Wednesday, June 21, 2006

Relationship between health literacy and medication errors

I know that many of our colleagues in a variety of care and library settings are interested in health literacy, so I thought I'd share this review of current literature on the relationship between medication errors and literacy. The researchers found none, but encourage the field to continue studying the matter.

Warner A, Menachemi N, Brooks RG. Health literacy, medication errors, and health outcomes: is there a relationship? Hosp Pharm. 2006;41:542-551.

Does this present an opportunity for librarians to contribute to patient safety research?

Could be -


Lorri Zipperer said...

What metrics would you put in place (from the librarian's perspective) that could help measure the impact of what they do on safety due to improved literacy? Do they count reference questions / interviews etc that indicate an interest in improving literacy from that angle? Are they working with researchers in health literacy to include one or two questions that relate back to the librarians role in providing information to patients? You see what I mean?

Any dialogue would be helpful.


Maura Sostack, MLS said...


I feel noncompliance absolutely falls into the patient safety arena. A place to start, would be in patient information/consumer health libraries. Currently, I am a consultant working with a nonprofit organization that, among other things, has a clinic onsite and a library. Patients from the clinic are directed to the library for information about their disease.

They are also directed to sign up for computer classes -- how to use the Internet to find health information, etc. The problem is literacy. Most of the patients from the clinic, have very low literacy levels - 4th grade and below - so, as an example, we've had to overall the computer class curriculum in order to assist patients. What would be interesting is to monitor their medication regime and that would require working with the docs and nurses directly in the clinic, sit in on patient interviews, etc., and follow their progress in medication compliance.

The library and librarians could directly influence the medical staff - overhaul their printed patient information guidelines, etc.

There is a lot of data out their that links noncompliance to literacy levels. It would be difficult to separate patient safety from noncompliance. Does this make sense?


Maura Sostack, MLS said...

I feel so passionately about noncompliance and literacy. It is why I became a literacy tutor, so I tend to look at the passionate side, rather than the science of it all. Frankly, from a humane perspective, it really bothers me that physicians and other clinical people, are blind to this problem.

Lorri Zipperer said...

There are efforts to raise awareness of the role of health literacy in patient safety, and in other facets of health care. JCAHO is having a meeting [ ] here in Chicago next week on the issue. The NPSF safety foundation has had programming on this issue for several years running. See: "How Literacy and Communication Initiatives Improve Patient Safety." Volume 8, Number 3, 2005. [ ] and I heard several speakers from Iowa talk about programs in their state that are helping to combat the problem. I am sure there are others out there, too.

What I think needs to be done is to look at the lack of clinician involvement in the issue, use the systems thinking "5 whys" tool to dig deep to identify the root cause of the current situation, and then see how librarians can help solve the problem. Can we help hospitals understand the failures in the patient education and interaction processes in order to change things in a way that will sustain improvements.

I am sure you must have a sense of why clinicians are not as involved. What do you see as being the root cause and how can librarians and improved knowledge transfer help?

cylon said...
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