Kel-ED Screening Tool: Jamie

Is using a nutrition label to assess health literacy too narrow to capture a patient’s understanding of healthcare instructions or explanations, given that many healthcare providers can’t read nutrition labels properly themselves? Is it a little bit too specific and math focused?

Jamie handled the question with confidence, professionalism and strong evidence-based reasoning. She effectively justified the choice of using her Kel-ED screening tool by referencing validated tools that it was based off of. The answer could be strengthened by more directly addressing the conceptual concern about the breadth of the tool in using a nutrition-label type approach as an overall measure of health literacy. She did acknowledge the trade-off between practicality and comprehensiveness. Overall, she was thoughtful in her answer, recognizing gaps in her solution.

Jamie clearly defined health literacy, explained why it matters and related it directly to ED overcrowding at Kelowna General Hospital. Her use of the Fatima and Sergio scenario effectively demonstrated how low health literacy can lead to repeat ED visits and increase inefficiencies. The flow of her presentation was clear and she used existing research and successful implementation of similar tools elsewhere which added to the credibility of her solution. She covered not only the tool, but benefits, challenges and implications for patient outcomes. Her slides were well organized and not over-crowded and she had a great pace throughout.

1. Critical reflection on limitations: While challenges in implementing the Kel-ED tool were acknowledged, they were more of a description than critically explored. Deeper reflection on how to mitigate barriers like stigma and workflow burden would strengthen the analysis of the solution
2. A greater exploration of why health literacy matters and what nurses can do once health literacy deficits are detected would enhance the presentation. In Jamie’s example, Fatima seemed to ask many questions demonstrating her inability to understand the health information as presented without the use of a tool. The Kel-ED tool may further identify the issue, but what would make education easier to understand for Fatima?

1. Deepen critical analysis: Jamie can expand on how challenges like staff buy-in, patient stigma and tool validity could realistically be addressed, as well as what will be done once issues are identified. Jamie also mentioned questioning the breadth of the tool given it focuses on reading a nutrition label and basic math. Exploring concerns with the tool in the presentation could build on the analysis.
2. Evaluation: It remains unclear how the use of the Kel-ED screening tool will be evaluated. Jamie could strengthen the link between health literacy deficit identification and reduced readmission rates using a brief cause-effect summary or data point. For example: “Hospitals using the ___ tool reported a x% reduction in readmissions linked to low health literacy” or “Patients screened with ____ tool demonstrated x% improved comprehension of discharge instructions.” Including these numbers adds empirical weight to the argument.
3. Visual comparison slide: Show the original tool and the Kel-ED tool side by side and highlight what was adapted and what literacy domains are assessed. This would visually reinforce the evidence base and make the rationale clearer to visual learners.