In this 'Talking Women' article for Medical Observer, senior research fellow Alison Beauchamp, discusses the method 'teach-back' to improve the health outcomes of a consultation.
Jean Hailes is proud to provide a monthly column in the medical newspaper, Medical Observer. Designed to give GPs and health professionals a short informative summary of important women's health topics and conditions, these articles provide practical information to inform and enhance clinical practice.
A medical consultation is a situation that is potentially ripe for crossed wires and confusion. The woman in your office may be struggling to get their head around new information about their health and any associated terminology. There may be questions not asked, or answers not heard, understood or remembered.
However, there is a proven communication tool that can help safeguard both patients and healthcare professionals from misinformation and missed information during a consultation – and it can take as little as one minute to use. This tool is called teach-back. Teach-back, quite simply, involves asking a patient to explain, in her own words, what the healthcare provider has just told them. Healthcare professionals provide the majority of health information to people, yet effective communication in healthcare between clinicians and patients remains a challenge.
Research shows that up to 80% of healthcare information is forgotten immediately, and 78% of patients discharged from the ED did not understand the information given to them. Crucially, most of these 78% did not realise they had not understood. The way in which healthcare providers communicate health information affects adherence and health outcomes.
Although the aim of the healthcare system is to reduce health inequities, the universal approach (or one-size-fits-all model) has, at times, widened the gap. In Australia, vulnerable and disadvantaged populations carry a greater burden of chronic disease, including higher rates of mortality, morbidity and unplanned hospital readmissions. The importance of clear, two-way communication between patient and healthcare provider is crucial. Patients must be able to understand, remember and act on that information.
Teach-back is used widely in the US but is just starting to be used in Australia. It can be tailored to a patient's health literacy ability and socio-economic status. A 2016 systematic review of teach-back use in chronic disease found that, overall the tool was associated with improved knowledge, skills and self-care abilities in patients. The teach-back tool has five steps:
- Teach-back is an evidence-based health literacy intervention that improves patient-provider communication and health outcomes.
- It is intended to improve efficiency during the consultation and has been shown to take no more time than a normal consultation.
- Teach-back is a way of checking the patient's understanding of the health information conveyed in their own words and, if needed, offers the chance to re-explain and check again.
In summary, think about what the patient really needs to know. Do not assume baseline understanding of the health topic. Given that most people only remember about three things at any one time, try to focus on the three most important points and ask the patient to teach-back just on those; don't ask the patient to teach-back everything. This will keep the time required to complete the teach-back process to a minimum.
Dr Alison Beauchamp was recently awarded an NHMRC Medical Research Future Fund TRIP fellowship to evaluate the use of teach-back in Australian healthcare settings.