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Easy ways to build health literacy into your daily routines

In honour of health literacy month last October, we shared some of the ways low health literacy can impact patient outcomes and our health system. To add to this information, we've compiled a list of communication strategies to help health care staff and providers build health literacy into their daily routines. These strategies aim to:

• Accommodate different levels of health literacy
• Enhance Nova Scotia Health’s overall health literacy across the organization

Universal Precautions Approach

The universal precautions approach, which assumes that everyone may have difficulty understanding (Seidel, Cortes & Chong, 2021), is an easy way to accommodate differing levels of health literacy in our interactions with the public. Since you can’t gauge someone’s understanding just by looking at them or speaking briefly with them, focus instead on communicating with everyone clearly. This can increase their understanding and engagement.

The language used in the health field is not commonly used in everyday conversations. Even those with higher levels of education may not understand what their diagnosis means. Remember, everyone benefits from clear communication (Glick, Brach, Yin & Dreyer, 2019). It is best to use simple, clear language to avoid any opportunity for misunderstanding, both at the point-of-care and in all written communication.

Strategies for communicating clearly

At the point-of care, remember to:

• Ask about language preference.
• Speak slowly and pace the conversation.
• Explain uncommon medical terms the patient will likely hear often.
• Check understanding using the teach-back method.
• Provide clear, specific discharge and follow-up instructions.
• Support with plain language written materials that are consistent with what was discussed in person.

When sharing written information, including appointment letters, discharge summaries, or patient education materials, make sure your content follows these guidelines:

• Use plain language (around a grade 6 reading level)
• Avoid medical jargon
• Write out acronyms
• Consider readability and layout
• Use lists and short sentences instead of dense paragraphs
• Have a colleague and a Patient and Family Advisor review it
• Translate, if possible

Nova Scotia Health provides the following tools to help with language barriers

Language Services

Oral translation of information:

• 24/7 access to translators via Language Line Services
• Add a translator to a Zoom for Healthcare call
• Schedule an in-person interpreter

Written translation of information:

French
Mervat Ismail, Provincial French-Language Services Consultant
Tel: 902-220-7886
Email: Mervat.Ismail@nshealth.ca

All languages other than French
Nicole Holland, Interpretation and Language Services Coordinator
Tel: 902-473-1909 or 902-219-2551 (cell)
Email: Nicole.Holland@nshealth.ca

Would you like to learn more about health literacy in health care?

Register for the upcoming Education and Training session or request a custom session for your colleagues or team.

See all references

1. Canadian Council on Learning. (2006). Never too old to learn: Seniors and learning in Canada. http://en.copian.ca/library/research/ccl/lessons_learning/never_too_old/never_too_old.pdf

2. Canadian Council on Learning. (2008). Health literacy in Canada: A healthy understanding. Canadian Council on Learning. http://www.en.copian.ca/library/research/ccl/health/health.pdf

3. Council of Ministers of Education, Canada & Employment and Social Development Canada. (2017). Skills proficiency of immigrants in Canada: Findings from the Programme for the International Assessment of Adult Competencies (PIAAC). Retrieved from: https://www.piaac.ca/docs/PIAAC%202012%20Immigrants%20Canada%20Final%20EN.pdf

4. Bartlett, S., Dezii, C., & Sandt, K. (2020). The Universal patient language: A set of resources and tools to design patient communications that support better health literacy. Studies in Health Technology & Informatics, 269, 264–274. https://doi.org/10.3233/SHTI200041

5. Brach, C., & Harris, L. M. (2021). Healthy People 2030 health literacy definition tells organizations: Make information and services easy to find, understand, and use. Journal of General Internal Medicine, 36(4), 1084–1085. https://doi.org/10.1007/s11606-020-06384-y

6. Brach, C., Keller, D., Hernandez, L., Baur, C., Parker, R., Dreyer, B., Schyve, P., Lemerise, A., & Schillinger, D. (2012). Ten attributes of health literate health care organizations. NAM Perspectives, 02(6). https://doi.org/10.31478/201206a

7. Farmanova, E., Bonneville, L., & Bouchard, L. (2018). Organizational health literacy: review of theories, frameworks, guides,and implementation issues. Inquiry: A Journal of Medical Care Organization, Provision and Financing, 55, 46958018757848. https://doi.org/10.1177/0046958018757848

8. Glick, A. F., Brach, C., Yin, H. S., & Dreyer, B. P. (2019). Health literacy in the inpatient setting: Implications for patient care and patient safety. Pediatric Clinics of North America, 66(4), 805–826. https://doi.org/10.1016/j.pcl.2019.03.007

9. Seidel, E., Cortes, T., Chong, C. (2021). Strategies to improve organizational health literacy. Patient Safety 101 Primer, Patient Safety Network. https://psnet.ahrq.gov/primer/strategies-improve-organizational-health-literacy

10. Smith, P. D., Martin, B., Chewning, B., Hafez, S., Leege, E., Renken, J., & Ramos, R. S. (2018). Improving health care communication for caregivers: A pilot study. Gerontology & Geriatrics Education, 39(4), 433–444. https://doi.org/10.1080/02701960.2016.1188810

Kallen Rutledge

Librarian Educator, Patient Education Pamphlets Lead
Nova Scotia Hospital, Central Zone

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• October is health literacy month
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• When it comes to patient education, are some things better left unsaid? A look at writing for readability