The IUEM Advocacy Track hosted a workshop entitled “Health Literacy in the Emergency Department: Barriers and Solutions” with the help of our resident expert Jill Sracic and invited guest panelists from the School of Nursing and The Indiana Center for Intercultural Communication. The turnout, passion, and creative conversations about integrating improved patient communication for better health outcomes was inspiring. At one point. Dr. Carol Shieh from the School of Nursing said, “I feel better about my daughter being a second year medical student knowing that there are doctors out there like you.”
According to the 2004 IOM Prescription to End Confusion:
“More than a measurement of reading skills, health literacy also includes writing, listening, speaking, arithmetic, and conceptual knowledge. Health literacy is defined as the degree to which individuals have the capacity to obtain, process, and understand basic information and services needed to make appropriate decisions regarding their health. At some point, most individuals will encounter health information they cannot understand. Even well educated people with strong reading and writing skills may have trouble comprehending a medical form or doctor’s instructions regarding a drug or procedure.”
At the end of the session, everyone generated a personal learning point that they planned to incorporate into their practice immediately. Here they are:
1) Stop asking people, “Do you understand?” to end the discharge instruction process. They will usually say yes even when they mean no.
2) Anticipate cultural differences instead of waiting for them to be a problem. Educate yourself on cultures commonly seen in your ED.
3) Talk about the discharge plan on the first visit. That way when you come back, they have had time to think about it.
4) Understand “cultural humility” even in truly emergency situations. What we do can have lasting impact even beyond medical management.
5) Explain how to take medicine then ask the patient to explain it back.
6) Be aware of the differences between us and our patients and try to bridge the gap.
7) The more you know, the more humble you become.
8) Edit discharge instructions.
9) Add a question to the end of the discharge instructions about the content to assess understanding.
10) Verify new medications with the patient and one more person.
11) Communication is not one size fits all.
12) We should try to have a better understanding of a patient’s healthcare environment. (Home, primary care, transportation, etc.)
13) Don’t think only about patients with poor health literacy as deficits. Try to see the strengths they have as well.
Indiana Center for Intercultural Communication
Check out the IOM document in the Resources section!
“Caring for patients from different cultures” by Geri-Ann Galanti