Imagine you’re a patient coming to the hospital for a breast cancer screening, and you can’t find Mammography. You find someone to ask for directions, but you can’t understand what the person is saying. You might feel intimidated or overwhelmed, and not speak up. As a result, you may not get the care you need.
How well patients can find, understand, and use the Hospital of the University of Pennsylvania’s services to take care of themselves – known as “health literacy” – is the focus of a wide-ranging assessment that will continue through next spring. Patient education specialists Carolyn Cutilli, PhD, RN, Andrea Blount, MPH, BSN, and Maureen Bonnell, MSN, as chairs of the Patient and Family Education Committee, are leading the initiative with help from groups of staff and volunteers throughout the hospital. They’ll be using a rubric developed by Harvard University’s T.H. Chan School of Public Health as well as an international “Health Literate Health Care Organization questionnaire” to evaluate the hospital’s strengths and opportunities for improvement. (See examples below)
“We did a research study at HUP a few years ago and asked patients what communication skills were important to them as part of the patient experience. The study found that caring for patients as individuals, paying attention and addressing patients' fears and concerns, and clearly explaining information to promote understanding were critical,” Cutilli said. “This assessment is the next step to tell us if we have specific processes in place to help us meet our patients’ health literacy needs.”
Volunteer Mary Lanken, a member of the Patient and Family Advisory Council (PFAC) who is helping with the assessment, said that knowing HUP cares so much about how patients navigate the health system gives her a good feeling.
“It makes me feel more safe and secure as a patient to realize that they’re working all the time to make things better, more convenient, and more understandable for patients,” she said.
Here are some examples of what the assessment will review:
Patient Input
How often are new print materials piloted with their intended audience? Currently, the PFAC, led by Karen Anderson, MSN, joins the staff in providing feedback on broad projects such as the After Visit Summary given to each patient. Other materials are reviewed by patients with a specific health concern. “It is important to build relationships with patients,” Cutilli said. “If you answer what they’re focused on, then patients may be more receptive to learning information that they weren’t focused on.”
Wayfinding
How do patients find their way around HUP? The assessment team will be looking for signs clearly directing to and from parking and public transportation; consistent symbols, graphics, and icons; and approachable staff or volunteers who speak in plain language.
Patient Portal Functionality
How easy is it to navigate myPennMedicine? “If patients can effectively interact with the portal, that can help them make decisions that affect their care,” Cutilli said. “A patient could contact their doctor if they were concerned about a lab result, for example, or read information on diabetes in the Medical Library.”
Cultural and Language Differences
How well do HUP’s staff, policies, written materials, and language services work to bridge cultural differences that can lead to miscommunication? This is especially relevant now, as Cultural Humility has become a standard of the Penn Medicine Experience (PMX) and is the focus of this year’s PMX campaign.