Table 1.
Summary of AHRQ’s Work to Promote Health Literate Health Care, 2005-2019
| Activity | Outcome |
|---|---|
| Develop Measures | |
| Developed health literacy patient survey items | Validated CAHPS® survey items that capture distinct communication behaviors that can be targeted for improvement |
| Identified and assessed organizational health literacy quality improvement measures | Organizational health literacy quality improvement measures that do not rely on patient-reported data which were determined to be useful, meaningful, feasible, and have face validity |
| Added health literacy items to national household survey (MEPS) | National tracking and reporting of health care providers’ communication practices by Healthy People and the National Healthcare Quality and Disparities Report |
| Improve the Evidence Base and Create Implementation Tools | |
| Co-sponsored health literacy research program announcement with NIH | Funded grants focused on understanding and promoting health literacy |
| Commissioned health literacy systematic evidence reviews | Literacy and Health Outcomes and Health Literacy Interventions and Outcomes summarized and synthesized evidence on the impact of limited literacy and identified effective strategies to mitigate its effects |
| Created and updated tools to help primary care practices adopt health literacy “universal precautions” | AHRQ Health Literacy Universal Precautions Toolkit (1st and 2nd editions) |
| Developed health literacy educational modules for clinicians as part of ongoing continuing medical education requirements | AHRQ Health Literacy Knowledge Self-Assessment Module, offered by American Board of Pediatrics (ABP), American Board of Family Physicians (ABFP), and Optum Health Education; and Health Literacy Practice Improvement Module offered by ABP and ABFP |
| Developed pharmacy health literacy plug-and-play modules for pharmacy colleges | Advancing Pharmacy Health Literacy Practices Through Quality Improvement (Four PowerPoint presentations and 17 guides for student projects |
| Developed health literate approach to obtaining informed consent from prospective research participants and authorization to use medical information | AHRQ Informed Consent and Authorization Toolkit for Minimal Risk Research |
| Integrated health literacy into other tools | Examples: Guide to Patient and Family Engagement in Hospital Quality and Safety (Strategy 2: Communicating to Improve Quality); Guide to Improving Patient Safety in Primary Care Settings by Engaging Patients and Families (Be Prepared To Be Engaged, Teach-Back); SHARE Approach (Tool 4: Health Literacy and Shared Decision Making) |
| Create and Support Change | |
| Supported other organizations efforts to promote health literacy | Collaborated (e.g., co-sponsoring meetings, drafting white papers, educating, and serving on expert health literacy advisory groups) with a variety of U.S. organizations, including the American College of Physicians Foundation, the American Medical Association Foundation, America’s Health Insurance Plans, U.S. Pharmacopeia, The Joint Commission, and Roundtable on Health Literacy of the National Academies of Science, Engineering, and Medicine |
| Provided inspirational and conceptual leadership | Articles and presentations: Ten Attributes of Health Literate Health Care Organizations, A Proposed ‘Health Literate Care Model’ Would Constitute a Systems Approach to Improving Patients' Engagement in Care. |
| Disseminate and Transfer Knowledge and Tools | |
| Portrayed how health literacy strategies could help organizations achieve their goals | Crosswalk between the standards for patient-centered care and the tools in the AHRQ Health Literacy Universal Precautions Toolkit |
| Helped hospitals replicate the Re-Engineered Discharge (RED), a patient safety and health literacy intervention | Program of education and technical assistance, and the Re-Engineered Discharge (RED) Toolkit |
| Practice What We Preach | |
| Developed tool to assess the understandability and actionability of print and audiovisual materials and used it to identify areas for AHRQ improvement | Patient Education Materials Assessment Tool (PEMAT), PEMAT checklist, opportunities for AHRQ improvement identified |
| Applied health literacy principles to U.S. Preventive Services Task Force (USPSTF) Clinician Summary, addressing user feedback and measuring improvement with the PEMAT |
Improved Clinician Summary, the summary version of USPSTF recommendations for clinicians, so that only the most important and actionable information is included, easy to find, and easy to understand |