Journal of general internal medicine
-
Research into health literacy and shared decision-making has largely developed along parallel, but distinct lines over the past two decades. There is little evidence that the concepts and related practice have intersected except in the most functional way, for example, to simplify shared decision-making tools by improving readability scores of decision aids. ⋯ This includes addressing patients' skills and capacities, alongside modifications to written and verbal information. We propose an expanded model of shared decision-making which incorporates health literacy concepts and promotes two-tiered intervention methods to improve the targeting and personalization of communication and support the development of transferable health literacy skills among patients.
-
Measuring the health, economic, and cultural gains generated by scientific investments is crucial to reducing waste and improving quality of care. To date, there is no comprehensive framework for assessing the multi-faceted contributions of implementation and quality improvement sciences towards quality, cost, and patient and provider experiences in health systems. ⋯ The QUERI Impact Framework aligns multiple stakeholders at different levels of a health system around common metrics, which cross implementation science and quality improvement boundaries. The Framework supports a comprehensive assessment of the short-term and distal impacts of implementation efforts in a health system, allowing both research and operations leadership to understand the value of implementation and quality improvement investments to inform program and policy decisions.