The first step in creating a Health Literacy Improvement Plan is deciding which health literacy-related improvements to work on first. The Primary Care Health Literacy Assessment can help you examine your practice's strengths and weaknesses in five key areas:
- Practice Change
- Spoken Communication
- Written Communication
- Self-Management and Empowerment
- Supportive Systems
After identifying priorities for improvement, your Health Literacy Team can develop a plan to implement selected tools.
Actions
Prepare the practice.
- Engage practice leadership and prepare your staff for organizational change. can provide some ideas for how to do this.
- Educate staff about health literacy. You can use resources provided in Tool 3: Raise Awareness.
Review the Primary Care Health Literacy Assessment in a Health Literacy Team meeting.
- Collect assessment data. Ask each member of the Health Literacy Team to complete the Primary Care Health Literacy Assessment. (It takes less than 30 minutes.) Make sure everyone has the same understanding of each question. Note that a few questions will require staff to walk through the practice and see it from a patient's point of view. You can also broaden the exercise by asking everyone in your practice to complete the assessment. Be sure to give them a deadline.
- Discuss responses. Have team members bring their completed assessments to a team meeting. If you had everyone complete the assessment, tally results before the meeting.
- Congratulate yourselves on high performance areas, where there is consensus that the practice is doing well.
- Discuss opportunities for improvement. You may want to begin by identifying questions commonly answered, "Needs Improvement" or "Not Doing," or those for which there is wide variation in responses.
Practice Experiences
Many practices have found the health literacy assessment to be beneficial. Here are some typical comments:
- "The assessment increased our attention to areas not previously identified as concerns, like the signs in our practice. We just don鈥檛 think of those things every day."
- "Before doing the assessment, we had an idea about what tool we wanted to try. But after discussing our assessment questions, we completely changed our selection."
- "We liked the assessment process, and when we looked at our answers, our priorities just lit up."
Develop a Health Literacy Improvement Plan.
- Set your health literacy improvement goals. In addition to the results of your assessment, think about your practice's specific aims, practice improvement efforts already underway, and whether you want an "easy win" to jump-start the quality improvement process.
- Use the Primary Care Health Literacy Assessment to identify which tools to use for each area targeted for improvement. The Health Literacy Team should read the chosen tools carefully.
- Develop a clear, written improvement plan.
- For each tool you implement, designate champions who can model changes for their peers.
- Set SMART (Specific, Measurable, Attainable, Relevant, and Time-bound) objectives.
- Establish measures to assess whether your objectives are being met. Consider using measures you already track (e.g., patient experiences of care, staff satisfaction), other measures specific to health literacy, and the Health Literacy Patient Feedback Questions. Specify when and how you will collect data for these measures, remembering that you may want to collect information before and after you begin tool implementation. Note that each tool in this Toolkit provides suggestions for tracking your progress.
- Identify who will be responsible for implementing changes.
- Include a plan for spreading successful changes throughout the practice. Improvements will not be adopted throughout your practice without a concerted effort to get everyone on board.
Prepare for implementation.
- Brief the entire practice on the results of the practice assessment and the Health Literacy Improvement Plan. This is an opportunity to get additional input and buy-in from others in the practice.
- Get implementation tips from Implementing the 大象视频Health Literacy Universal Precautions Toolkit: Practical Ideas for Primary Care Practices.
- Use the Plan-Do-Study-Act (PDSA) method to test and refine the changes you make. Work out the kinks on a small scale before implementing changes practice-wide. In this Toolkit's appendix is an explanation and directions for conducting PDSA cycles, along with a PDSA worksheet that can help you plan your changes. Try changes that can reasonably be expected to achieve your goals. Keep trying new changes until you achieve the results you want. For more information about quality and process improvement strategies, go to .
Sustain your efforts.
- Inform the whole practice about health literacy improvement goals, activities, challenges, and accomplishments. This is critical to maintaining awareness of health literacy-related issues and enthusiasm for your quality improvement efforts. Consider posting updates in the lunchroom and making announcements at staff meetings.
- Regularly brief practice leadership. They may be able to help with challenges you are facing.
- Celebrate successes, even small ones. Start with celebrating what your practice did well before you started improving and continue with each achievement.
Track Your Progress
For each of the tools you implement, use the tool's suggestions for tracking progress. Even after goals are met, track some metrics for an extended period to monitor continued performance.
Use the Primary Care Health Literacy Assessment to re-assess your practice at regular intervals (e.g., twice a year). Doing so will help you confirm areas of improvement, find areas that need more work or a different approach, and identify new goals and objectives to update your Health Literacy Improvement Plan.
