Navigation of healthcare and public health systems requires
being familiar with the vocabulary, concepts, and processes
needed to access health services and information. This
includes understanding insurance coverage and eligibility
for public assistance, filling out patient information
forms, scheduling appointments and follow-up procedures,
and locating services.
Strategies to improve the usability of health services
include:
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Improve the usability of health forms and instructions
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Improve the accessibility of the physical environment
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Establish a patient navigator program
Improve
the usability of health forms and instructions
Healthcare and public health systems rely heavily on
printed materials, including:
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Medical history forms
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Insurance forms
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Informed consent forms
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Patients' rights and responsibilities
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Test results
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Directions to the lab or pharmacy
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Hospital discharge and home care instructions
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Clinical research protocols and announcements
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These documents, particularly forms which contain blank
spaces to be filled in by the user, are often more difficult
to understand than regular prose.1
Consent forms and other legal documents related to patients'
rights often contain long sentences and difficult legal
terms. It is critical that these forms be translated
into plain language. According to recent guidelines prepared
by the National Quality Forum, healthcare providers should
ask each patient to recount what he or she has been told
during the informed consent process to check for understanding.2
Tips for improving the usability of health forms and instructions:
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Revise forms to ensure clarity and simplicity.
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Test forms with intended users and revise as needed.
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Provide plain language forms in multiple languages.
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Provide clear information about eligibility for
public assistance.
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Train staff to give assistance with completing forms
and scheduling follow-up care.
Sample informed
consent language
Voluntary participation:
“You don't have to be in this research
study. You can agree to be in the study now and
change your mind later. Your decision will not
affect your regular care. Your doctor's attitude
toward you will not change.”
New information about risks:
“We may learn about new things that may
make you want to stop being in the study. If this
happens, you will be informed. You can then decide
if you want to continue to be in the study.”
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Improve
accessibility of the physical environment1
Settings with a large number of signs and postings have
a high literacy demand. Maps, directions, signs, schedules,
and instructions are posted throughout the healthcare
setting to help consumers locate services and information.
Many of these signs contain unfamiliar phrases and symbols.
This environment can be intimidating and overwhelming
for persons with limited health literacy skills. Too
often, confusing signs and postings create more work
for healthcare staff and cause embarrassment for patients.
Tips for improving the physical environment:
Establish
a patient navigator program
Patient navigators can help consumers access services
and appropriate health information. Patient navigators
are health professionals, community health workers, or
highly trained patient liaisons who coordinate healthcare
for patients and assist them in navigating the healthcare
system. Patient navigators can help patients evaluate
their treatment options, obtain referrals, find clinical
trials, and apply for financial assistance.
Did you know?
Congress recently passed the Patient Navigator
Outreach and Chronic Disease Prevention Act of
2005. The bill authorizes $25 million in grants
over 5 years to establish patient navigator programs
in low-income and rural communities nationwide.
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