Reducing ER overuse through a primary care provider health literacy awareness initiative
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Background: Health literacy (HL) is a significant indicator of patient health status. Research has shown that a substantial number of patients seeking care in the emergency room (ER) have limited HL. Primary care providers (PCPs) serve a pivotal role in improving patient health, but are often underprepared, unaware, and/or overestimate their ability to address patient HL. Purpose: This quality initiative (QI) aimed to improve PCP knowledge about patient HL, self-perceived communication practices relating to HL, and reduce ER overutilization in a South Texas clinic providing indigent care. Methods: This QI project was a cross-sectional study. A single group, pre- and post-test design was conducted to evaluate provider knowledge about patient HL and self-perceived communication practices before and after a provider in-service. A third focus was to reduce ER overutilization after provider education and patient enrollment into a population health program, measured by a paired t-test for the preceding 90 days compared to the post intervention rates at 90 days. The sample consisted of five PCPs and six patients identified as ER overutilizers. Results: Provider knowledge about patient HL and provider self-perceived communication skills improved after an educational in-service. Patient participants had a statistically significant reduction in ER use post provider education. Conclusion: Health literacy training for PCPs improved provider knowledge and self-perceived communication practices, and reduced ER overutilization in this South Texas clinic. Research is needed to evaluate the long-term effects related to provider HL knowledge and communication practices.