- The Agency for Healthcare Research and Quality (AHRQ) has released a new guide for patient teach-back strategies, which could improve patient education and provider communication.
During patient teach-back, providers explain patient medical conditions, treatment options, or self-care instructions to patients. They then ask patients to repeat the information back to them in their own words.
“The goal of teach-back is to ensure that you have explained medical information clearly so that patients and their families understand what you communicated to them,” the AHRQ guide explains. “This low-cost, low-technology intervention can be the gateway to better communication, better understanding, and ultimately shared decision-making.”
The guide explains that improving patient-provider communication and patient education is a critical aspect of healthcare quality, one that is reportedly lacking.
“Research indicates that clinicians underestimate their patients’ needs for information and overestimate their ability to communicate effectively with patients,” AHRQ says.
The agency cited research showing that patients forget 80 percent of what their providers tell them, and that 50 percent of what they do manage to remember is incorrect. Patient teach-back, however, asks patients to absorb the information, making them more likely to understand and remember it.
This can improve quality care and patient safety because patients may remember to adhere to treatments, to properly address chronic conditions, or understand how to adequately prepare for an upcoming procedure.
In the recently-released guidebook on patient teach-back, AHRQ explains how to implement the initiative in the practice.
Identify leadership, begin staff training
As with any large practice undertaking, the first step to beginning a patient engagement initiative is to identify leadership. An initiative champion will not only be helpful in guiding staff training, setting goals, and evaluating progress, but she will also be helpful in setting the tone and practice culture.
When the leadership is passionate about patient teach-back, AHRQ said, they may encourage other providers to be excited about the strategy as well.
Training staff should begin with short training module sessions, the agency explained. Introductory training should underscore the goals behind patient teach-back, highlighting that this is a strategy to improve patient-provider communication and patient education.
Training should also include strategies for starting a teach-back conversation. An AHRQ-issued clinician training guide offers the following suggestions for teach-back conversation starters:
“Just to be safe, I want to make sure we are on the same page. Can you tell me…”
“I want to make sure that I explained things clearly. Can you explain to me…”
“Can you show me how you would use your inhaler at home?”
By establishing a solid training base, providers can seamlessly and efficiently integrate the patient teach-back technique into their workflows.
Implement strategy incrementally
Because time is tight for many providers, it is important that they begin using the patient teach-back method strategically. While providers comfortable with the technique may be able to conduct teach-back efficiently, those just starting may need more practice.
“You may want to start small and build. For example, initially clinicians could try teach-back with the last patient of the day or with patients at off-peak times,” the agency says.
“Staff might at first use teach-back in specific situations, such as when they schedule follow-up activities. Work toward expanding the use of teach-back to all patients whenever they are given important information.”
Practices can encourage expanded teach-back use by praising providers who utilize the technique effectively and regularly sharing tips for more success.
Educate patients about teach-back
In order to more seamlessly integrate patient teach-back into doctor’s appointments, practice leaders should distribute patient education materials. Posting informative signs and reading materials in the waiting room is one method for this. AHRQ also suggests individual providers explain the technique to patients.
Providers should emphasize that patient teach-back is not a test or something for patients to be nervous about. Instead, it’s a technique to ensure the provider clearly explained clinical information and self-care instructions.
Evaluate progress and effectiveness
As providers continue to adopt patient teach-back strategies, practice leaders should conduct evaluation measures. An AHRQ assessment tool suggests providers evaluate their views on and preparedness for the technique before implemention, one month in, and three months in.
The assessment asks providers about their confidence in using the strategy, how often they use it, how convinced they are of its effectiveness, and the specific techniques they use.
The agency also suggests practices conduct surveys to collect patient and family feedback on the technique. Individual providers may also collect patient feedback during doctor’s appointments.
From there, practice members may work collaboratively to make improvements.
“The teach-back champion can serve as an expert resource for team members to improve individual strategies,” AHRQ says. “The team can work collaboratively to remove barriers and challenges and to improve processes across the practice.”
As the healthcare industry moves toward value-based care, it will be important for healthcare providers to deliver quality care that results in positive outcomes. Ensuring patients are fully engaged in and knowledgeable about their own care is one step toward this, AHRQ says.
“Effective communication is a clinician’s first step to helping a patient with a health problem,” AHRQ says. “The evidence-based, low-technology teach-back technique can be the gateway to better communication and better understanding, and ultimately it can improve patient outcomes.”