Health Literacy

Given the high number of low health literacy rates, there is a high probability that you will encounter patients with low health literacy. However, you can’t always tell. Patients with limited literacy say they feel shame and hide their limited reading ability from others (Parikh, 1996; Wolf, 2007). 

That's why it is recommended you use universal precautions. “Health literacy universal precautions are the steps that practices take when they assume that all patients may have difficulty comprehending health information and accessing health services” (AHRQ, 2019). For more information on how to do this, see the AHRQ Universal Precautions Toolkit: https://www.ahrq.gov/health-literacy/quality-resources/tools/literacy-toolkit/index.html. 

3 Tips for Taking a Universal Precautions Approach*:

Tip 1: Simplify communication and confirm comprehension for all patients.

Tip 2: Make the office environment and healthcare system easier to navigate.

Tip 3: Support your patients’ efforts to improve their health

*From IHA's Communication Microbadge. 

Patients say that the healthcare environment can make it hard to tell their provider they do not understand. Below are some communication strategies you can use to help. 

• Plain Language.
  • Using plain language means you are using everyday communication.
  • It is not "dumbing down" the information. Rather you are talking to the patient in a language they understand. By using plain language and avoiding medical jargon, you can help ensure your patient understands. 
• Speak slowly. 
• Ask "What questions do you have for me?" instead of "Do you have any questions?"
  • By asking "what questions do you have for me" it is like you are expecting a question and your patient might feel more comfortable in asking. 
  • It is better to ask an open ended question than a yes or no. 
• Do not ask "do you understand?"
  • It may make the patient feel shame if they do not understand. 
  • They will most likely say yes even if they do not understand. 
• Use Teachback. 

Studies have shown that 40% to 80% of the medical information patients are told during their office visits is immediately forgotten. Of that information that is remembered, nearly half of it is remember incorrectly. 

Teachback is a great tool that can help you confirm understanding with your patient and possibly help to ensure information retainment. 

When using teachback, you ask your patient to explain back to you what you told them. For example, you can say "I want to be sure I explained your medication correctly. Can you tell me how you are going to take this medicine when you get home?" 

Remember, this is not a test for the patient but how well you communicated the information. According to IHA, it is important to place it on yourself as a communicator. Take care not to make patients feel uneducated or out of place. Suggest to them that having questions is normal and expected. This reduces shame.

Teachback has been shown to: 

• Improve patient understanding and adherence.
• Decrease call backs and cancelled appointments.
• Improve patient satisfaction and outcomes. 

It is also a great way to uncover any misunderstandings.