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

Objectives Define teach-back and key components 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

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.

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

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.

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. Clin Geriatr 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 Not only is teach-back a good thing to do, it is supported by research. In fact, many studies have shown that patients recall as little as 50% of what they are told. This can lead to increased risk for the patient if they don’t understand.

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

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

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

Use teach-back to close the communication loop

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

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