This document contains a self-assessment for a primary care practice to evaluate their performance on various health literacy-related activities. The assessment addresses areas like spoken communication, written materials, self-management and empowerment support, and the practice environment's support for health literacy. Staff are asked to rate how well their practice performs each activity and identify any areas needing improvement.
This document contains a self-assessment for a primary care practice to evaluate their performance on various health literacy-related activities. The assessment addresses areas like spoken communication, written materials, self-management and empowerment support, and the practice environment's support for health literacy. Staff are asked to rate how well their practice performs each activity and identify any areas needing improvement.
This document contains a self-assessment for a primary care practice to evaluate their performance on various health literacy-related activities. The assessment addresses areas like spoken communication, written materials, self-management and empowerment support, and the practice environment's support for health literacy. Staff are asked to rate how well their practice performs each activity and identify any areas needing improvement.
This document contains a self-assessment for a primary care practice to evaluate their performance on various health literacy-related activities. The assessment addresses areas like spoken communication, written materials, self-management and empowerment support, and the practice environment's support for health literacy. Staff are asked to rate how well their practice performs each activity and identify any areas needing improvement.
Please select one answer that most accurately describes your practice:
Doing Well Our practice is doing this well
Needs Improvement Our practice is doing this, but could do it better Not Doing Our practice is not doing this Not Sure or N/A I don’t know the answer to this question OR This is not applicable to our practice
1. Prepare for Practice Change
Needs Doing Not Sure Improve- Not Doing Tools to Help Well or N/A ment 1. Our health literacy team meets regularly. ☐ ☐ ☐ ☐ 1-Form Team
2. Our practice regularly re-assesses 2-Create a
Health Literacy our health literacy environment and updates our health literacy ☐ ☐ ☐ ☐ Improvement Plan improvement goals. 13-Welcome Patients
3. Our practice has a written Health 2-Create a
Literacy Improvement Plan and collects data to see if objectives ☐ ☐ ☐ ☐ Health Literacy Improvement Plan are being met. 4. All staff members have received 3-Raise health literacy education. ☐ ☐ ☐ ☐ Awareness
5. All levels of practice staff have
agreed to support changes to make it easier for patients to ☐ ☐ ☐ ☐ 3-Raise Awareness navigate, understand, and use health information and services. 6. All staff members understand that limited health literacy is common and can affect all individuals at ☐ ☐ ☐ ☐ 3-Raise Awareness one time or another. 7. Our Health Literacy Team 2-Create a understands how to implement and test changes designed to ☐ ☐ ☐ ☐ Health Literacy Improvement Plan improve performance.
AHRQ Health Literacy Universal Precautions Toolkit Second Edition:
Primary Care Health Literacy Assessment Page 1 2. Improve Spoken Communication Doing Needs Not Doing Not Sure Tools to Help Well Improve- or N/A ment
8. All staff members speak clearly
(e.g., use plain, everyday words ☐ ☐ ☐ ☐ 4-Commun. Clearly and speak at a moderate pace). 9. All staff members listen carefully to patients without interrupting. ☐ ☐ ☐ ☐ 4-Commun. Clearly
10. All staff members limit
themselves to 3-5 key points and repeat those points for ☐ ☐ ☐ ☐ 4-Commun. Clearly reinforcement. 11. All staff members use audio/video 4-Commun. materials and/or visual aids to Clearly promote better understanding (e.g., food models for portion ☐ ☐ ☐ ☐ 12-Use Health Ed. Material Effectively sizes, models of body parts, instructional health videos). 12. Our practice ensures patients have 12-Use Health Ed. Material the equipment and know-how to use recommended audio-visual ☐ ☐ ☐ ☐ Effectively
materials and Internet resources.
13. All clinicians talk with patients about any educational materials 12-Use Health they receive during the visit and ☐ ☐ ☐ ☐ Ed. Material Effectively emphasize the important information. 14. All staff members ask patients to state key points in their own words (i.e., use the teach-back ☐ ☐ ☐ ☐ 5-Teach-Back Method method) to assess patients’ understanding of information. 15. Clinicians routinely review with patients all the medicines they 5-Teach-Back take, including over-the-counter Method medicines and supplements, and ☐ ☐ ☐ ☐ 8-Brown Bag Review ask patients to demonstrate how to take them.
AHRQ Health Literacy Universal Precautions Toolkit Second Edition:
Primary Care Health Literacy Assessment Page 2 2. Improve Spoken Communication Continued Doing Needs Not Doing Not Sure Tools to Help Well Improve- or N/A ment 16. Our practice routinely provides patients with updated medicine lists that describe in easy-to- understand language what ☐ ☐ ☐ ☐ 8-Brown Bag Review medicines the patient is to take and how to take them. 17. Our practice trains patients to use 12-Use Health our patient portal. ☐ ☐ ☐ ☐ Ed. Material Effectively
18. Staff members contact patients
between office visits to ensure understanding or to follow up on ☐ ☐ ☐ ☐ 6-Follow up
plans made during the visit.
19. Staff members assess patients’ 9-Language language preferences and record ☐ ☐ ☐ ☐ Differences 13-Welcome them in the medical record. Patients
20. Our practice always uses
appropriate language services (e.g., trained medical interpreters, trained bilingual clinicians, ☐ ☐ ☐ ☐ 9-Language Differences materials in other languages) with patients who do not speak English very well. 21. When staff members give directions for finding the office, they refer to familiar landmarks ☐ ☐ ☐ ☐ 7-Telephone and public transportation routes as needed. 22. If there is an automated phone system, one option is to speak ☐ ☐ ☐ ☐ 7-Telephone with a person. 23. Our practice is able to respond to phone calls in the main languages ☐ ☐ ☐ ☐ 7-Telephone spoken by our patients. 24. Staff members offer everyone help 12-Use Health Ed. Material (e.g., filling out forms, using patient portal) regardless of ☐ ☐ ☐ ☐ Effectively 13-Welcome appearance. Patients
AHRQ Health Literacy Universal Precautions Toolkit Second Edition:
Primary Care Health Literacy Assessment Page 3 3. Improve Written Communication Doing Needs Not Doing Not Sure Tools to Well Improve- or N/A Help ment 25. At least one staff member knows 11- Assess, Select, and how to assess, prepare, and Create Easy-to- simplify written materials so they ☐ ☐ ☐ ☐ Understand are easier to read. Materials
26. Our practice gets patient feedback 11- Assess,
Select, and on written materials. Create Easy-to- Understand ☐ ☐ ☐ ☐ Materials 17-Patient Feedback
27. Our practice assesses whether 11- Assess,
Select, and written materials are easy to Create Easy-to- understand. ☐ ☐ ☐ ☐ Understand Materials
28. Our practice’s patient education 11- Assess,
materials are concise, use plain Select, and Create Easy-to- language, and are organized and ☐ ☐ ☐ ☐ Understand formatted to make them easy to Materials read and understand. 29. If appropriate, our written 9-Language materials are available in ☐ ☐ ☐ ☐ Differences languages other than English. 30. Our practice’s forms are easy to 11- Assess, Select, and understand and fill out, and collect only necessary information. ☐ ☐ ☐ ☐ Create Easy-to- Understand Materials
31. Lab and test results letters are
concise, use plain language, and 11- Assess, are organized and formatted to Select, and
make them easy to read and ☐ ☐ ☐ ☐ Create Easy-to-
Understand understand (e.g., avoid the use of Materials “positive” or “negative” results). 32. The name of the practice is clearly displayed on the outside of the building, and signs are posted throughout the office to direct ☐ ☐ ☐ ☐ 13-Welcome Patients patients to appropriate locations (e.g., practice entrance, restrooms, check-in, check-out, lab, etc.).
AHRQ Health Literacy Universal Precautions Toolkit Second Edition:
Primary Care Health Literacy Assessment Page 4 3. Improve Written Communication Continued Doing Needs Not Doing Not Sure Tools to Help Well Improve- or N/A ment 33. The walls and bulletin boards are not covered with too many printed notices. It is easy for anyone to ☐ ☐ ☐ ☐ 13-Welcome Patients pick out the important information. 34. Office signs use large, clearly visible lettering and plain, everyday words such as “Walk‐ In” and “Health Center” rather ☐ ☐ ☐ ☐ 13-Welcome Patients than formal words such as “Ambulatory Care” or “Primary Care Practice.” 35. Office signs are written in English and in the primary languages of the populations being served (e.g., 13-Welcome
if most of the patients speak ☐ ☐ ☐ ☐ Patients
English or Spanish, signs are
written in English and Spanish).
AHRQ Health Literacy Universal Precautions Toolkit Second Edition:
Primary Care Health Literacy Assessment Page 5 4. Improve Self-Management and Empowerment Doing Needs Not Doing Not Sure Tools to Help Well Improve- or N/A ment 36. Our practice creates an environment that encourages our 13-Welcome Patients patients to ask questions (e.g., asking “What questions do you ☐ ☐ ☐ ☐ 14-Enc. Questions have?” instead of “Do you have 15-Make Action any questions?”) and get involved Plans with their care. 37. Clinicians help patients choose health improvement goals and develop action plans to take ☐ ☐ ☐ ☐ 15-Make Action Plans manageable steps toward goals. 38. Clinicians consider their patients’ religion, culture, and ethnic customs when devising treatment ☐ ☐ ☐ ☐ 10- Consider Culture options. 39. Our practice follows up with 6-Follow up patients to determine if their action ☐ ☐ ☐ ☐ 15-Make Action Plans plan goals have been met. 40. Clinicians write precise instructions for taking medicine that are easy-to-understand (e.g., “take 1 pill in the morning and 1 ☐ ☐ ☐ ☐ 16-Help Patients with Medicine pill at bedtime” instead of “take twice daily”). 41. Staff members discuss different methods for remembering to take medicines correctly and offer patients assistance setting up a ☐ ☐ ☐ ☐ 16- Help Patients with Medicine system (e.g., pill box, medicine chart). 42. Our practice requests feedback 11-Assess, Select, and Create from patients. Easy-to- ☐ ☐ ☐ ☐ Understand Materials 17-Patient Feedback
AHRQ Health Literacy Universal Precautions Toolkit Second Edition:
Primary Care Health Literacy Assessment Page 6 5. Improve Supportive Systems Doing Needs Not Doing Not Sure Tools to Help Well Improve- or N/A ment 43. Staff members assess patients’ ability to pay for medicines. ☐ ☐ ☐ ☐ 19-Medicine Resources
44. Staff members connect patients
with medicine assistance programs, including helping them ☐ ☐ ☐ ☐ 19- Medicine Resources fill out applications as needed. 45. Staff members assess patients’ non-medical barriers and take 18-Non-Medical initiative to address them and ☐ ☐ ☐ ☐ Support provide appropriate referrals or extra support as needed. 46. Staff members ask patients if they have trouble reading or ☐ ☐ ☐ ☐ 20-Literacy and Math Resources understanding and using numbers. 47. Our practice maintains an up-to- 18-Non-Medical Support date list of community resources ☐ ☐ ☐ ☐ 20-Literacy and and refers patients as needed. Math Resources
48. Staff members help patients access
adult literacy and math programs. ☐ ☐ ☐ ☐ 20-Literacy and Math Resources
49. Our practice shares important
referral information (e.g., reason for referral, pertinent medical ☐ ☐ ☐ ☐ 21- Referrals history, test results) directly with other health care clinicians. 18-Non-Medical 50. Staff members offer patients help Support with referrals, such as making an ☐ ☐ ☐ ☐ 20-Literacy and Math Resources appointment. 21- Referrals 6-Follow up 51. Staff members confirm patient 18-Non-Medical follow through after a referral is ☐ ☐ ☐ ☐ Support 20-Literacy and made. Math Resources 21- Referrals
AHRQ Health Literacy Universal Precautions Toolkit Second Edition: