2. WHAT IS HEALTH LITERACY?
• Basic reading skills
• Ability to understand oral communication
• Ability to use numbers and math skills
• Basic understanding of how to navigate the
health system
• Ability to communicate with health providers
and their staff.
3. WHY IMPROVE COMMUNICATION
• 40-80% of medical information patients
receive is forgotten immediately and nearly
half of the retained information is incorrect.
(AHRQ 2010)
• 98% of medical errors are communication-
related (AMA 2007)
4. WHY IMPROVE COMMUNICATION
• Nearly half of all adult Americans have
difficulty understanding and using health
information due to low health literacy (IOM
2004)
5. RISKS OF LOW HEALTH LITERACY
• Patient risks
Physical
Emotional
Financial
6. RISKS OF LOW HEALTH LITERACY
• Provider risk
Inefficiency
Financial
Legal
7. HOW TO IMPROVE COMMUNICATION
• SLOW DOWN
• USE PLAIN, NON MEDICAL LANGUAGE
• SHOW OR DRAW PICTURES
• LIMIT THE AMOUNT OF INFORMATION – AND
REPEAT IT
• CREATE A SHAME FREE ENVIRONMENT
• USE TEACH-BACK TECHNIQUE (AMA 2007)
8. TEACH-BACK
• A research-based health literacy intervention
that improves patient-provider
communication and patient health outcomes.
• Transfers knowledge and skill to the patient
• Enhances patient understanding and
integration of health related information and
behaviors
• Goal is competency in management of self
care
9. TEACH-BACK
• PATIENT-CENTRED COMMUNICATION
• MECHANISM BY WHICH A PATIENT’S
UNDERSTANDING CAN BE ASSESSED
• TEACH A CONCEPT THEN CONFIRM THE
PATIENTS UNDERSTANDING BY ASKING THEM
TO EXPLAIN THE CONCEPT BACK TO YOU
ACCURATELY.
10. USING TEACH BACK
Assures that you have explained the information
clearly. It is not a test of the patient.
Involves asking a patient to repeat back
information shared, in order to assess additional
needs and close communication gaps.
Offers the opportunity to re-explain, in a different
way, and assess again until patient understanding
is confirmed.
11. ELEMENTS OF COMPETENCY
Use a caring tone of voice and attitude.
Make eye contact and use comfortable body language.
Use plain language.
Ask the patient to explain back, using their own words.
Use open ended questions.
Avoid asking yes/no questions.
Emphasize the responsibility to explain clearly is on you,
the provider.
If the patient cannot Teach-Back correctly, explain again
and recheck.
Use user friendly print materials to support learning.
Document the use of and patient response to Teach-Back.
12. PLAIN LANGUAGE
INSTEAD OF
o HYPERTENSION
o MODIFY
o RESPIRATORY
o ORAL
o AMBULATE
o OPTIMAL
o NEGATIVE
o DIET
TRY SAYING
HIGH BLOOD PRESSURE
CHANGE
BREATHING
BY MOUTH
WALK
GOOD
BAD
WHAT YOU EAT
13. ASSESSMENT OF UNDERSTANDING
“I want to be sure I did a good job explaining
everything clearly. Can you explain it back to
me so I can be sure that I did?”
“What will you tell your wife about the
changes that we made in your medications
today?”
“We’ve gone over a lot of information. In your
own words, please review with me what we
talked about”
14. ASSESSMENT OF UNDERSTANDING
• The Teach-back Method: Teach-back is a way
for practitioners to confirm that what they
explain to the patient was clear and
understood. Patient understanding is
confirmed when the patient explains it back to
the practitioner or does a return
demonstration (instead of just saying, “Yes, I
understand.”)
15. BE SURE TO
Check of understanding for each important
concept before moving on to the next “CHUNK
and CHECK”.
Re-phrase rather than repeat information the
patient does not understand.
Continue the use of Teach-Back until you’re
comfortable the patient understands.
Include information on how to integrate new
skills into lifestyle.
