www.hsph.harvard.edu/sisterstogether

>>> <http://www.hsph.harvard.edu/sisterstogether>

>>> <http://www.hsph.harvard.edu/sisterstoget

>> 

>>> > her>

>> 

>>> > 

>> 

>>>>>> > >>> <IHABRAMSON at aol.com> 10/30/2009 2:13 PM >>>

>> 

>>> > Hello Everyone.

>> 

>>> > 

>> 

>>> > I am in the process of preparing a curriculum involving simulated hospital

>>> patients,

>> 

>>> > particularly those who might be illiterate, and was wondering if anyone

>>> had

>> 

>>> > sample material to share. Given all our tight schedules, it's never great

>>> to re-

>> 

>>> > invent the wheel. Thank you in advance.

>> 

>>> > 

>> 

>>> > 

>> 

>>> > Ilene

>> 

>>> > 

>> 

>>> > Ilene Abramson, Ph.D.

>> 

>>> > Member- Policy Committee

>> 

>>> > Michigan Board of Pharmacy (2009 - 2011)

>> 

>>> > 

>> 

>>> > Member - Rules Committee (2009-2012)

>> 

>>> > Michigan Board of Respiratory Care

>> 

>>> > 

>> 

>>> > ihabramson at aol.com<mailto:ihabramson at aol.com>

>> 

>>> > Tel:    248-926-0695

>> 

>>> > Fax:   248-926-9080

>> 

>>> > 

>> 

>>> > 

>> 

>>> > 

>> 

>>> > ----------------------------------------------------

>> 

>>> > National Institute for Literacy

>> 

>>> > Health and Literacy mailing list

>> 

>>> > HealthLiteracy at nifl.gov

>> 

>>> > To unsubscribe or change your subscription settings, please go to

>> 

>>> > http://www.nifl.gov/mailman/listinfo/healthliteracy

>> 

>>> > Email delivered to ihabramson at aol.com

>> 

>>> > 

>> 

>>> > 

>> 

>>> > ----------------------------------------------------

>> 

>>> > National Institute for Literacy

>> 

>>> > Health and Literacy mailing list

>> 

>>> > HealthLiteracy at nifl.gov

>> 

>>> > To unsubscribe or change your subscription settings, please go to

>> 

>>> > http://www.nifl.gov/mailman/listinfo/healthliteracy

>> 

>>> > Email delivered to ihabramson at aol.com

>> 

>>> > ----------------------------------------------------

>> 

>>> > National Institute for Literacy

>> 

>>> > Health and Literacy mailing list

>> 

>>> > HealthLiteracy at nifl.gov

>> 

>>> > To unsubscribe or change your subscription settings, please go to

>> 

>>> > http://www.nifl.gov/mailman/listinfo/healthliteracy

>> 

>>> > Email delivered to frances.e.robinson at hitchcock.org

>> 

>>> > --- end of quote ---

>> 

>>> > 

>> 

>>> > 

>> 

>>> > ----------------------------------------------------

>> 

>>> > National Institute for Literacy

>> 

>>> > Health and Literacy mailing list

>> 

>>> > HealthLiteracy at nifl.gov

>> 

>>> > To unsubscribe or change your subscription settings, please go to

>> 

>>> > http://www.nifl.gov/mailman/listinfo/healthliteracy

>> 

>>> > Email delivered to ar at plainlanguageworks.com

>> 

>> ----------------------------------------------------

>> National Institute for Literacy

>> Health and Literacy mailing list

>> HealthLiteracy at nifl.gov

>> To unsubscribe or change your subscription settings, please go to

>> http://www.nifl.gov/mailman/listinfo/healthliteracy

>> Email delivered to njmeyers at gmail.com

>> 

> 

> 

> ----------------------------------------------------

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> Email delivered to pleasant at aesop.rutgers.edu



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