Better, sooner, more convenient health care in Midlands

CommunityA focus on health literacy5Listening to UnderstandTo listen with understanding, listeners need to develop a critical awareness of who is speaking andwhy. As they become aware of different speakers’ purposes and points of view, they are able to maketheir own judgments about the relevance, reliability or bias of what they hear.Effective listening takes place during two way communication. The important element thatdistinguishes two-way communication from one-way communication is verbal feedback. Verbalfeedback occurs when the listener sends verbal responses to the speaker about their conversation. Inessence we are attempting to eliminate misunderstanding.The key to Listening To Understand is to use verbal feedback to eliminate misunderstandings. Verbalfeedback can be in the form of asking clarifying questions or paraphrasing.Speaking to CommunicateThe need to listen for details in specific situations, and to be able to communicate those details backto the practitioner is vital. The “CUT” method is an extremely effective technique in which you (asthe General Practitioner, nurse, pharmacist, Flow Team member etc) ask the patient to explain toyou the critical action items from the consultation. Health professionals can then provide immediatefeedback and educational efforts to correct details the patient did not comprehend.Creating an environment that ensures equitable access to the health systemThe goal is to help patients become informed and motivated. This cannot be achieved without awelcoming environment in which patients are comfortable asking questions. Shame is a prominentemotion that patients with limited literacy associate with medical encounters. Everything from theinitial contact with the Flow Team through to referrals should be made clear and simple.Patients with low literacy harbour a deep sense of shame, which is reinforced by healthcare staff whobecome frustrated or angry when someone cannot complete a form or read instructions. Seekingmedical care is intimidating for patients with low literacy because they cannot understand signs andregistration forms.A Network committed to improving their Health Literacy standardsA baseline set of health literacy standardsA Midlands Network Health and Literacy Committee made up of health providers, librarians,communications and marketing specialists, adult educators, and literacy practitioners will set andmanage a baseline set of health and literacy standards. The committee will use a broad scope forhealth literacy interventions, basing initiatives on both literacy and health literacy research.Workforce Development and trainingEfforts to improve health literacy will include appropriate educational and support strategiesdirected toward health professionals. Health care providers need to be supported to develop thecompetencies to provide self-management support and to have options for self-managementsupport available to match the needs of the patients. Best practice models of care for long termconditions need to be designed to reflect the needs of people with low health literacy levels.Development of a health literacy screen based on NZ data (using AsTTle)An online interactive screening tool to assess a patient’s health literacy level will be developed. Thepatient will use the screen on an interactive webhealth touch screen in an Integrated Family HealthCentre environment. The screen will use the AsTTle literacy and numeracy assessment tool and havethe option of “clip-on” modules that screen for individual comprehension levels and understandingby key disease state and level of care.Using theCUT MethodThe CUT Methodasks all membersof the Heath Team tofocus on the cycleof learning• Check the patient isgiven the informationin an appropriateformat• confirmUnderstanding ofthe information isparamount• Teach theinformation ina patientcentred manner64