Theoretical Framework: Quality Improvement using PDSA Cycle
Background: Over 80 million adults in the United States are estimated to have low health literacy (Hickey et al., 2018; Polster, 2018). Low health literacy is associated with decreased health outcomes and increased costs, especially in non-native English-speaking patients with lower income, limited education, and multiple medical conditions (Hickey et al., 2018; Yen & Leasure, 2019). Several health organizations recommend the teach-back method as a health literacy-based communication approach; however, utilization is inconsistent (Talevski et al., 2020; Yen & Leasure, 2019).
Purpose: This quality improvement project aimed to enhance overall health literacy and patient-centered care are in the non-native English-speaking population. This was carried out through evidence-based health literacy toolkit with teach-back methods and printed management plans.
Methods: The project was implemented at a primary clinic in Chicago, IL, with a diverse patient population. The DNP project leader implemented methods from The Agency for Healthcare Research and Quality (AHRQ) 's evidenced-based Universal Health Literacy Precautions Toolkit. This QI project educated providers on the importance of health literacy and teach-back methods. Patients were then screened using a BRIEF Health Literacy Assessment Tool. Teach-back methods were initiated at the end of patient visits with personalized handouts, and efficacy was assessed using an AURA survey.
Results: The project included 28 patients, with 60.7% scored as having an Inadequate Health Literacy Level, 21.4% having a Marginal Health Literacy Level, and 17.9% considered to have an Adequate Health Literacy Level. After interventions, AURA scores demonstrated high patient self-efficacy scores. The implementation of the teach-back methods was 100%. With 78.6% of patients receiving a personalized management handout.
Conclusions & Implications: Teach-back methods are an effective evidence-based tool to reinforce and confirm patient education and improve health literacy. With the growing diverse population, providers are essential to enhancing patient care and increasing health literacy through improved patient education and communication.
Keywords: evidence-based practice, family