Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
J Am Board Fam Med. 2011 May-Jun;24(3):281-9. doi: 10.3122/jabfm.2011.03.100212.
Difficulties in identifying and caring for patients with limited health literacy have prompted interest in clinical screening to assess health literacy. Little agreement exists, however, on the utility of such screening. In this case study we explore the business and clinical cases for screening for health literacy using the Newest Vital Sign (NVS), a brief instrument specifically developed for use in primary care settings.
Data were collected in 2008 in the Morehouse School of Medicine Department of Family Medicine Primary Care Clinic, where health literacy screening was implemented as part of routine intake procedures within an ongoing quality improvement effort to improve cardiovascular disease and diabetes outcomes. Specifically, we monitored time requirements, administrative and training costs, and clinician utilization associated with the NVS.
Results identified only small time and cost constraints associated with implementing NVS screening. Clinical utility was more problematic, however, because refresher trainings were needed to ensure continued staff and clinician buy-in, use of the NVS data, and implementation of best practices to communicate with at-risk patients.
Though the time and cost constraints associated with screening for health literacy were small, clinician utilization of this data in decision making and care processes may require further training and/or support.
由于难以识别和照顾健康素养有限的患者，因此人们对临床筛查以评估健康素养产生了兴趣。然而，对于这种筛查的效用，尚未达成共识。在本案例研究中，我们使用专门为初级保健环境开发的简短工具“最新生命体征”（NVS），探讨了筛查健康素养的商业和临床案例。
2008 年在莫尔豪斯医学院家庭医学初级保健诊所收集数据，在一项持续的质量改进工作中，作为常规入学程序的一部分，实施了健康素养筛查，以改善心血管疾病和糖尿病的结果。具体而言，我们监测了与 NVS 相关的时间要求、管理和培训成本以及临床医生的使用情况。
结果仅确定了与实施 NVS 筛查相关的小时间和成本限制。但是，临床实用性更成问题，因为需要进行刷新培训，以确保员工和临床医生继续接受培训、使用 NVS 数据以及实施与高风险患者进行沟通的最佳实践。
尽管筛查健康素养的时间和成本限制很小，但临床医生在决策和护理过程中使用这些数据可能需要进一步的培训和/或支持。
