How Health Literacy Affects Patient Safety

More than 77 million individuals in the United States have limited health literacy skills and will likely encounter challenges interpreting and acting upon health information. (2) According to the National Assessment of Adult Literacy, nine out of ten adults may not have the skills needed to manage their health and prevent disease.

Health literacy, as defined by The Center for Disease Control (CDC), is the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services needed to make appropriate health decisions. (3) It can affect a patient’s ability to navigate the healthcare system, locate providers and services, fill out complex medical forms, and engage in chronic- disease management and self-care.

One of the most common patient safety issues linked to poor health literacy is the risk of medication errors resulting from improper dosing administration. Additionally, some studies have found low health literacy to be associated with the misunderstanding of medical instructions, medication names, indications and poor adherence to treatment regimens. (1)

Research has also shown limited health literacy to be connected to delayed diagnoses, decreased use of preventative services, increased rates of hospitalization, poorer health status, limited self-management skills, and a greater mortality risk. Consequently, health literacy issues cost the U.S. health care system between $106 and $238 billion annually. (2)

Therefore, addressing health literacy has become a primary objective for many healthcare systems across the US, to improve patient safety. Improving health literacy is a collective responsivity that includes healthcare organizations, healthcare providers, policymakers, purchasers and payers, regulatory bodies, and healthcare consumers themselves.  (1)

The Joint Commission encourages healthcare organizations to start by creating and maintaining cultures of quality and safety. Below they have outlined some best practices for making effective communications a priority to protect the safety of patients. (1)

• Increase awareness throughout the organization regarding the impact of health literacy and English proficiency on patient safety.
• Create an organizational culture of safety and quality that values patient-centered communications as a key component to the delivery of patient-centered care.
• Create patient-centered environments, from the reception desk to discharge planning, that stress the use of clear communications in all interactions with patients. 
• Ensure that all staff is trained to recognize and respond appropriately to patients with literacy and language needs.
• Use medical interpreters for patients with poor English proficiency.
• Understand the literacy levels and language needs represented by the community served.
• Assess the organization’s patient safety culture using a reliable assessment tool, such as the AHRQ Hospital Survey on Patient Safety Culture.
• Demonstrate cultural competence by hiring practices that value diversity and the ongoing education of the staff. 

References:

1. https://www.jointcommission.org/assets/1/18/improving_health_literacy.pdf
2. https://psnet.ahrq.gov/perspectives/perspective/72/the-role-of-health-literacy-in-patient-safety
3. https://www.cdc.gov/healthliteracy/learn/understanding.html