Health Literacy in the Inpatient Setting

Glick, Alexander F.; Brach, Cindy; Yin, H. Shonna; Dreyer, Benard P.

doi:10.1016/j.pcl.2019.03.007

Cited by 21 publications

(20 citation statements)

References 79 publications

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“…In pediatrics and its subspecialties, providers must consider parental/guardian understanding and knowledge application, in addition to the evolving role of the child in their care over time [8]. Children and their parents/guardians seek health information from multiple sources, including those that supplement (or at times replace) information from their providers [4,8,9]. The importance of online information continues to grow.…”

Section: Communicating Diagnosis and Treatment Informationmentioning

confidence: 99%

Health literacy in pediatric dermatology: challenges and opportunities

Williams

Housten

Coughlin

2023

Current Opinion in Pediatrics

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Purpose of review Health literacy influences how children and families participate in their medical care, use health services, and overall health outcomes. Health literacy is underexplored in pediatric dermatology. In this scoping review, we provide examples of how limited health literacy can be a barrier to patient care in pediatric dermatology and how to mitigate its effects. Recent findings Limited health literacy is associated with worse health outcomes, decreased medication adherence, and decreased use of the healthcare system versus those with adequate health literacy. Materials created to help patients understand their medical conditions and treatment options often are written at a reading level far above that of the average patient and caregiver. Given the reading level of patient-facing materials, those with limited health literacy are more susceptible to medication administration errors, with omissions or incorrect dosing being most frequent to occur. There is limited research about how skills related to health literacy, including numeracy and electronic health literacy, can be addressed in pediatric dermatology. Summary Health literacy impacts patient care, treatment, and adherence in pediatric dermatology. This article gives examples of how to address common challenges in the pediatric dermatology clinic and presents areas for further research and improvement.

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Section: Communicating Diagnosis and Treatment Informationmentioning

confidence: 99%

Health literacy in pediatric dermatology: challenges and opportunities

Williams

Housten

Coughlin

2023

Current Opinion in Pediatrics

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“…4 Consequently, it is also extremely important to engage patients and families in collaborative, shared care models and use highly reliable processes in provider-patient communications. 29,30 Khan et al 12 demonstrated a 37.9% reduction in harmful adverse events after an adaptation of the I-PASS program for use in provider-patient communications. Dykes et al 31 demonstrated a 29% reduction in adverse events through the implementation of a structured team communication and patient engagement program.…”

Section: Discussionmentioning

confidence: 99%

Frequency and Nature of Communication and Handoff Failures in Medical Malpractice Claims

Humphrey

Sundberg²,

Milliren³

et al. 2022

J Patient Saf

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Background:The Joint Commission has identified miscommunication as a leading cause of sentinel events, the most serious adverse events, but it is unclear what role miscommunications play in malpractice claims. We sought to determine the proportion of medical malpractice claims involving communication failure and describe their nature, including providers involved, locations, miscommunications types, costs, and the potential for handoff tools to avert risk and associated costs. Methods:We retrospectively reviewed a random sample of malpractice claims from 2001 to 2011, collected in CRICO Strategies' Comparative Benchmarking System, a national claims database. Two researchers reviewed cases to determine if a claim involved communication failure, its type, and potential preventability using a communication tool. Interrater reliability was assessed by dual review of 50 cases (81% agreement, κ = 0.62 for evidence of miscommunication). Claimant demographics, case characteristics, and financial data were analyzed.Results: Communication failures were identified in 49% of claims. Claims with communication failures were significantly less likely to be dropped, denied, or dismissed than claims without (54% versus 67%, P = 0.015). Fiftythree percent of claims with communication failures involved provider-patient miscommunication, and 47% involved provider-provider miscommunication. The information types most frequently miscommunicated were contingency plans, diagnosis, and illness severity. Forty percent of communication failures involved a failed handoff; the majority could potentially have been averted by using a handoff tool (77%). Mean total costs for cases involving communication failures were higher ($237,600 versus $154,100, P = 0.005).Conclusions: Communication failures are a significant contributing cause of malpractice claims and impose a substantial financial burden on the healthcare system. Interventions to improve transmission of critical patient information have the potential to substantially reduce malpractice expenditures.

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“…17 Children and families face many health literacy-related challenges related to health system processes, including participation in hospital procedures, understanding care plans, and preparing for discharge. 18 Safety events occurred had a lack of understanding of system procedures. Providers' use of medical jargon and lengthy, complex questions when obtaining a history creates difficulty for some families to provide a complete and accurate picture.…”

Section: Discussionmentioning

confidence: 99%

“…30 Health literacy strategies to improve spoken and written communication and tactics to address health literacy challenges specific to the inpatient hospital setting will prove useful. 3,11,18 Additional evidence-based recommendations to improve communication between healthcare providers and patients and families are available and can be used to address identified gaps. 29,31 Moving forward at our organization, our Health Literacy Task Force will use the themes and subthemes generated in this study to prioritize our work.…”

Section: Discussionmentioning

confidence: 99%

Health Literacy–Related Safety Events: A Qualitative Study of Health Literacy Failures in Patient Safety Events

Morrison

Gibson

Higgins

et al. 2021

Pediatric Quality &Amp; Safety

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Introduction: Communication failures are the leading root cause of safety events. Although much communication research focuses on the healthcare team, there is little focus on communication with patients and families. It is not known what deficits in health literate patient communication lead to patient safety events. We aimed to identify themes of health literacy–related safety events to describe the impact of health literate communication on patient safety. Methods: The safety events were entered into a system-wide self-reported safety event collection database. A patient safety specialist trained in health literacy prospectively tagged events for health literacy. The authors retrospectively queried the database for all health literacy tagged events during 9 months (September 2017–May 2018). The authors reviewed and independently coded health literacy-associated safety events. Qualitative content analysis of events facilitated by software (NVivo) was completed to identify the health literacy–related safety event themes. Results: Health literacy events comprised 4% (152/3911) of self-reported safety events during the 9 months. Main themes of the health literacy safety events related to (1) medication; (2) system processes; and (3) discharge/transition. Subthemes of each of the events further described the event types. Health literacy–associated safety events encompass all safety event outcomes (near miss, precursor, and serious safety events). Conclusions: Health literacy–related safety events occur in the healthcare environment. This review characterizing health literacy–related safety events prioritizes areas to implement health literate safety practices. Many opportunities exist to address communication-related safety events around medication, system processes, and discharge using health literate best practices.

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Health Literacy in the Inpatient Setting

Cited by 21 publications

References 79 publications

Health literacy in pediatric dermatology: challenges and opportunities

Health literacy in pediatric dermatology: challenges and opportunities

Frequency and Nature of Communication and Handoff Failures in Medical Malpractice Claims

Health Literacy–Related Safety Events: A Qualitative Study of Health Literacy Failures in Patient Safety Events

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