- pick a known issue (eg, ‘did not attends’)
- start with a willing service
- looking issues highlighted by patient feedback
- select an area where there are high needs (eg, type 2 diabetes)
- start with a high level strategic review.
Include all the systems and processes that affect the service you are reviewing – for example:
- staff recruitment, induction and training
- communication systems and procedures.
In the videos on the Reasons for doing a health literacy review page, the three district health boards who participated in the trial of the guide talk about the services they chose to focus on and why.
r Chris Reid (Clinical Leader, GP, Kerikeri Medical Centre):
Well, the first thing I’d say is do it. You don’t have to go in with any specific targets or ideas. I think it’s more a reflection on the philosophy of your care.
We all want to provide the best possible care and so it’s a very useful thought process to go through because you can pick fairly simple things and you can see improvements, and you can, you know, do that amazing thing of asking a patient do they feel like that’s improved their care.
It’s a great idea. It can be fitted into your care plan, your practice plan, your quality improvement plan, and it can involve the whole team.
Lauren Demblon (Practice Manager, Kerikeri Medical Centre):
I guess each practice is individual but the simple methods are always best. Keeping it simple. Having everybody have some input into the planning and to the conversations that need to be had, and focusing it perhaps on a certain and specific area of practice in the first instance.
We chose our focus as diabetes because we had already identified that as a quality initiative within our practice and part of that quality initiative was looking at reviewing other resources and tools that we had available to support patients.
Our main priority and what we wanted to achieve was better communication with our patients. We wanted our patients to go away having a better understanding of their condition and where our role was in supporting them.
Cheryl Goodyer (Manager, Capability, Māori Health Development Group, CCDHB):
Gaining an understanding of where people’s interest is at and aligning it with some work that’s already going on in the organisation. I felt that with an organisation this size, this large, it was useful to not create any extra work but look at aligning with work that was currently in place.
In this instance we used a project in and around the DNAs where there was already an infrastructure and a lot of the work was around communication so therefore this was an enhancement of what was already under way.
Benedict Hefford (Director Primary Health & Community Services, CMDHB):
It is important to actual follow a method and a structure and there is obviously this guide, which is out here so that is – we found it extremely useful. What that does is give a bit of a template to follow and make sure that all the bases are covered.
Margie Apa (Director Strategic Development, CMDHB):
Having a deliberate approach to planning actions and really engaging your staff because all the parts of the team need to be involved. Very difficult to take insights from a health literacy review and only have half of your team being prepared to take them on board, so really important – the teamwork, the leadership of the team.
But I think a really important tip is actually for people to be open-minded and be prepared to be challenged.
[Logos: Ministry of Health and Workbase]