Partnership for Patients Teach-back Basics

1. Partnership for Patients Teach-back Basics 100 E. Grand Ave., Ste. 360 • Des Moines, IA 50309-1800 Office: 515.283.9330 • Fax: 515.698.5130 www.ihconline.org

2. Objectives • Upon completion of the teach-back training, participants will be prepared to : • Define teach-back and key components • Explain the value of teach-back in improving patient care • Apply knowledge and skills to conduct teach-back throughout patient care

3. What is Teach-back? Teach-back is a simple mechanism by which a patient’s understanding of a concept or topic may be assessed. It can be used to teach concepts as well as techniques.

4. Who? • Should be used with every patient; never assume literacy or health literacy • All staff should know how to do it and use it whenever critical information is being communicated to the patient and/or family member • Is NOT a test of the patient but rather a test of how well you explained a concept

5. Why? • We remember: • 10% of what we read • 20% of what we hear • 30% of what we see • 50% of what we see and hear • 80% of what we say • 90% of what we say and apply “What I hear, I forget; what I see, I remember; but what I do I understand” - Confucius in 451 B.C.

6. Teach-back is supported by research • Studies have demonstrated that patients recall and comprehend as little as 50% of what they are told by their physicians. • -Schillinger, Arch Intern Med/Vo640 l 163, Jan 13, 2003, “Closing the Loop” • In some disease conditions, more than 40% of patients sustain significant risks by misunderstanding, forgetting, or ignoring healthcare advice. • Roter DL. The outpatient medical encounter and elderly patients. ClinGeriatr Med. 2000;1695- • Asking patients to recall and restate what they have been told, is one of the 11 top patient safety practices. • -AHRQ, 2001 Report, Making Health Care Safer

7. When? • Every patient, every time • Whenever teaching new concepts • After re-teaching using a different method • Throughout the patient’s hospital stay

8. How? • Do not ask a patient, “Do you understand?” • Ask patients to explain or demonstrate • Ask open-ended questions • Do not ask yes/no questions • Re-teach in a different way

9. Additional Tips for Teach-back: • Slow down • Use a caring tone of voice and attitude • Use plain language; simple words • Avoid using medical jargon • Focus on the 2 or 3 most important concepts. • Break it down into short statements(chunk & check) • Highlight or circle key information

10. Use teach-back to close the communication loop

11. “If they don’t do what we want, we haven’t given them the right information.” -Vice Admiral Richard Carmona Former Surgeon General

12. References: Minnesota Health Literacy Partnership (MHLP) http://www.healthliteracymn.org/ American Medical Association (AMA) http://www.ama-assn.org/ Agency for Healthcare Research & Quality (AHRQ) http://www.ahrq.gov/browse/hlitix.htm Centers for Disease Control and Prevention (CDC) http://www.cdc.gov/healthliteracy/ Institute for HealthCare Improvement http://www.ihi.org