Teach back
- 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.