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Health Literacy Universal Precautions Toolkit and the Health Literate Care Model

The Agency for Healthcare Research and Quality (AHRQ) developed the Health Literacy Universal Precautions Toolkit to help primary care practices improve navigation of the healthcare system, increase patient understanding of health information, and enhance support for patients of all health literacy levels. This approach provides evidence-based guidance to adult and pediatric clinicians to ensure that systems are in place to improve understanding by all patients. The goal is to ensure all patients' needs are met and not just those who providers assume need extra assistance. The AHRQ toolkit is divided into segments to help ease the burden on the provider.

As part of the Universal Precautions approach, the Health Literate Care Model (formerly the Chronic Care Model) calls for approaching all patients with the assumption that they are at risk of not understanding their health conditions or how to deal with them. It then confirms and ensures that patients understand what is being communicated to them in a clear and actionable way. This model incorporates health literacy strategies from the toolkit and transforms the Chronic Care Model into the Health Literate Care Model.

This model calls for clinicians to:

  • Employ a range of strategies for clear communication
  • Confirm that patients understand what providers are saying

By incorporating specific approaches from the Health Literacy Universal Precautions Toolkit, the Health Literate Care Model gives examples of improving health literacy at the healthcare system level.

Examples of Programs Using the Health Literacy Universal Precautions Toolkit and Health Literate Care Model

  • In 2014, the Southern Kentucky Area Health Education Center, located in rural Mount Vernon, Kentucky, used AHRQ's Health Literacy Universal Precautions Toolkit to provide organizational health literacy training to approximately 280 medical professionals in rural Kentucky through educational sessions held at their workplaces over a one-year period.
  • Healthy Adams County in rural Pennsylvania is a community-led initiative focusing on improving the health and well-being of Adams County residents. The community is working to address a variety of health concerns including improving health literacy. Through the initiative, the community formed a Health Literacy Task Force that uses the Health Literacy Universal Precautions Toolkit to improve patient-provider communication. The Task Force also helps educate providers about the importance of using plain language and building awareness of the influence of culture on healthcare.

Implementation Considerations

The Health Literacy Universal Precautions Toolkit encompasses various tools for clinicians and organizations to utilize to ensure adult and pediatric practices have the information and resources to promote better understanding by all patients. The approaches presented in the toolkit can be implemented in combination or separately to help patients become more informed and be able to better navigate the healthcare system. AHRQ implementation guides are also available for health literacy team leaders, clinicians, and organizational staff to supplement the toolkit, which provides lessons learned in various healthcare settings and considerations for organizations implementing this approach.

Resources to Learn More

Guide to Implementing the Health Literacy Universal Precautions Toolkit
A companion guide to the Health Literacy Universal Precautions Toolkit offering information on the implementation experiences of twelve diverse primary care practices involved with improving and developing health literacy-related quality improvement (QI) projects.
Organization(s): Agency for Healthcare Research and Quality (AHRQ)

Implementing Health Literacy Universal Precautions
Creates an awareness of health literacy issues and advocates for change. Offers strategies to address health literacy for all populations in accordance with the Health Literacy Universal Precautions Toolkit. Highlights effective examples of health literacy practices.
Author(s): De Walt, D.
Organization(s): University of North Carolina at Chapel Hill, Department of Medicine

The Journey to Become a Health Literate Organization: A Snapshot of Health System Improvement
Describes the steps health systems can take to become health literate. Identifies ten attributes of a health literate organization and highlights a few examples of health systems going through this process.
Author(s): Brach, C.
Citation: Studies in Health Technology and Informatics, 240, 203-237
Date: 2017

A Model Collaboration to Develop a Health Literate Care Curriculum: Preparing the Next Generation of Physicians to Deliver Excellent Patient Outcomes and Experiences
Offers information about the incorporation and utilization, in physician training, of the Health Literate Care Curriculum model, a health literacy strategy making it easier for patients to make informed decisions on the available services to maintain and improve their health.
Author(s): Harris, L., Ginzburg, S., Brach, C., Block, L., & Parnell, T.A.
Organization: National Academy of Medicine (NAM)
Date: 10/2019