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03/18/2024
profile-icon Kallen Rutledge

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.

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

Dynamic Health round-up posts keep you informed about implementation and use of Dynamic Health at Nova Scotia Health. They highlight any new priority projects and events, as well as updates to our Workplace Notes and Custom Workplace Skills.

Updates: Reviewed Skills and Workplace Notes

We receive feedback submissions about Dynamic Health skills on an ongoing basis through the Suggest an Edit form and through partnerships with departments and teams.

We continue to process skill reviews received as a part of our second skill review push up to and including March 8th, 2024.

Reviewed: New Workplace Note

Reviewed: No Workplace Note

New Custom Skills

Health Promotion in March and Dynamic Health Topics

March 2024 marks the promotion of:

In recognition of these health promotion events, we encourage you to engage with the curated list of Dynamic Health content below.

If you spot any Skills below that you feel need a Workplace Note, consider being a reviewer! Fill out our Suggestions for Skills form with your notes and we will get in touch!

Colorectal Cancer Awareness Month

National Poison Prevention Week

The Atlantic Canada Poison Centre provides our local guidance on poisoning information. Dynamic Health content may be used in combination with their recommendations.

Dynamic Health Project Team

Gloria Connolly, RN, BScN, NCA, WOCC(c), GNC(c)
Clinical Nurse Educator, (CNE)
Interprofessional Practice & Learning

Leah MacDonald
Professional Practice Leader
Interprofessional Practice & Learning, COVID-19 Response

Katie McLean
Librarian Educator
Interprofessional Practice & Learning, Library Services

Margaret Meier
Policy Lead
Policy Office

Ann Slaunwhite
Library Technician
Interprofessional Practice & Learning, Library Services

03/04/2024
profile-icon Kendell Fitzgerald

Writing in plain language matters. In Canada, it’s reported that nine million people have limited literacy skills, with over half of Canadians reading below a high school level. This is just one of the reasons why it is important to offer additional support to patients and families with easy-to-read, straightforward patient pamphlets. For more information about creating or updating patient pamphlets, please visit the Content Creator Toolkit. Please contact Pamphlets@nshealth.ca with any questions. You can search for pamphlets by title, keyword, or four-digit pamphlet number in the pamphlets catalogue, or view the complete listing of active titles in our Print Code Index.

The following pamphlets were updated or created in February 2024. 

Burns 
WR85-2384 NEW Electrical Stimulation in Wound Healing

Cardiovascular System 
WG85-0931 Ventricular Assist Devices (VADs) (En français: FF85-1853)
                     (Previous title: Ventricular Assist Devices (VAD))

Digestive System 
WI85-0441 Gastrectomy

Emergency & Public Health 
WA85-1845 Your Emergency Department Visit (En français: FF85-1851; Arabic: 2323)

Endocrine System 
WK85-0222 Hydrocortisone Injection

French Translations (en français)
FF85-1109 Angiofluorographie (English: WW85-0132)
FF85-1216 Prévention et contrôle des infections (English: WC85-1441)
FF85-1218 Conseils alimentaires pour la santé du cœur (English: LC85-0524)
                   (Previous title: Conseils alimentaires favorisant la santé cardiaque)
FF85-1716 Règles de sécurité liées à l’eau (English: WC85-0057)
FF85-1791 Angioplastie des artères de jambe (intervention par ballonnet) (English: WG85-1296)
FF85-1852 Clostridioides difficile (C. difficile) (English: WC85-0602)
                   (Previous title: Clostridium difficile (C. difficile))
FF85-1908 Exercices pour les jambes à faire debout (English: WB85-0937)
FF85-2096 Utilisation des gouttes pour les yeux (English: WW85-0137)
FF85-2100 Examen du champ visuel (English: WW85-0503)

Gynecology & Reproductive Health
WP85-2387 Treatment After Early Pregnancy Loss - Eastern Zone

Hematology
WH85-0100 Bone Marrow Test

Infectious Disease
WC85-1149 Sexually transmitted infections (STI) Clinic

Nervous System
WL85-2388 NEW My Action Plan - Spine Assessment Clinic (SAC) [not available online]

Nursing Units
WZ85-1022 Welcome to the Medical Day Unit (MDU) - Victoria General Site (En français: FF85-2194)
                    (Previous title: Welcome to the Medical Day Unit (MDU) - Victoria General Hospital)

Nutrition & Food
LC85-0655 High-energy, High-protein, Low-fibre Eating Guidelines
                   (Previous title: High Energy, High Protein, Low Fibre Diet Guidelines)

Physiotherapy & Rehabilitation
WB85-0727 Using TENS for Pain
WB85-1825 The Driver Evaluation Program: Frequently Asked Questions (En français: FF85-2187)
                    (Previous title: Driver Evaluation Program: Frequently Asked Questions)

Respiratory System
WF85-0611 Adult Cystic Fibrosis (CF) Program - Halifax Infirmary, QE II
                   (Previous title: The Adult Cystic Fibrosis (CF) Program at the QEII)

The following pamphlets were archived in February 2024:
WE85-1575 After Your Orthopaedic Surgery: What You Need to Know -- Arthroplasty, Fracture Surgery, Sports Medicine
QV85-1869 Keeping Vaccine Safe
WJ85-1572 Urology Stone Clinic - 4 Day Food Record
CB85-1164 Options for Non-Urgent Care

If a pamphlet that has been archived is still needed, please let us know as soon as possible and we will work with you to make it available again.

Kendell Fitzgerald

Librarian Educator
Central Zone

03/01/2024
Lana MacEachern

We're often asked whether it is OK to share copyright-protected resources with colleagues. The answer is, “it depends.”

Canadian copyright law gives copyright owners the right to determine how their works may be copied or distributed. The law does not distinguish between internal and external distribution. Internal distribution can include:

  • Attaching a PDF of an article to an email
  • Saving an image to a SharePoint site
  • Storing an ebook on a shared drive

In each of these instances, you are essentially making a copy of the work for every person who has access to those shared workspaces.

Before hitting ‘Send’ or ‘Save’:

  1. Read the terms of use. Journals, websites, and electronic databases often state explicitly how their content can be used. For example, they may permit distribution for educational purposes, or downloading for personal use only. You must use the content as directed and get permission to share if necessary. Look for terms of use in the fine print of websites. If you have questions about terms of use for journals or electronic databases, email Copyright@nshealth.ca.
  2. Determine if your use is Fair Dealing. Canadian copyright law allows limited use of short excerpts of copyrighted works without getting permission. You may be allowed to share a work if your use is for research, private study, education, parody or satire, criticism, review, or news reporting and it meets conditions determined by Canadian courts. Examples might include sharing an article with a Nova Scotia Health colleague for collaborative research, or with students in an in-person lecture. Learn more about Fair Dealing.
  3. Share a link to the resource if possible! It is generally considered copyright compliant to share a link to an electronic resource. Linking to the original document also ensures that if a document is updated or revised, readers are directed to the most recent version.

To learn more about best practices for sharing articles with colleagues, check out our new ‘Copyright Minute’ video, below. You can also contact us any time at Copyright@nshealth.ca.

Copyright - A Copyright Minute: Sharing Articles with Colleagues

Nova Scotia Health, 2023.


Lana MacEachern

Library Technician
Pictou/Colchester-East Hants/Cumberland Region

Roxanne MacMillan

Librarian Educator
Halifax Infirmary, Central Zone

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