Health literacy, cultural competence, and language access services are distinct but inextricably linked concepts for delivering equitable care to all members of the increasingly diverse population of the United States. These concepts are linked, but they developed via different paths, and each has its own unique focus with regard to enabling every individual to obtain the ability to process and understand basic health information and services needed to make appropriate health care decisions. Fragmentation of these disciplines has impeded implementation of relevant measures for quality improvement and accountability.

To foster an integrated approach to health literacy, cultural competency, and language access services, the Roundtable on Health Literacy initiated a project with three components: a commissioned paper to propose a framework for integrating measurements of health literacy, cultural competency, and language access; a workshop to review and discuss the framework; and a second commissioned paper that will provide a roadmap for integrating health literacy, cultural competency, and language access services as well as a revised measurement framework. Held on May 4, 2017, the workshop explored the quality performance measures for integration of health literacy, cultural competence, and language access services. This publication summarizes the presentations and discussions from the workshop.

Contents

• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• PLANNING COMMITTEE ON QUALITY MEASURES FOR INTEGRATING HEALTH LITERACY, CULTURAL COMPETENCE, AND LANGUAGE ACCESS SERVICES
• ROUNDTABLE ON HEALTH LITERACY
• Reviewers
• Acknowledgments
• Acronyms and Abbreviations
• 1. Introduction
  • ORGANIZATION OF THE PROCEEDINGS
• 2. A Proposed Framework
  • NATIONAL COMMITTEE FOR QUALITY ASSURANCE COMMISSIONED PAPER
  • DISCUSSION
• 3. Reaction Panel of Developers and Users
  • QUESTIONS REGARDING AN INTEGRATED APPROACH TO MEASUREMENT
  • HELPING HEALTH CARE ORGANIZATIONS IMPROVE SERVICES TO DIVERSE POPULATIONS
  • EQUITY PERFORMANCE MEASURES WITHIN PAYMENT AND DELIVERY SYSTEM REFORM
  • LEADERSHIP DEVELOPMENT, TALENT MANAGEMENT, ORGANIZATIONAL DEVELOPMENT, AND CHANGE
  • DISCUSSION
• 4. Moderated Discussion with Implementer Panel 1
  • WILL THE PROPOSED APPROACH FACILITATE LITERACY, CULTURALLY, AND LINGUISTICALLY SENSITIVE PERSON-CENTERED CARE?
  • WHEN YOU THINK ABOUT THIS APPROACH, IS THERE ANYTHING YOU WOULD LIKE TO CHANGE SO THAT IT WOULD LEAD TO DESIRED DELIVERY CHANGES?
  • WHAT DO YOU THINK IS THE RIGHT BALANCE OF STRUCTURE, PROCESS, AND TYPE OF OUTCOME PATIENT EXPERIENCE MEASURES?
  • HOW WOULD YOU OR YOUR ORGANIZATION USE THIS APPROACH?
  • WHAT WOULD YOU NEED TO IMPLEMENT THIS APPROACH?
  • DISCUSSION
• 5. Moderated Discussion with Implementer Panel 2
  • WHAT DO YOU LIKE ABOUT THE FRAMEWORK AND WHAT IS MISSING IN TERMS OF INTEGRATING THE CONCEPTS OF HEALTH LITERACY, CULTURAL COMPETENCE, AND LANGUAGE ACCESS?
  • WHAT WOULD THE CHIEF EXECUTIVE OFFICER OF A HOSPITAL NEED TO IMPLEMENT THIS FRAMEWORK?
  • IS PATIENT-CENTEREDNESS ENOUGH OF A FOCUS TO GET DISRUPTIVE CHANGE?
  • WOULD THE CONCEPTS IN THIS FRAMEWORK APPLY TO A PATIENT-CENTERED DENTAL HOME?
  • WHAT WOULD BE THE IMPACT OF INTEGRATING MEASURES OF HEALTH LITERACY, CULTURAL COMPETENCE, AND LANGUAGE ACCESS?
  • WHAT ARE SOME OF THE ISSUES YOU FORESEE WITH IMPLEMENTATION OF THE FRAMEWORK?
  • DISCUSSION
• 6. Reflections on the Day
• References
• APPENDIXES
  • Appendix A. Workshop Agenda
  • Appendix B. Biographical Sketches of Moderators, Speakers, and Panelists
  • Appendix C. Commissioned Paper on a Proposed Framework for Integration of Health Care Quality Measures Related to Health Literacy, Language Access, and Cultural Competence
  • Appendix D. Accompanying Exhibits to the Commissioned Paper

Rapporteur: Joe Alper.

Suggested citation:

National Academies of Sciences, Engineering, and Medicine. 2018. A proposed framework for integration of quality performance measures for health literacy, cultural competence, and language access services: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/24918.