JONA Article Looks at Health Literacy, Readmission Reduction

August 1, 2013 - Improving the health literacy of patients may help reduce hospital readmissions, according to new article by two faculty members and a student at the School of Nursing & Health Studies.

Patricia Cloonan, PhD, RN, chair of the Department of Health Systems Administration, is lead author of “Reducing 30-Day Readmissions: Health Literacy Strategies,” which appeared in The Journal of Nursing Administration.

“The imperatives of the Affordable Care Act to reduce 30-day readmissions present challenges and opportunities for nurse administrators,” the authors write in the peer-reviewed publication. “…Evidence-based interventions addressing low health literacy, when used with all patients, hold promise to promote understanding and self-management.”

Readmissions and Health Literacy

Cloonan authored the manuscript along with Jade Wood (G’14), MA, a master’s degree student in health systems administration, and Joan Burggraf Riley (NHS'76, G'97), MS, MSN, RN, FNP-BC, FAAN, assistant professor of human science and nursing.

As cited in the article, an estimated 20 percent of patients are readmitted within 30 days of their discharge. Medicare readmission spending, they write, hits $17.5 billion – $12 billion of which is potentially preventable.

“The characteristics of patients at highest risk for readmission parallel those of the population with low health literacy,” the authors write. “…Low health literacy is associated with poorer knowledge of chronic disease and decreased ability to successfully self-manage chronic conditions.”

Scope and Strategies

The problem is vast in the United States, they note, as more than 35 percent of adults have limited literacy skills and 30 million adults have below basic skills.

“[T]here are evidence-based strategies and approaches that have been demonstrated to be successful in improving comprehension, knowledge, and self-management among the population with low health literacy,” the article says.

Those strategies include a “teach back” or “show me” method to confirm a patient’s understanding, avoiding jargon, developing understandable written materials that employ plain language and pictures, implementing follow-up phone calls to discharged patients, and beginning discharge planning early.

“Lower-cost, evidence-based interventions hold promise of reducing readmissions among patients with low health literacy,” the authors write.

By Bill Cessato