Implementation of an organisational wide approach to improving policy documents using plain language: a case study
Kelly Lambert A , Ceinwen Johnstone B , Lucia Vellar B and Natalie Berg B *A School of Medical, Indigenous and Health Sciences, Building 41.319C, Northfields Avenue, University of Wollongong, Wollongong, NSW 2522, Australia.
B Clinical Governance Unit, Illawarra Shoalhaven Local Health District, Level 1, 66–71 King Street, Warrawong, NSW 2522, Australia.
Australian Health Review 46(3) 361-366 https://doi.org/10.1071/AH21297
Submitted: 29 August 2021 Accepted: 10 February 2022 Published: 28 April 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.
Abstract
The impact of poorly written policies in healthcare is enormous, with the potential for significant economic and personal costs. Our local health district embarked on a major revision of policy document development that sought to reframe the process of policy development using health literacy principles. This included mandatory policy development changes that require policy to be written in plain language, at a readability level of grade 10–12. Staff training in plain language writing was undertaken. Consumer and staff feedback was incorporated in policy development. Four elements were critical to this process: effective leadership, effective instruction, practical support, and evidence-driven decisions. Staff responses to the revised processes were overwhelmingly positive and resulted in improved policy readability. The involvement of consumers in policy development has evolved. From this study, we have learned how to improve the governance of policy documents. It is possible for health literacy principles to be embedded in the development and revision of these documents.
Keywords: consumers, health literacy, health literate organisation, organisational health literacy, plain language, policy, quality, readability, safety.
References
[1] Clinical Excellence Commission. Incident Management Policy Directive PD2019_034. 2019. Available at https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2020_047.pdf[2] Clinical Excellence Commission. Biannual Incident Report. 2020. Available at http://www.cec.health.nsw.gov.au/Review-incidents/Biannual-Incident-Report
[3] Panagioti M, Khan K, Keers RN, Abuzour A, Phipps D, Kontopantelis E, et al. Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis. BMJ 2019; 366 l4185
| Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar | 31315828PubMed |
[4] Clinical Excellence Commission. System Factors – Clinical Management. 2021. Available at https://www.cec.health.nsw.gov.au/Review-incidents/Biannual-Incident-Report/rca-data/system-factors-clinical-management
[5] Rebikov A. Thematic summary of Root Cause Analysis investigations. Illawarra Shoalhaven Local Health District, Clinical Governance Unit; 2018.
[6] Illawarra Shoalhaven Local Health District. Community Health Centres. 2019. Available at https://www.islhd.health.nsw.gov.au/community-health-centres
[7] Illawarra Shoalhaven Local Health District. Strategic Directions for Illawarra Shoalhaven Local Health District: 2017–2020. 2017. Available at https://www.islhd.health.nsw.gov.au/sites/default/files/Health% 20Plans/ISLHDStrategicDirections.pdf
[8] Illawarra Shoalhaven Local Health District. About us. 2019. Available at https://www.islhd.health.nsw.gov.au/about-us
[9] Illawarra Shoalhaven Local Health District. In: Clinical Governance Unit, editor. Procedure for Policy Document Evaluation ISLHD OPS PROC 130. Clinical Governance Unit, Illawarra Shoalhaven Local Health District; 2019.
[10] Vellar L, Mastroianni F, Lambert K. Embedding health literacy into health systems: a case study of a regional health service. Aust Health Rev 2016; 41 621–625.
| Embedding health literacy into health systems: a case study of a regional health service.Crossref | GoogleScholarGoogle Scholar |
[11] Illawarra Shoalhaven Local Health District. Clinical Governance Council. SAER Thematic Analysis Report: January–June 2021 DT21/89090. 2021.
[12] Australian Commission on Safety and Quality in Health Care. National safety and quality health service standards. Sydney; Australian Commission on Safety and Quality in Health Care; 2017.
[13] Mastroianni F, Chen Y-C, Vellar L, Cvejic E, Smith JK, McCaffery KJ, et al. Implementation of an organisation-wide health literacy approach to improve the understandability and actionability of patient information and education materials: A pre-post effectiveness study. Patient Educ Couns 2019; 102 1656–1661.
| Implementation of an organisation-wide health literacy approach to improve the understandability and actionability of patient information and education materials: A pre-post effectiveness study.Crossref | GoogleScholarGoogle Scholar | 30962076PubMed |
[14] Australian Commission on Safety and Quality in Health Care. National Statement on Health Literacy. 2014. Available at https://www.safetyandquality.gov.au/wp-content/uploads/2014/08/Health-Literacy-National-Statement.pdf
[15] Australian Bureau of Statistics. Programme for the International Assessment of Adult Competencies, Australia. ABS; 2013.
[16] Biro V, Mastroianni F. ISLHD Health Literacy Framework 2021–2015. A plan for becoming a health literate organisation. Illawarra Shoalhaven Local Health District; 2014.