What can health-care facilities do to help patients better understand medical information

Diane Smith, an assistant professor in MU's Department of Occupational Therapy and a collaborator with the University of Missouri's Center for Health Policy, and four occupational therapy graduate students conducted a pilot study focusing on the "health literacy environment" of two health care facilities. "Health literacy" is defined as a patient's ability to understand the health information provided to them by health professionals. The study focused on ease of navigation, including use of signage, facility maps and verbal & written communication.

"Our study is directed toward the provider making health information easier to understand for the client," said Smith, who is the interim chair of the occupational therapy department. "If patients can understand information better, they are going to be more compliant with medical direction. If they are more compliant, they are more likely to get better outcomes."

The study examined a rehabilitation facility and an independent senior-living facility. Although both facilities exhibited many strong points, both had areas in need of improvement. At the independent living facility, paperwork was written at a college-sophomore reading level. Previous studies have recommended that medical information be written at a fifth to eighth-grade reading level. Another common health literacy issue is clear oral communication between health care professionals and patients. At the rehabilitation facility, health care professionals rarely asked patients if they were "being clear." Problems with oral communication also extend to a lack of availability of multilingual employees who can translate for providers. Following the evaluation, the researchers gave suggestions to each facility.

Smith recommends several steps that the health care industry can take to increase patient understanding:

• Health care professionals should use plain language, instead of professional jargon, as well as make sure a patient understands their directions.
• Printed materials should be available in large, easy-to-read fonts and written at a fifth to eighth grade level.
• Clear maps and consistent navigational signs should be posted throughout the interior, as well as on the exterior of the building.
• Wheelchair accessibility also should be a consideration beyond mobility. For example, maps should be posted at wheelchair-level.

Smith is working to educate current and future health care professionals on the importance of patient understanding by speaking at professional conferences and advocating curriculum changes. This year, Smith has spoken and is scheduled to speak at professional conferences for rehabilitation professionals including occupational and speech therapists. MU's School of Health Professions also has added a health care literacy requirement to some of its degree programs.

"Health literacy is even more important as people are being discharged sooner from hospitals and are charged with their own care," Smith said. "I don't think miscommunication with patients is anything that anyone does on purpose. To facilitate better understanding, health literacy is something that should be more on the forefront of curriculum."

Smith is planning a future study focusing on more health care facilities in Missouri. The study was published in the journal Occupational Therapy in Health Care.