Partnership for PatientsTeach-back Basics

100 E. Grand Ave., Ste. 360 • Des Moines, IA 50309-1800Office: 515.283.9330 • Fax: 515.698.5130

www.ihconline.org

Upon completion of the teach-back training, participants will be prepared to :

1. Define teach-back and key components 2. Explain the value of teach-back in improving

patient care3. Apply knowledge and skills to conduct teach-

back throughout patient care

Objectives

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

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 closethe communication loop

“If they don’t do what we want, we haven’t given them the right information.”

-Vice Admiral Richard CarmonaFormer 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 Improvementhttp://www.ihi.org