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Implementation of a Routine Health Literacy Assessment at an Academic Medical Center

Warring, Carrie D.; Pinkney, Jacqueline R.; Delvo-Favre, Elaine D.; Rener, Michelle Robinson; Lyon, Jennifer A.; Jax, Betty; Alexaitis, Irene; Cassel, Kari; Ealy, Kacy; Hagen, Melanie Gross; Wright, Erin M.; Chang, Myron; Radhakrishnan, Nila S.; Leverence, Robert R.

The Journal for Healthcare Quality (JHQ): September/October 2018 - Volume 40 - Issue 5 - p 247–255
doi: 10.1097/JHQ.0000000000000116
Original Article

ABSTRACT Limited health literacy is a common but often unrecognized problem associated with poor health outcomes. Well-validated screening tools are available to identify and provide the opportunity to intervene for at-risk patients in a resource-efficient manner. This is a multimethod study describing the implementation of a hospital-wide routine health literacy assessment at an academic medical center initiated by nurses in April 2014 and applied to all adult inpatients. Results were documented in the electronic health record, which then generated care plans and alerts for patients who screened positive. A nursing survey showed good ease of use and adequate patient acceptance of the screening process. Six months after hospital-wide implementation, retrospective chart abstraction of 1,455 patients showed that 84% were screened. We conclude that a routine health literacy assessment can be feasibly and successfully implemented into the nursing workflow and electronic health record of a major academic medical center.

For more information on this article, contact Robert R. Leverence, M.D. at

This work supported in part by the NIH/NCATS Clinical and Translational Science Award to the University of Florida UL1 TR000064.

The authors declare no conflicts of interest.

C. D. Warring is supported by the Gatorade Trust through funds distributed by the University of Florida, Department of Medicine.

The funding source had no role in the design of the study; the collection, analysis, and interpretation of the data; or the decision to submit the manuscript for publication.

© 2018 National Association for Healthcare Quality
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