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Educational Tools for Our Trade

Culture and Languages    Health Literacy    Patient and Family-Centered Care and Engagement
Health on the Internet    Patient Education    Quality Improvement    Staff Development



Culture and languages

The Spirit Catches You and You Fall Down. Anne Fadiman. 1997. (Link to Amazon website, also available as a pdf version for free download on various websites).

Crosswalk of the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care to The Joint Commission Hospital Accreditation Standards. The Joint Commission. 2014.

Center of Cultural and Linguistic Competence in Health Care. Office of Minority Health, Department of Health and Human Services, 2014.

Limited English Proficiency. National Libraries of Medicine, 2014.

Multicultural Resources for Health Information. National Library of Medicine., 2014.

Bridging the Cultural Divide in Health Care Settings. National Center for Cultural Competence (NCCC) at Georgetown University. (2004).

National Center for Cultural Competence (NCCC) at Georgetown University. Website devoted to enhancing the delivery of culturally competent care through the use of cultural brokers.

Ethnomed. Comprehensive website containing information related to numerous worldwide cultural groups.

Health Information Translations. This site is a compilation of translated healthcare documents provided by a 5-hospital consortium in Ohio.

Culture, Language and Health Literacy. Health Resources and Service Administration (U.S. Dept of Health and Human Services). This comprehensive website provides many resources and aids for learning more about cultural and literacy issues.  Search.

Health Literacy

Writing Health Information for Patients and Families. A comprehensive health literacy guide for developing consumer educational materials from Hamilton Health Sciences in Ontario, Canada. (PDF). 2014.

Building Health Literate Organizations: A Guidebook to Achieving Organizational Change. Abrams MA, Kurtz-Rossi S, Riffenburgh A, Savage B. 2014.

Health Literacy Tool Shed.  National Library of Medicine and Boston University.A free online database of more than 100 empirically validated health literacy instruments. 2015.

Everyday Words for Public Health Communication. Centers for Disease Control. 2015.

The National Academies of Science, Engineering and Medicine. 2015. Health Literacy: Past, Present, and Future: Workshop Summary. Washington, DC: The National Academies Press. This report highlights the progress made in the field of health literacy since the IOM's insightful report from 2004 entitled Health Literacy: A Prescription to End Confusion.

Association between health literacy and medical care costs in an integrated healthcare system: a regional population based study.
Jolie Haun et al. BMC Health Serv Res. 2015; 15: 249.Published online 2015 Jun 27. PMCID: PMC4482196

Health Literacy Lab.  Free online library offering lessons and tips to help health and safety professionals hone their communication skills. City of New York School of Public Health, 2015.

Health Insurance Literacy ResourcesList of resources for consumers and insurance navigators to help explain health insurance terms, benefits, and terms, 2015.

Health Literacy Practices and Educational Competencies for Health Professionals: A Consensus Study. Coleman, C et al. Journal of Health Communication: International Perspectives Volume 18, Supplement 1, 2013

Reasons for and predictors of patients' online health information seeking following a medical appointment. Li N. et al. Fam Pract. 2014 Jun 24.

First impressions: towards becoming a health-literate health service. Community Engagement Consultant. Aust Health Rev. 2014 May;38(2):190-3.

Health Literacy Universal Precautions Toolkit. Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 2013.

Improving Health Literacy Within a State: Workshop Summary/ Institute of Medicine.  Washington, D.C., National Academies Press, 2011.

Promoting Health Literacy to Encourage Prevention and Wellness: a workshop summary/ Institute of Medicine.  Washington, DC: The National Academies Press, 2011.

A practical guide to informed consent - developed with a grant from the Robert Wood Johnson Foundation.

The AHRQ Informed Consent  and  Authorization Toolkit for Minimal Risk Research.  Rockville, MD, Agency for Healthcare Research and Quality, 2009.  AHRQ Pub. No. 09-0089-EF.

Health Literacy and America's Health Insurance Plans:  laying the foundation and beyond. Summaries of the Health Literacy Activities in 27 AHIP Member Companies.  Washington, AHIP, 2013.

Plain Language.
These are resources, tools and training opportunities to create effective written materials and spoken messages using plain language that is clear, simple, and easy to understand. It is one piece of the complex web that makes up health literacy.

Presenting research risks and benefits to parents:  does format matter? Alan R. Tait [et al]. Anesth Analg. 2010; 111(3):718-23.   PMID: 20686011.
Many parents and patients have difficulty in assimilating and interpreting risk/benefit information for both research and treatment. The results of this study suggest a simple and practical method for enhancing understanding of risk/benefit statistics for parents with varying numeracy and literacy skills.

Plain Language: a Handbook for Writers in the U.S. Federal Government.
Richard Lauchman. Lauchman Group, c2009.

The Health Literacy Style Manual prepared for covering kids and families.
CKF National Program Office, Southern Institute on Children and Families, 2005.

Health Literacy, eHealth, and Communication: Putting the Consumer First: Workshop Summary.
Lyla M. Hernandez.  Institute of Medicine, 2009 [Download free PDF].

National Action Plan to Improve Health Literacy: Summary.
U.S Department of Health and Human Sciences, Office of Disease Prevention and Health Promotion, 2010.

National Action Plan to Improve Health Literacy: Report.
U.S Department of Health and Human Sciences, Office of Disease Prevention and Health Promotion, 2010.

Health Literacy Online: a guide to writing and designing easy-to-use health Web sites.
U.S. Department of Health and Human Sciences, Office of Disease Prevention and Health Promotion, 2010.

Assessing and Addressing Health Literacy by Sandy Cornett. "Assessing and Addressing Health Literacy." OJIN: The Online Journal of Issues in Nursing. 2009 Sept; 14(3), Manuscript 2.
Provides evidence-based research and tips about how to assess for low health literacy and how to communicate with and teach patients who struggle with this often times hidden disability.

Understanding Cultural and Linguistic Barriers to Health Literacy by Kate Singleton, Elizabeth M. S. Krause.  OJIN: The Online Journal of Issues in Nursing.  2009 Sept; 14(3), Manuscript 4.
The purpose of this conceptual article is twofold. The first aim is to help nurses appreciate how culture and language can affect patient health literacy. The second aim is to demonstrate the need for nursing interventions that fully integrate health literacy, language, and culture.

AHRQ Health Literacy Universal Precautions Toolkit.
Updated November 2013. The toolkit is based on the principles of universal precautions, or specific actions that providers can take to make health information more understandable for all patients. It is designed to be used by all levels of staff in practices providing primary care for adults and/or pediatric patients.

Ohio State University AHEC Health Literacy Program.
The Ohio State University AHEC Health Literacy Program offers a comprehensive online professional development and continuing education program in the field of health literacy.  There are a total of 11 modules to choose from and each module costs $15.00 to complete, in addition to a $20.00 one-time registration fee.

Training Course: Health Literacy for the Public Health Professionals.
Free "Health Literacy for Public Health Professionals Online Training" program. The purpose of this training is to educate public health professionals about limited health literacy and their role in addressing it in a public health context.

Using Principles of Health Literacy to Enhance the Informed Consent Process (PDF) by Bonne Lorenzen, RN,, MSN; Constance Melby, RN, MS, CNOR; Barb Earles, RN, MHA, CPHRM. AORN Journal. 2008. July: 88(1).
The language commonly used in consent documents often exceeds the average person's reading level in the U.S. Because of this, many patients do not stop to read their consent form before signing it.  By incorporating reader-friendly principles into consent documents, it is more likely that patients will read it, understand it, and actually provide their informed consent.

Communication Techniques for Patients with Low Health Literacy: A Survey of Physicians, Nurses and Pharmacists (PDF).
Health care providers can improve communications with patients with low health literacy by following certain techniques such as slowing down, using drawings, common language and teach-back techniques and creating a shame-free environment. This article explores the use of these techniques and what HCPs can do to improve patient understanding and care outcomes, 2007.

Joint Commission white papers on culture, language family-centered care and literacy.
These white papers provide an overview of what health care providers need to know in order to address needs related to culturally and linguistically diverse patient populations, effective communication, cultural competence, and patient-centered care, 2012.

America's health literacy: why we need accessible health information.  An issue brief from the U.S. Department of Health and Human Services, 2008.

Improving health literacy for older adults.  Rep. US Department of Health and Social Sciences, 2009.

Federal Plain Language Guidelines:  improving communication from the Federal government to the public (PDF), March 2011.

Plain language principles and thesaurus for making HIPAA privacy notices more readable;  prepared for the Health Resources and Services Administration, in consultation with the Office for Civil Rights, and other offices and agencies within the U.S. Department of Health & Human Services, Washington, D.C., and plain language specialists.

The health literacy and plain language resource guide;  created by Health Literacy Innovations, and supported by the AmeriHealth Mercy Family of Companies, 2008.

Hospitals, language, and culture:  a snapshot of the nation:  exploring cultural and linguistic services in the nation's hospitals; a report of findings/ Amy Wilson-Stronks and Erica Galvez, 2010.

About the CAHPS® Item Set for Addressing Health Literacy. CAHPS® Clinician & Group Survey and Reporting Kit, 2009.

Pfizer principles for clear health communication:  a handbook for creating materials that enhance understanding, promote health outcomes.  Pfizer Inc., 2004.

Is our pharmacy meeting our patients' needs?  A pharmacy health literacy assessment tool user's guide.  Agency for Healthcare Research and Quality, 2007.

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Patient and Family-Centered Care and Engagement

Patient and Family Engagement: a Survey of US Hospital Practices.  Herrin, J. et al. BMJ Quality and Safety. 2015.

Guide to Patient and Family Engagement in Hospital Quality and Safety.  The Agency for Healthcare Research and Quality's (AHRQ). A tested, evidence-based resource to help hospitals work as partners with patients and families to improve quality and safety. 2013.

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Health on the Internet

Exceptional Lives. Plain language online tools and guides geared to help parents of children or adult family members with disabilities gain better access to services and support. 2016.

Seeking Doctor Information Online: A Survey and Ranking of State Medical and Osteopathic Board Websites in 2015. Informed Patient Institute, Consumer Reports. March 2016.

Healthcare 411. Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services.
Audio podcast series produced by AHRQ to improve the quality, safety, efficiency and effectiveness of health care for all Americans by giving them information they can use in their health care decision making. News and information are shared in 60-second audio news programs that feature current research on important health care topics.

Finding good information on the internet.  Kevin McCluney.  Scientific American, Guest Blog, 16 July 2011.
This article points out a real problem our society faces in the digital information age: anyone can put anything on the internet.  If we believe everything we find on the internet, we are likely to wind up making some very poor decisions.  A few tricks that anyone can use to find and select high-quality information from the internet are discussed.

The Social Life of Health Information. Susannah Fox, Sydney Jones.  Pew Internet & American Life Project, 2009.
This Pew Internet/California HealthCare Foundation survey finds that technology is not an end, but a means to accelerate the pace of discovery, widen social networks, and sharpen the questions someone might ask when they do get to talk to a health professional. Technology can help to enable the human connection in health care and the internet is turning up the information network's volume.

PatientInform - patientINFORM is a program that brings together the publishers of the world's leading medical journals and the U.S.'s most trusted health organizations to provide patients and their caregivers with access to some of the most up-to-date, reliable and important research available about the diagnosis and treatment of specific diseases.

MedlinePlus Connect - A free service that allows electronic health records (EHR) systems to link users to MedlinePlus (, an authoritative up-to-date health information resource for patients, families and health care providers. MedlinePlus provides information about conditions and disorders, medications, and health and wellness.

Finding Clinical Trial Results - National Library of Medicine Resources.

Patients' reasons for refraining from discussing internet health information with their healthcare providers by Imes RS, Bylund CL, Sabee CM, Routsong TR, Sanford AA, Department of Communication, Carroll University, Waukesha, WI 53186, USA.
This exploratory study examined factors that constrain patients from discussing Internet health information with their healthcare providers. Provider and patient education can help to overcome barriers that restrict communication concerning Internet health research.

National Institute of Health. Helping Older Adults Search for Healthcare Information Online: A Toolkit for Trainers  Updated December 2013.
The Toolkit is a valuable asset for anyone in healthcare who uses the web or who teaches others to use the web for medical information. Although it is written with seniors in mind, it is a useful guide for anyone.

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Patient Education

Medical Education Institute. Links to tools and resources written at the 6th grade reading level and grounded in motivational theory to help people with chronic kidney disease learn how to self-manage. (Posted 2/2/16)

Helping Patients Manage Their Chronic Conditions. California HealthCare Foundation, 2005.

Communicating with Older Adults: an Evidence-Based Review of What Really Works. Gerontological Society of America, 2012.

Building Peer Support Programs to Manage Chronic Disease:  seven models for success. California HealthCare Foundation, 2006.

Using Telephone Support to Manage Chronic Disease. California HealthCare Foundation, 2005.

Patient-Clinician Communication: basic principles and expectations/ Institute of Medicine. Washington, DC:  The National Academies Press, 2011.

Talking with Your Doctor.
Communication between doctor and patient is one of the most important parts of getting good health care. The tips in this chapter will make it easier for patients and their doctors to cover everything they need to talk about.

Improving Patient-Provider Communication: Joint Commission Standards and Federal Law.
Free video on how to meet new communication standards, Title VI of the Civil Rights Act and CLAS standards. Oakbrook Terrace, IL: The Joint Commission, 2010.

Toolkit for Making Written Material Clear and Effective.
Health literacy resource for writing materials with plain language techniques.

Program for Readability In Science & Medicine (PRISM).
Free one-hour online tutorial geared toward writing plain language consent forms. Group Health, 2010.

Training Nurses to Be Teachers by J.A. Burkhart. J Contin Educ Nurs. 39.11 (2008): 503-10. The article explores existing patient education skills at one community hospital and evaluates the effectiveness of improvements when new teaching techniques are applied.

Teaching nurses how to teach: An evaluation of a workshop on patient education by G. Lamiani, A. Furey.  Patient Educ Couns 75.2 (2008): 270-273.
The article assesses the value of a staff education workshop designed to teach nurses how to improve their patient education skills and techniques.

Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care: A Roadmap for HospitalContains idea to help your organization meet the new Joint Commission communication standards coming in 2011. Oakbrook Terrace, IL: The Joint Commission, 2010.

Nancy Forsberg
Forsberg, N. (2010) Family Friendly Space for Research, Reflection and Respite: a Family Resource Center and Library in a Pediatric Hospital Setting. Journal of Hospital Librarianship, 10: 1, 82-87.

Penny Overgaard - Patient and staff education publications:

Diseases A-Z -
This organization's mission is to provide clear and concise health education in American Sign Language to promote the overall wellness of the Deaf & Hard of Hearing community.

MedlinePlus. Over 900 health topics. In English, Spanish, and select topics in an additional 48 languages.

No Time To Teach: The Essence of Patient and Family Education. Fran London. Atlanta: Pritchett & Hull. 2009. Fran redefines patient and family education and provides research-based essentials needed to make an impact on the quality of care and a patient's quality of life in this condensed, power-packed patient education how-to book.

Reducing Hospital Readmissions With Enhanced Patient Education.  2011. Krames Patient Education. Whitepaper examining research supporting successful programs to educate patients.

Patient education program slashes ED readmissions [No authors listed].
The program has several key elements that contributed to its success, including: Customized booklets for each patient, with information specific to their disease or injury, their medications, and follow-up appointments. Charts in which patients can track important data, such as their blood sugar levels. Contact by a pharmacist two to four days after discharge to reinforce the key education messages.

Filling gaps in knowledge:  educating nurses to provide appropriate patient materials, by Cannon S, Boswell C., Contin Educ Nurs. 2009 Apr;40(4):148-9.
Assessing and addressing health literacy is a key issue in providing quality patient education contributes to better and safer patient care.

Individual and Family Engagement in the Medicaid Population: Emerging Best Practices and Recommendations. Minniti, M. et al. (Institute of Family Centered Care), November, 2014.

How to Stay Safe in the Hospital. Summary published in Consumer Reports, December, 2014.

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Quality Improvement

Free From Harm: Acceleration Patient Safety Improvement Fifteen Years after To Err is Human. National Patient Safety Foundation. 2015.

Teach Back Method. Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 2013.

Always Use Teach Back. Institute for Healthcare Improvement (UnityPoint Health, formerly Iowa Health System).

Teach Back Tool Kit.  UnityPoint Health, et al.

You Tube Teach Back Videos. Many videos demonstrating teach back by various organizations.

Project RED Toolkit. (Project Re-Engineered Discharge) Boston University Medical Center. 2010.

Free Online Multicultural Health Care Improvement Guide.
The guide, developed by NCQA in collaboration with Lilly USA, LLC, serves as a resource for those wanting to undertake quality improvement initiatives to improve culturally and linguistically appropriate services and to reduce disparities in care.

Health care leader action guide to reduce avoidable readmissions.  Health Research and Educational Trust, 2010.

The AHRQ informed consent and authorization toolkit for minimal risk research. Agency for Healthcare Research and Quality, 2009.

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Staff  Development

Grey's Anatomy introduction to patient simulators: meet iStan - istan introduction as seen on Grey's Anatomy

Trauma scenario using patient simulators - Human Patient Simulator in Action

Presenting research risks and benefits to parents:  does format matter? Alan R. Tait [et al]. Anesth Analg. 2010; 111(3):718-23.   PMID: 20686011.
Many parents and patients have difficulty in assimilating and interpreting risk/benefit information for both research and treatment. The results of this study suggest a simple and practical method for enhancing understanding of risk/benefit statistics for parents with varying numeracy and literacy skills.

Susan Boyer - Competency, coaching and preceptor publications:

Lions and Tigers and Nurses by Amy Glenn Vega. Atlanta: Pritchett & Hull. 2009.
A nursing novella that deals with the lateral violence in healthcare. This thoroughly entertaining book takes readers through a series of learning opportunities using creative story telling with drama, romance, conflict - and a happy ending! 3 CEs available upon completion.

Broken Heart by Amy Glenn Vega. Atlanta: Pritchett & Hull. 2009.
Amy's second nursing novella deals with coping with change and loss. Through the eyes and heart of the book's fictional heroine, Med-Surg South nurse Imelda Tagaro, nurses learn life lessons to apply in their own professional practice. 3.5 CEs available upon completion.

Point, click & wow! The techniques and habits of successful presenters by Claudyne Wilder.   San Francisco:  Jossey-Bass, 2008.
In Point, Click & Wow!, the insider knowledge of public speaking that we all need but were never taught is given. This book offers myriad new features and updated slide designs as well as illustrative stories and advice from executives.

Guidelines for the Practice of Diabetes (Word .doc 28K).

Do you have an educational resource that you would like to share with other HCEA members? Contact Kathy Ordelt at

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