Organizational Health Literacy: Quality Improvement Measures with Expert Consensus.
Organizational Health Literacy: Quality Improvement Measures with Expert Consensus.
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DOI：
10.3928/24748307-20190503-01
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发表时间：
2019-04-01
影响因子：
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通讯作者：
Gritz, R Mark
中科院分区：
文献类型：
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作者：
Brega, Angela G;Hamer, Mika K;Gritz, R Mark
背景：组织健康素养（OHL）是医疗保健组织实施策略以使患者更容易理解健康信息、导航医疗保健系统、参与医疗保健过程和管理其健康的程度。尽管存在指导 OHL 相关质量改进 (QI) 举措的资源，但在建立组织可用于监控其改进工作的措施方面所做的工作却很少。 目标：我们试图识别和评估现有的 OHL 相关 QI 措施。为了补充之前根据患者报告的数据制定措施的努力，我们试图确定根据临床、管理、QI 或工作人员报告的数据计算的措施。我们的目标是制定一套专家认为对于 OHL 相关 QI 活动有价值的衡量标准。方法：我们使用四种方法来确定根据临床、管理、QI 或工作人员报告的数据计算得出的相关衡量标准。我们召集了技术专家小组，发布了措施请求，进行了文献综述，并采访了 20 个致力于改进 OHL 的组织。从确定的措施的综合清单中，我们选择了一组高度优先的措施供第二个专家小组审查。使用修改后的德尔菲审核流程，小组成员根据四个评估标准对措施进行评级，参加电话会议讨论小组成员之间存在分歧的领域，并重新评估所有措施。 主要结果：在所有方法中，我们确定了 233 项措施。德尔福小组审查了 70 项措施。对于22项措施，专家组一致认为这些措施是有用的、有意义的、可行的、具有表面效度。另外五项措施在有用性、意义和表面有效性方面获得了很高的评价，但未能在小组成员之间就可行性达成共识。结论：我们确定了得到该领域专家支持的 OHL 相关 QI 措施。尽管建议开发和测试额外的措施，但共识 OHL QI 措施适合立即使用。 [HLRP：健康素养研究与实践。 2019;3(2):e127-e146.].通俗语言摘要：医疗保健系统很复杂。医疗保健组织可以通过做出改变来改善沟通并帮助患者找到自己的出路、参与医疗保健过程并管理他们的健康，从而使患者的生活变得更轻松。我们确定了组织可以用来监控其改善与患者沟通和支持的 22 项措施。
BACKGROUND: Organizational health literacy (OHL) is the degree to which health care organizations implement strategies to make it easier for patients to understand health information, navigate the health care system, engage in the health care process, and manage their health. Although resources exist to guide OHL-related quality improvement (QI) initiatives, little work has been done to establish measures that organizations can use to monitor their improvement efforts.OBJECTIVE: We sought to identify and evaluate existing OHL-related QI measures. To complement prior efforts to develop measures based on patient-reported data, we sought to identify measures computed from clinical, administrative, QI, or staff-reported data. Our goal was to develop a set of measures that experts agree are valuable for informing OHL-related QI activities.METHODS: We used four methods to identify relevant measures computed from clinical, administrative, QI, or staff-reported data. We convened a Technical Expert Panel, published a request for measures, conducted a literature review, and interviewed 20 organizations working to improve OHL. From the comprehensive list of measures identified, we selected a set of high-priority measures for review by a second expert panel. Using a modified Delphi review process, panelists rated measures on four evaluation criteria, participated in a teleconference to discuss areas of disagreement among panelists, and rerated all measures.KEY RESULTS: Across all methods, we identified 233 measures. Seventy measures underwent Delphi Panel review. For 22 measures, there was consensus among panelists that the measures were useful, meaningful, feasible, and had face validity. Five additional measures received strong ratings for usefulness, meaningfulness, and face validity, but failed to show consensus among panelists regarding feasibility.CONCLUSIONS: We identified OHL-related QI measures that have the support of experts in the field. Although additional measure development and testing is recommended, the Consensus OHL QI Measures are appropriate for immediate use. [HLRP: Health Literacy Research and Practice. 2019;3(2):e127-e146.].PLAIN LANGUAGE SUMMARY: The health care system is complex. Health care organizations can make things easier for patients by making changes to improve communication and to help patients find their way around, become engaged in the health care process, and manage their health. We identify 22 measures that organizations can use to monitor their efforts to improve communication with and support for patients.