How To Make Sure Patients Understand Health Information

by Webmaster
Published on Jul 23, 2015

In the current issue of American Family Physician, Dr. Barry Weiss shares an anecdote about a hospitalized patient's confusion about a conversation between himself and a consultant who said that it was okay to move her from the intensive care unit to the floor. The perplexed patient interpreted "floor" literally to mean that the hospital was so overcrowded that she would not be able to sleep in a bed! Although this mildly comical story might elicit chuckles at health professional gatherings, it also highlights the serious potential for limited health literacy to lead to misunderstandings between doctors and patients.

Health literacy encompasses essential skills that patients need to access health services, understand and apply health information, and make good decisions: reading, writing, numeracy, and communication. A large body of evidence demonstrates strong associations between low health literacy and poorer health outcomes; compared to patients with high health literacy, patients with low literacy have more hospitalizations, more emergency department visits, and are less likely to receive appropriate preventive and chronic care services. According to a clinical review by Dr. Lauren Hersh and colleagues, "More than one-third of U.S. adults, an estimated 80 million persons, have limited health literacy, making it more difficult for them to read, understand, and apply health information. ... Although U.S. adults on average read at an eighth-grade level, more than 75% of patient education materials are written at a high school or college reading level." Limited health literacy is more common in patients age 65 years and older and in minority populations.

How can case managers make sure their patients understand health information? One successful strategy is the "teach back" method.  Ask patients to restate the reason they were admitted, what their treatment plan is for the hospitalization, and what their plans are when they are ready for discharge. The goal is to confirm the patient/family understanding. Patients also benefit from being encouraged to participate actively in formulating their care plans and identifying their post-acute needs.  This is being done more and more via room-by-room walking huddles with members of the patients' healthcare team. 
Portions of this post first appeared in AFP Community Blog