"Teach Back" Effective in Improving Patient Communication

Participants in a Tuesday workshop at HM12 in San Diego learned how using "teach back" as a patient-education strategy can solve some of the barriers to communicating post-discharge information to hospitalized patients.

These barriers include failure to assess a patient’s health literacy or to identify the key learner in the patient’s family, as well as the sheer volume of important information some patients need, and the lack of time in busy hospital units to convey it all.

The teach-back process involves asking patients to repeat in their own words what the health professional has told them.

"Most people are under the misconception that teaching takes too much time," said Paula Robinson, MSN, RN-BC, manager of patient, family, and consumer education for Lehigh Valley Health System in Allentown, Pa. She advised hospitalists to give patients smaller amounts of information, in three- to five-minute chunks over several days. Further, it may be necessary to prioritize what the patient needs to know, rather than present so much information that the patient won’t remember much of it.

Lehigh Valley’s commitment to teach back grew out of a QI project mapping patient-flow processes, including care transitions, throughout its health system. It was tested in a pilot unit and included prompts and scripts hardwired into the electronic health record for unit nurses to easily access. Readmission rates at the pilot unit dropped to 14.0% from 28.2% in the year after teach back was implemented; hospital-wide rates shrunk to 21.9% from 25.3%.

Teach back is presented to patients in the spirit of evaluating how effectively the professional has explained the information, and not as a way to test the patient, Robinson said.

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