Talking to Patients


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Communicating Health Information with Adults

Also from HIQA/NALA:


The HSE has launched a short guide for health professionals with helpful tips on communicating with patients with a handy glossary of medical terms and their more user-friendly explanation.  This is available to download here.

Older people and polypharmacy

Older people in particular may be taking multiple medications and managing these can be a cause of anxiety.  Errors can be dangerous.  In addition to the  “Crystal Clear” programme developed by NALA, the Irish Pharmacy Union (IPU) and MSD Ireland, there is an EU-wide initiative addressing this issue, called SIMPATHY.  

The project includes case studies from 9 European countries including one from Northern Ireland.  It is a work in progress, but worth following.


Tools and resources for health service organisations from The Australian Commission on Safety & Quality in Health Care.

This includes 5 practical easy to use Fact Sheets

Health Literacy Universal Precautions Toolkit, 2nd Edition

There are many helpful tools available to copy or adapt for your practice on this site:

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Health Literacy Standards for Health Organisations

NALA and HIQA have also set out guidelines for health literacy in healthcare organisations – Hospitals, GP Practices, Pharmacies etc – as part of their “Crystal Clear” programme.  These are practical and easy to follow, and each one brings immediate benefits to patients and visitors.  The standards are listed below, with the kind permission of NALA, along with their introduction.

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Developing quality standards for a health literacy friendly hospital
September 2017
Health literacy and numeracy is important for everyone. International research has shown that people who are better informed about their health have more effective consultations with their healthcare provider and are more likely to take their medication correctly. This results in
improved health outcomes and living longer.

Better health literacy can improve services and outcomes.  The National Adult Literacy Agency (NALA) wants to improve health literacy and numeracy levels among the Irish people alongside developing literacy friendly health and social care services. We want a health service where:
1. health providers deliver a literacy friendly service including communicating clearly, and
2. individuals are able to get, process and understand health information and be confident taking action and making decisions about their health and wellbeing.

NALA works with health services to help them to deliver a health literacy friendly service. A health literacy friendly service takes account of the literacy and numeracy needs of the public and regularly evaluates and consistently improves this.  NALA’s supports services to do this through audit tools, developing health literacy resources and delivering training and workshops.

Developing health literacy quality standards
In 2015, we launched the Crystal Clear programme for pharmacies and general practices (GPs). It is Ireland’s first health literacy quality mark. To date, 59 pharmacies and four general practices have achieved the Crystal Clear mark. To get the Crystal Clear mark, you must do an online audit which has nine quality standards under four areas.

Developing quality standards for hospitals

Hospitals provide essential health services to the public. NALA wants to support hospitals become more aware of and active in addressing health literacy. Building on the standards in the Crystal Clear programme and other audits, NALA has identified 18 standards for hospital settings:

Communications (8 standards)

Staff Awareness (3 standards)

Policies & procedures (4 standards)

Evaluating & improving (3 standards)

Many of these standards complement HIQA’s National Standards for Safer Better Healthcare, in particular theme one: Person-Centred Care and Support. They also complement the Quality Framework: Mental health services in Ireland, in particular themes two (respectful, empathetic relationships) and three (empowering approach to service delivery).  They are a work in progress and may change as we introduce and trial them in hospitals.

1 The layout of our reception area is clear. There is a sign for reception or information. The area is free from clutter. Our leaflets and posters are clearly displayed.
2 We help the public find their way around the hospital easily: There is a clear map at the door, clear and consistent signage and staff available to provide clear directions.  (See also the UK Government guidance for developing helpful signage “Wayfinding“)
3 All health and safety notices are clear and accessible.
4 The computer kiosks are easy to use and understand.
5 Our phone system is easy to use and understand. If automated, people have the option
to repeat items.
6 We use plain English in all written information.
7 Our staff follow plain English guidelines when speaking with patients: for example
avoiding unnecessary jargon, explaining necessary terms and checking that patients
understand what we have told them (teach back).
8 If the hospital runs patient programmes, we use varied active learning methods and
written materials are in plain English.

Staff awareness and development
9 New and existing staff attend a health literacy awareness session. This is logged in
their induction training record or in their ongoing training record.
10 Our staff use literacy aware work practices and respond sensitively to the literacy
and numeracy needs of our patients.
11 We support staff members who need help with their literacy and numeracy.

Policies and procedures
12 We have a health literacy friendly policy.
13 We have an in-house health literacy committee and/or a staff member with
responsibility for health literacy.
14 We have a complaints procedure that is literacy friendly, supporting patients in whatever
way necessary to formally record and submit their complaint.
15 We offer the patient, wherever possible and without unduly compromising privacy, the
option of having staff fill in any essential paperwork.

Evaluating and improving
16 We ask for feedback from patients and staff using a variety of methods, including phone,
forms (print), online, focus groups and so on.
17 We regularly evaluate and continually improve our service to be health literacy friendly.
18 We have an agenda item ‘health literacy’ on the senior management team meeting.

Further information
Helen Ryan, Policy Officer, NALA
National Adult Literacy Agency
Sandford Lodge, Sandford Close
Ranelagh, Dublin 6
Tel: +353 1 412 7900

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