Tuesday, August 25, 2015

Health Literacy Forum, ACT Health - 24 August 2014

I attended the ACT Health forum on Health Literacy. I attended for three reasons: to support Yelin Hung who has been completing the course; to hear about what the other participants have learnt and also to present on consumer perspectives of health literacy. While the turn out was smaller than anticipated it was still a very useful morning of sharing and discussion.

What follows are the notes that I took from the forum.

Health Literacy - Michal Morris, Centre for culture, ethnicity and health

Michal Morris is the General Manager of the Centre for Culture, Ethnicity and Health (CEH). The CEH has been working with ACT Health staff on building their understanding of health literacy and devising quality improvement projects they can undertake in their workplace.
Defining health literacy:

Not one definition of health literacy that is a strength as it is content and context specific. It has to make sense to individual. It is going to change in professional lifetimes as the environment changes and the community changes.
There are commonalities that fit into every definition:
·         Have a good understanding of health outcomes
·         Focus on disadvantage – but you don’t have to define the disadvantage but acknowledge the barriers
·         The service system has to respond.
·         It can be an asset or deficit model.
·         Health literacy is not just when consumers are compliant but when they understand what is being said and interpreting it with their values and beliefs and come up with their own opinion.

Health literacy is being driven by the Commission at the national level. There is a strengthening of the links to the national health quality standards and a strong relationship with consumer participation and cultural diversity. There is a growth of interest and understanding of how it links to the health system.
Around 20 participants are completing the Health Literacy Course. There are four modules delivered over eight months. The four modules are:
·         Health literacy and communication
·         Organisational health literacy
·         Capacity building
·         Building on the knowledge

Health literacy – national perspective. Dr Nicola Dunbar, Australian Commission for the Safety and Quality in Healthcare (ACSQHC)

Definitions were developed over time with stakeholders. The Commission separated health literacy of individuals and the environment.

Work started in 2011 and they recognised it as a safety and quality issue. They reviewed the activity in health literacy and found about half of all health literacy related to health information but it also includes research and knowledge sharing, building individual health literacy, workforce training and policy development. The released a discussion paper and received 66 submissions and found out about over 200 initiatives that health services were using and there were a range of approaches with great variability. After this they developed a discussion paper to developing a national statement on health literacy.

At its core health literacy is about people being able to access, understand and act on health related information. There are three main areas of focus: embed it into systems, integrate in education and ensure effective communication.

Embedding health literacy into systems through the national level policies, curriculum and standards as well as policies and procedures at organisational level.

Ensuring effective communication with appropriate information is provided in a way that people can understand it in a form they need. IT is also part of interpersonal communication with education and recall as well as shared decision making.

Integrating health literacy in education included education for consumers about health, children at school. It is also included in the education and training of health care providers and students.
Di Webb, Tasmanian health department has been active in this area. They have had a health literacy strategy. They have videos with staff. Doesn’t matter where you start, you just have to start somewhere.

Everyone has a role in addressing health literacy – consumers and our families and carers, health care providers, health care organisations, government and education and training organisations.
The national statement was endorsed by Health Ministers in August 2014 and there was a national workshop on health literacy in November 2014. The workshop identified where to go next: building health literacy into systems, developing and implementing health information standard, supporting and empowering consumers, address the gaps between policy and practice, support staff to address health literacy needs through the provision of training and resources.

The Commission has published a series health literacy infographics and have also developed summaries of health literacy for consumers, clinicians and and executives and managers.

What are the drivers for quality improvement in Australia? The National Safety and Quality Health Service Standards are being reviewed and there is more explicit reference to health literacy in the new draft standards.

·         Governance systems – systems to support consumers to be partners n the healthcare design, delivery, measurement and evaluation.
·         Partnering with consumer sin organisational design and governance: understanding of diversity of needs of consumers; consumers are partnering in design and governance
·         Health literacy: embedded in systems; consumer receive information that supports safer care and better health outcomes and is easy to understand and use
·         Partnering with consumer in their own care

Clinicians provide consumers with information about health and healthcare that is easy to understand and use, is in a format that meets their needs, includes information about the things that are important like treatment and options and risks and benefits.


Where to next? If we are going to do this in a comprehensive way this is a long term proposition. There is no quick fix and it requires a multilevel approach. We need coordinated national approach to raise the profile of health literacy. But there are things that we can do locally to advance health literacy to improve the environment. Think about who uses the services, build health literacy into the policy framework and the training you provide to health staff.

Darlene Cox
Executive Director

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