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The Agency for Healthcare Research and Quality (AHRQ) is developing a survey instrument to measure how effectively hospitals address patients' health literacy needs. The tool will consist of a new module for the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, and will solicit patients' perspectives on how well health information is communicated to them by health care professionals. Questions will consider the clarity of written and verbal communications about treatment choices, screening results, medications, educational techniques, and language assistance.
The CAHPS program began in 1995 with a survey and report on consumers' perspectives on the quality of their health plans. Since then, CAHPS has partnered with CMS and others to expand its scope, developing consumer surveys and reports on individual clinicians, group practices, in-center hemodialysis services, nursing homes and hospitals.
"AHRQ determined that the CAHPS teams should develop a survey to obtain the consumers' perspective on how well health plans, hospital, clinicians, and group practices address health literacy issues," says Charles Darby, CAHPS project officer.
The CAHPS health literacy module measures physicians' ability to communicate effectively with their patients, verbally and in writing, and their use of state-of-the-art communication practices. Patients are asked how often their doctor reviewed all the medications the patient was taking, gave verbal and written instructions about how to take medicine, provided explanations of possible side effects that were easy to understand, and checked to make sure the patient understood instructions.
AHRQ is cognitively testing the module in English and Spanish, to be followed by field testing, with an expected 2008 release. Although the tool is designed to be used with the CAHPS clinician and group survey, it could be adapted for use in the hospital setting, says Darby.
The health literacy set of items could be used to identify areas related to communication between provider and patient, both oral and written, where patients report that they are not receiving the help they need to understand issues about their health and their treatment. "The quality professional may choose to gather more in-depth information from patients to help in designing a quality improvement strategy," says Darby.