Health systems put health personnel and consumers’ health literacy skills to the test. Since health literacy skills can plummet when consumers are in contact with the health system – feeling sick, frightened, drugged or in pain – health personnel and communicators working within care systems must attempt to communicate in a way that is universally accessible and most appropriate for each consumer at that time.
Within health systems, consumers routinely encounter legal, administrative and financial documents (privacy policies, intake forms, consent forms, billing statements). Depending on the care setting, consumers must also try to understand content requiring some form of action or self-care (vaccine schedules, medication lists, referrals, hospital discharge instructions, advanced directives).
Health system settings
- Ambulatory settings – includes primary care, urgent care and outpatient surgery clinics where consumers are generally health enough to walk in and walk out after treatment.
- Acute settings – includes emergency departments and hospitals where consumers need a high level of care right away.
- Sub-acute or skilled settings – includes skilled nursing facilities where consumers who no longer need to be in a hospital can get more care than is available at home.
- Home and community-based settings – includes home care, palliative care and hospice care in community dwellings or assisted living facilities.
Often delivered in short, condensed bursts, consumers do their best to process, ask questions and absorb information. Getting answers to follow up questions after leaving a health care encounter can be a challenge, making it all the more important that communication be understandable and actionable when it is delivered. Accessible communication that comes in a variety of formats, includes time to confirm understanding using teach-back, and involves other learners (family, caregivers) when appropriate, is more likely to be effective.