St. Vincent Charity promotes health literacy

March 15, 2011

Hospital replaces jargon with plain talk to improve patient outcomes


Simplified signage is in the works for St. Vincent Charity Medical Center in Cleveland.

"Admitting" will make way for "Patient Check-In." Instead of "Protective Services," visitors will see "Security" on the directional placards. "Radiology" will be called "X-Ray."

It's all part of St. Vincent Charity's ongoing effort to improve the way it communicates with patients. Since 2007, the hospital has sought to make health information easier to understand, which includes making the hospital hallways easier to navigate.

Of course, the physical layout of a medical campus isn't the only potential source of disorientation in the patient's experience. Studies show that in the verbal give-and-take between patient and health professional, the patient often gets lost.

Even before leaving the doctor's office, a patient may forget up to 80 percent of what they've just heard, says Karen Komondor, a veteran nurse who is director of education for St. Vincent Charity. And half of the information a patient does remember may be incorrect, she adds.

More than many other professions, health care has its own jargon, and it's easy for health care professionals to forget just how bewildering medical terminology can be to a layperson.

"I've been a nurse for over 30 years, and I never really realized the impact of this on patients,'' says Komondor.

Studies show there is a verbal disconnect between the health care profession and the American public, whose average citizen reads at the eighth grade level. But about 20 percent of Americans read at or below the fifth grade level, and in Cleveland, that number is 25 percent, says Komondor.

Yet many studies reveal that the majority of health care materials are written at the 10th grade level, says Komondor. The difference results in medication errors, hospital readmissions and excess use of emergency rooms from too many patients not equipped to handle their newly diagnosed conditions.

And, as the medical world gets ever more complex, patients are spending less time in hospitals or with health care staffers who can teach them how to manage their illnesses. Forty years ago, the average hospital stay for a newly diagnosed diabetic patient was three weeks, says Komondor. Today, that same patient may be in the hospital one day, and most are treated on an outpatient basis, she says.

One study estimates that anywhere from $106 billion to $238 billion is spent every year on health care costs arising from a lack of health literacy, as the issue is commonly called.

This may explain why health literacy has become a growing concern among federal and state officials, who are pushing public health care professionals nationwide to simplify the way they communicate with patients. Last year, the U.S. Department of Health and Human Services set goals for improving health literacy and suggested ways to achieve them.

St. Vincent Charity began looking at ways to improve how it communicates with patients after receiving a grant in 2007 from the Sisters of Charity Foundation, which was started by the hospital's founders, the Sisters of Charity of St. Augustine.

After forming a 14-member team comprised of staffers from departments across the hospital, one of the first things St. Vincent Charity did was rewrite over 100 health brochures and pamphlets, taking materials written at a 12th grade to college sophomore level, down to an eighth grade level. The goal is to simplify them even further to a sixth grade level, says Komondor.

The hospital also has trained its staff extensively, across all departments, in how to talk with patients about their health needs. "There probably isn't a caregiver in the house now that doesn't know about health literacy, so that's a really neat thing," says Komondor.

For Komondor, the issue of health literacy is not just professional, but also personal. She has three siblings with chronic diseases whom she has helped guide through the medical system, plus a mother who's had multiple stays in intensive care.

"Thank God I'm a nurse and I can interpret things for them,'' she says."But I wonder, what do other people do?"

St. Vincent Charity has taken the next step and has begun teaching what it has learned about health literacy to other health professionals in Cleveland, including the Department of Public Health, the Visiting Nurses Association and at MetroHealth, the county hospital, says Komondor.

The medical center also is planning a statewide conference on health literacy in October.

Improving health literacy "is really a simple solution," says Komondor, "and it has really increased my passion for this work. We have a team of caregivers who are equally passionate about the work, and we're trying to keep the momentum going."

Easy does it for effective patient communication

St. Vincent Charity Medical Center has developed what it calls the five STEPS approach to help staff members communicate more effectively with patients. They are:

Speak slowly. Take time to understand a patient's concerns. Studies show that a patient speaks for no more than 22 seconds before being interrupted by a health care provider.
Teach back. Ask patients to describe in their own words what they've just heard, or what their condition is and how it should be treated.
Encourage patients to ask questions, including writing down questions beforehand.
Plain language is the best way to communicate with a patient.
Show examples of what you're talking about, including drawing a picture. Many people are visual learners.


Copyright © 2011 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Copyright © 2011 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.